Current Research Projects

24-Hour Warning signs for adolescents

Funded by the National Institute of Mental Health
Principal Investigator: Cheryl A. King, Ph.D.
University of Michigan Co-Investigator: Polly Gipson, Ph.D.

This large-scale NIMH project will recruit 1800 youth at elevated risk for suicide from the ED-STARS study. The project is designed to identify the warning signs that are associated with near-term risk for suicide. We also hope to determine why a patient attempted suicide on a given day versus a day without a suicide attempt. Youth will complete biweekly text message surveys across an 18-month period, regarding their mental health status. The Warning Signs for Suicide Attempt Interview – Adolescent (WSSA-A), a computer-assisted telephone interview, will be conducted with adolescents who report a suicide attempt (and matched control adolescents). Using a case-crossover within-subject design, we will compare the events, behaviors, emotions and thoughts of these adolescents during the 24-hour case window (day of attempt) to those during a matched 24-hour control window. Using a case-control group comparison design, we also will identify differences between suicide attempters and non-attempters in events, behaviors, emotions and cognitions during the 24-hour case window.

Emergency Department Screen for Teens at Risk for Suicide (ED-STARS)

Funded by the National Institute of Mental Health
Principal Investigators: Cheryl A. King, Ph.D., Jacqueline Grupp-Phelan, M.D., M.P.H., David Brent, M.D.
University of Michigan Co-Investigators: Alex Rogers, M.D., Rebecca Cunningham, M.D., Kyle Grazier, Ph.D.

edstarsDr. King together with Dr. David Brent (University of Pittsburgh) and Dr. Jackie Grupp-Phelan (Cincinnati Children’s Hospital) are leading this large-scale NIMH collaborative project (U Award) aimed at improving the identification of youth at risk for suicide. This project is designed to develop and validate a computerized adaptive screen (CAS) for adolescent suicide risk. This screen will be brief, tailored and adaptive – with individualized sequences of screening questions conditional on previous responses. A wide range of acute suicide risk indicators will be tested for possible inclusion in the CAS. This project will test how the computerized adaptive screen performs as a screen relative to the Ask Suicide-Screening Questions (ASQ). We will also examine the incremental value of the Implicit Association Test (IAT), a behavioral test of implicit suicidal cognitions, which is important as many at-risk youth may deny suicidal thoughts. ED-STARS is a collaborative project with the Pediatric Emergency Care Applied Research Network (PECARN) in addition to the Whiteriver PHS Indian Hospital.

Electronic Bridge to Mental Health for College Students (eBridge)

Funded by the National Institute of Mental Health
Principal Investigator: Cheryl A. King, Ph.D.
University of Michigan Co-Investigators: Daniel Eisenberg, Ph.D., Todd K. Favorite, Ph.D., Inbal Nahum-Shani, Ph.D.

bridgeThis research initiative began with an intervention development grant funded by the National Institute of Mental Health (NIMH), which enabled us to develop, pilot-test and iteratively refine a theoretically-driven intervention, Students’ eBridge to Mental Health (eBridge). This online intervention screens students for mental health concerns that include elevated suicide risk and facilitates their linkage to mental health (MH) services. eBridge is designed to work on computers, tablets and smartphones (i0S, Android) and is easily adaptable to evolving technologies in the future. It incorporates motivational interviewing (MI) principles and draws from health behavior models that emphasize autonomy and self-determination. Following a web-based screen using standardized scales to identify students at elevated risk, eBridge offers students options for personalized feedback (provided online in a conversational MI-adherent format) and corresponding online with professionals trained in MI and knowledgeable about university and community resources. We are currently conducting a larger more definitive efficacy trial at four universities: the University of Michigan, the University of Nevada-Reno, the University of Iowa, and Stanford University.


Funded by the National Institute of Mental Health
Principal Investigator: Ewa Czyz, Ph.D.

The goal of this project is to conduct a Sequential, Multiple Assignment, Randomized Trial (SMART) pilot with teens at risk for suicide (ages 13-17). Given the heterogeneity of responses to intervention and post-discharge suicide risk among suicidal youth, this personalized approach represents a critical first step in developing an innovative, technology-augmented adaptive intervention for hospitalized adolescents aimed at reducing suicide-related outcomes following the transition from inpatient care. Findings from this study will provide the groundwork for the construction of a technology-augmented adaptive intervention that could lead to a reduction in suicidal behaviors and related events during the high-risk post-discharge period—an important suicide prevention target.

Transforming Youth Suicide Prevention in Michigan

Funded by Substance Abuse and Mental Health Services Administration to State of Michigan
Co-Principal Investigators: Patricia Smith and Cynthia Ewell Foster

The TYSP-MI 2 Project is a 3.75 million dollar five year grant awarded to the State of Michigan’s Department of Community Health to support a state-wide public health approach to youth suicide prevention. Focused on sustainable systems change, this grant establishes collaborative relationships between state agencies focused on injury prevention and control, child protective services, behavioral health, and education. The grant provides gatekeeper and clinical provider training and community-based technical assistance, funds state-wide data surveillance initiatives, and supports the development of urban and rural “model communities” working to establish a continuum of best-practice services in their counties.

