Silverstone Peter H, Bercov Marni, Suen Victoria Y M, Allen Andrea, Cribben Ivor, Goodrick Jodi, Henry Stu, Pryce Catherine, Langstraat Pieter, Rittenbach Katherine, Chakraborty Samprita, Engles Rutger C, McCabe Christopher
Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.
Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada.
Front Psychiatry. 2017 May 15;8:81. doi: 10.3389/fpsyt.2017.00081. eCollection 2017.
Here, we report on findings from a 15-month follow-up of a school-based program called Empowering a Multimodal Pathway Toward Healthy Youth (EMPATHY). This was primarily intended to reduce suicidal thinking in pre-teens, adolescents, and youth students aged 11-18 in middle schools (Grades 6-8) and high SCHOOLS (Grades 9-12). It also aimed to reduce depression and anxiety. The EMPATHY multimodal program consisted of repeated data collection, identification of a high-risk group, a rapid intervention for this high-risk group including offering supervised online cognitive behavioral therapy (CBT) program, a universal CBT intervention for those in Grades 6-8, a variety of interactions with trained staff ("Resiliency Coaches"), and referral to external medical and psychiatric services where appropriate. There were four time-points at which assessments were made: baseline, 3, 7, and 15 months. Here, we report cross-sectional findings over 15 months in a total of 6,227 students who were assessed at least once during the study period. Additionally, we report longitudinal findings from the 1,884 students who completed all 4 assessments. Our results found highly statistically significant decreases in suicidality rates, with the percentage of the total school population who were actively suicidal decreasing from 4.4% at baseline ( = 143 of 3,244) to 2.8% at 15 months ( = 125 of 4,496) ( < 0.001). There were also highly statistically significant reductions in depression and anxiety scores at each time-point. Thus, Mean Depression scores at baseline for the entire student population were 3.73 ± 3.87 ( = 3,244) at baseline and decreased to 3.22 ± 3.52 ( = 4,496) ( < 0.001). Since most students were not depressed, whole population changes such as this may indicate impact in many areas. In the longitudinal analysis of students who completed all four assessments, there were also highly statistically significant improvements in depression and anxiety scores at all time-points. For example, depression scores decreased from a mean of 3.43 ± 3.67 ( = 1,884) at baseline to 2.95 ± 3.53 ( = 1,884) at 15-months ( < 0.001), while the number who were actively suicidal decreased from 69 to 37. These results suggest that school-based multimodal programs, utilizing a combination of interventions, can have meaningful benefits across entire school populations.
在此,我们报告一项针对名为“赋能青少年健康多元途径”(EMPATHY)的校内项目进行的为期15个月的随访结果。该项目主要旨在减少11至18岁初中(6至8年级)和高中(9至12年级)的青少年及青年学生的自杀念头。它还旨在减轻抑郁和焦虑。EMPATHY多元项目包括重复数据收集、识别高危群体、对该高危群体进行快速干预,包括提供有监督的在线认知行为疗法(CBT)项目、针对6至8年级学生的通用CBT干预、与训练有素的工作人员(“复原力教练”)的各种互动,以及在适当情况下转介至外部医疗和精神科服务机构。共有四个评估时间点:基线、3个月、7个月和15个月。在此,我们报告在研究期间至少接受过一次评估的总共6227名学生15个月内的横断面研究结果。此外,我们报告了完成所有四项评估的1884名学生的纵向研究结果。我们的结果发现自杀率在统计学上有极显著下降,全校积极有自杀倾向的学生比例从基线时的4.4%(3244人中143人)降至15个月时的2.8%(4496人中125人)(P<0.001)。在每个时间点,抑郁和焦虑得分也有极显著降低。因此,全校学生基线时的平均抑郁得分是3.73±3.87(n = 3244),降至3.22±3.52(n = 4496)(P<0.001)。由于大多数学生没有抑郁,这样的全校范围变化可能表明在许多方面都有影响。在完成所有四项评估的学生的纵向分析中,在所有时间点抑郁和焦虑得分也有极显著改善。例如,抑郁得分从基线时的平均3.43±3.67(n = 1884)降至15个月时的2.95±3.53(n = 1884)(P<0.001),而积极有自杀倾向的人数从69人降至37人。这些结果表明,利用多种干预措施相结合的校内多元项目可使全校学生群体都获得有意义的益处。