Text-based Support for Parents of Adolescents Following an Emergency Department Visits (TESP)

Effectiveness of Text-based Support for Parents of Suicidal Adolescents Following Emergency Department Visits

The goal of this study is to determine the effectiveness of an adaptive text-based intervention for parents of adolescents seeking emergency department services for suicide risk concerns.

Study Overview

• Status: Recruiting
• Conditions: Suicide
• Intervention / Treatment: Behavioral: Text-based intervention

Detailed Description

Participants will be 420 adolescents (ages 13-17) seen in ED with recent suicidal ideation and/or attempt and their parents recruited from two health system EDs in the Midwest.

• Study Type: Interventional
• Enrollment (Estimated): 420
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ewa Czyz, Ph.D.; Phone Number: 734-764-9466; Email: ewac@umich.edu

Study Locations

• United States
  • Michigan
    • Ann Arbor, Michigan, United States, 48109
      • Recruiting
      • University of Michigan
      • Principal Investigator: Ewa Czyz, PhD
      • Contact: Ewa Czyz, PhD; Phone Number: 734-764-9466; Email: ewac@umich.edu
    • Flint, Michigan, United States, 48503
      • Recruiting
      • Hurley Medical Center
      • Contact: Courtney Mangus, M.D.; Phone Number: 810-262-9429; Email: cmangus@med.umich.edu
      • Principal Investigator: Courtney Mangus, M.D.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adolescent (13-17 years old) who present to Emergency Department (ED) due to (1) last-week suicidal ideation and/or (2) last-month suicide attempt, and their caregiver.

Exclusion Criteria:

Adolescents who are:

• medically unstable
• presenting with severe cognitive impairment, altered mental status, severe aggression/agitation
• presenting without a legal guardian
• whose parent does not own a cell phone

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Standard ED care
Experimental: Standard ED care with a text-based intervention; This arm incorporates adolescent-centered (A-C) and parent-centered (P-C) texting components Parents in the intervention arm will receive up to 3 text messages per day over six weeks after ED discharge: daily A-C text and up to two P-C messages. The P-C component includes an embedded micro-randomized trial (MRT), and parents will be randomized twice each day over the six-week intervention to either receive or not receive a P-C message.	Behavioral: Text-based intervention; Parents randomized to the texting intervention will receive up to 3 messages each day for 6 weeks: The intervention is comprised of adolescent-centered (A-C) texts focusing on parental adherence to recommended suicide prevention strategies to promote adolescents' safety and parent-centered (P-C) texts focused on improving parents' own well-being.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Aim 1 (primary aim): likelihood of suicidal behavior (actual, interrupted, or aborted attempts)	Suicidal behavior encompasses actual, interrupted, and aborted suicide attempts. Measured with the behavioral subscale of the Columbia-Suicide Severity Rating Scale (C-SSRS),and supplemented with available medical chart data.	12-week follow-up
Aim 2 (secondary aim) severity of parental stress	Measured with twice daily surveys over the 6-week intervention	Up to 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Aim 1 (primary aim): -time- to- suicidal behavior (actual, interrupted, or aborted suicide attempts	Measured with the behavioral subscale of C-SSRS and supplemented with available chart data.	24-week follow-up
Aim 1 (primary aim): time- to- return ED visit		24-week follow-up.
Aim 2 (secondary aim): parental negative affect	Measured with twice daily surveys over the 6-week intervention.	Up to 6 weeks
Aim 2 (secondary aim) parental positive affect	Measured with twice daily surveys over the 6-week intervention.	Up to 6 weeks

Collaborators and Investigators

• Sponsor: University of Michigan
• Collaborators: National Institute of Mental Health (NIMH)
• Investigators: Principal Investigator: Ewa Czyz, Ph.D., University of Michigan

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2025
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): July 1, 2028

Study Registration Dates

• First Submitted: October 23, 2024
• First Submitted That Met QC Criteria: October 23, 2024
• First Posted (Actual): October 28, 2024

Study Record Updates

• Last Update Posted (Actual): December 15, 2025
• Last Update Submitted That Met QC Criteria: December 12, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Suicidal Ideation; Suicide Attempt; Text
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Behavior; Suicide; Suicidal Ideation; Suicide, Attempted
• Other Study ID Numbers: HUM00254540; 1R01MH137012-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No