Links to Enhancing Teen Connectedness (LET’s CONNECT)

Funded by the Centers for Disease Control
Principal Investigator: Cheryl A. King, Ph.D.
Co-Investigators: Rebecca Cunningham, M.D., Cleopatra Caldwell, Ph.D., Cynthia Ewell Foster, Ph.D., Brenda Gillespie, Ph.D., Polly Gipson, Ph.D., Neera Ghaziuddin, M.D.

lets connectLET’s CONNECT is a randomized controlled trial that examines the effectiveness of a community-based mentorship intervention for youth, ages 12-15 years, who are victims of bullying, perpetrators of bullying, and/or exhibit low social connectedness. LET’s CONNECT was designed to enhance social and community connectedness, and reduce levels of depression, suicidal ideation and suicide risk. The intervention teams the adolescent with an adolescent-nominated “natural” mentor and a trained community mentor for a period of up to 16 months to actively facilitate and support healthy interpersonal and community connectedness. Current studies examine the efficacy of LET’s CONNECT and the trajectories of youth who are victims of peer bullying.
A new initiative that builds on the LET’s CONNECT project is “Community Mentors as Facilitators of Youth Mental Health and Connectedness,” (Polly Gipson, Ph.D., PI) which is funded by the Robert Wood Johnson Foundation. This project will examine the Mentoring Relationship Qualities (MRQs) between youth and assigned community mentors to determine which MRQs are most salient to positive youth outcomes and which match elements influence perceived relationship quality.

Safety Planning with Motivational Interviewing for Healthy Coping (MI-SafeCope)

Funded by the American Foundation of Suicide Prevention (AFSP) Postdoctoral Research Fellowship Grant and by a Michigan Institute for Clinical and Health Research (MICHR) Postdoctoral Translational Scholars Program (PTSP) Award
Principal Investigator: Ewa K. Czyz, PhD

cellThe goal of this project is to develop and pilot test a brief intervention for adolescents hospitalized due to suicide risk. The intervention focuses on enhancing adolescents’ adaptive coping following discharge. The project also seeks to better understand daily patterns of adaptive and non-adaptive coping in the critical post-discharge period.

The Emergency Department Mood and Coping Study (ED-MACS)

Funded by Rackham Graduate School, University of Michigan’s Institute for Research on Women and Gender, Active Minds, and Blue Cross Blue Shield of Michigan Foundation
Co-Principal Investigators: Adam Horwitz, M.S., Ewa Czyz, Ph.D., Johnny Berona, M.S.

emergencyThe ED Mood and Coping Study (ED-MACS) is a graduate-student led project that included the recruitment of 294 adolescents and young adults (ages 13-25) seeking services from University of Michigan’s Psychiatric Emergency Services (PES). Recruitment took place from June 2014 to January 2015. Participants completed a wide range of self-report measures on topics such as mood, coping, interpersonal problems, self-efficacy to cope with suicidal thoughts, sexuality and gender identity, non-suicidal self-injury, which were used in concert with data collected from their clinical interviews at PES, such as suicidal ideation severity, suicide attempt history, etc. Participants were contacted 3-5 months following their initial visit and assessed for suicidal thoughts, suicidal behaviors, and service utilization during the follow-up period.

Youth-Nominated Support Team Intervention for Suicidal Adolescents (YST)

Funded by Ronald McDonald House Charities and the National Institute of Mental Health
Principal Investigator: Cheryl A. King, Ph.D.
Co-Investigators: Paul Quinlan, D.O., Sanjeev Venkataraman, M.D.

YSTThis study was dedicated to developing and examining the efficacy of a psychosocial intervention for suicidal youth, the Youth-Nominated Support Team (YST). With initial funding from Ronald McDonald House Charities, we were able to develop the intervention protocol and implement a large-scale feasibility and preliminary efficacy trial. Funding from the National Institute of Mental Health (NIMH) then made it possible for us to implement a larger and more scientifically rigorous study of a revised version of the Youth-Nominated Support Team Intervention for Suicidal Adolescents Version II (YST-II). We involved two psychiatric hospitals and included over 400 suicidal youth and their families in this randomized controlled clinical trial. In addition to the efficacy trial which found only modest positive effects for YST-II, this large clinical sample with data from multiple youth assessments across a 12-month period has enabled us to contribute new findings related to the evidence-based risk assessment of suicidal youth and profiles of suicide risk over time. We are currently planning a 10-15 year prospective study of outcomes using data from the National Death Index.