Conference Agenda

Introduction:
Suicidal behavior among youth continues to rise, representing the leading cause of death in this age group. Individuals struggling with suicidality often experience disconnection from their social network, which contributes to feelings of hopelessness and loneliness. Parents, despite often feeling powerless and overwhelmed by the persistent threat to their child’s life, can play a meaningful role in addressing their child’s suicidality. To reduce parents' feelings of powerlessness and strengthen the parent-child relationship, an innovative parent-training was developed in close collaboration with parent- and youth representatives. This 12-session group training combines elements from Non-Violent Resistance and Dialectical Behavior Therapy. This project aims to implement and evaluate the parent-training across eight mental health institutions in the Netherlands.

Methods:
The evaluation follows a mixed-methods pre–post design to assess the feasibility and effectiveness of the parent training. Data are collected primarily through qualitative interviews with parents, adolescents, and therapists to capture multiple perspectives, complemented by quantitative measures. The program is delivered by trained systemic therapists across participating institutions, with each institution offering the training twice. Groups consist of 3–6 parent dyads. Observations of sessions assess protocol adherence and parent–trainer interactions. In addition, regular learning sessions with project partners are held to reflect on interim findings and iteratively refine the program during implementation.

Results:
Expected outcomes include reduced feelings of hopelessness and helplessness for parents, alongside increased feelings of agency, parental presence, connection with their child, and confidence in setting firm but supportive boundaries around harmful behavior. Parents are also expected to demonstrate improved communication skills and increased engagement with their social support networks. Ultimately, the intervention aims to contribute to a reduction in suicidal behavior among youth.

Conclusion:
With this innovative research project, we support wider dissemination of the parent training and contribute to innovating evidence-based suicide prevention practices.

Introduction: Suicide is a major contributor to adolescent mortality worldwide, yet the evidence base for effective prevention interventions remains incomplete. Mental health safety planning is recognized as an evidence-based practice for adults, but evidence of effectiveness for youth is limited and mixed. A recent meta-analysis in JAMA Pediatrics (Albaum et. al., 2025) found that stand-alone safety planning interventions were not significantly associated with reductions in suicidal ideation, attempts, or re-presentations to care among youth, underscoring the need to rethink how safety planning is implemented with youth. Existing literature has emphasized the importance of developmental factors, caregiver inclusion, and staff education.

Method: At a Canadian children’s hospital, we addressed gaps in documentation and caregiver involvement by embedding a dynamic standardized Mental Health Safety Plan (MHSP) into the electronic health record that is easy to access and update. Co-designed with clinicians, caregivers, and youth, it involves identifying warning signs, coping strategies, means restriction, reasons for living, and crisis resources using youth friendly language. Implementation was supported through education sessions and youth and caregiver-focused resources.

Results: By October 2025, 805 youth had documented MHSPs using the standardized tool, and over 200 staff participated in training to optimize adoption and reinforce the importance of a collaborative approach and caregiver engagement with the launch of an updated tool in November 2025. Early feedback suggests improved clarity, continuity of care, and family engagement.

Conclusion: Rethinking safety planning means moving beyond static, narrowly focused interventions toward approaches that improve youth experience, foster collaboration and support system level learning. Standardization reduces variability and creates opportunities for robust evaluation and research, for example, inclusion in Precision Health models identifying which youth benefit from MHSPs and which components are most beneficial. It is also important to determine whether embedding MHSPs into digital systems improves equitable access to care.

Introduction

Research indicates that asking about suicidality does not increase suicidal thoughts or behaviours but rather reduces risk, partly by breaking taboos, validating emotions, and strengthening social support. However, clinicians frequently report a need for practical, age-specific methods to initiate and facilitate conversations about suicidal ideation and behaviour with children and adolescents. SParcours, a set of creative materials, was co-created with young people with lived experience and professionals in youth mental health care to support such conversations about suicidal ideation and behaviour. This study evaluates the usability and implementation outcomes of SParcours in routine care.

Methods

A pragmatic evaluation study is conducted with a target sample of 160 mental health professionals working with children and young people (developmental age ≥10 years) who may experience suicidal ideation. Recruitment occurs via a suicide prevention website, social media, and newsletters. After completing a brief online registration form asking about demographics, work context, and experience with suicidal clients, participants can use SParcours in their professional context for 2–3 months. SParcours is a card-based toolkit offering three flexible pathways (talking, drawing, and walking) selected according to preferences and context. The materials support clinicians in introducing and exploring suicidal ideation, severity, and behaviour, identifying risk and protective factors and support resources, formulating risk and care needs, and generating inputs for an individualized safety plan. Participants complete a post-use online questionnaire assessing engagement, perceived usability and feasibility, acceptability, and implementation outcomes.

Results

Data collection is ongoing. Analyses will describe usage, user experience, and implementation outcomes including barriers and facilitators. Results will be presented at the ESSSB 21 conference.

Conclusions

Findings will inform iterative optimisation of SParcours and support implementation planning in child and adolescent mental health care settings.

This presentation describes the co-design development of an innovative assessment tool – the Co-designed Assessment Tool of Child Self-Harm and Suicidal Behaviours (CATCH-HARMS) – designed to identify and assess self-harm and suicidal behaviours in children aged 12 years and under.

We assembled a group of adults with lived experience of childhood self-harm and/or suicidal behaviours to formulate an assessment to identify and assess self-harm and suicidal behaviours in children. Adults in the group consisted of those with lived experience from their own childhood (<12 years of age), parents/carers of children with lived experience of childhood self-harm, and clinicians/academics with expertise in developmental and clinical psychology. Guided by a co-design approach, we utilised literature reviews, collaborative meetings, online bulletin boards, and a modified Delphi-informed approach to co-design an assessment tool that seeks to identify and understand the early indicators, experiences and related factors behind these behaviours in children.

Outcome: A novel 28-item assessment tool was developed to identify and assess self-harm and suicidal behaviours, as well as associated risk factors, with the intention of informing early intervention. Utilising a co-design process increased the capacity for creative solutions and supports the practical utility and acceptance of the assessment in real-world contexts.

Background: Universal suicide risk screening is increasingly recommended in pediatric healthcare, yet the question, “does screening work?” remains difficult to answer, in part because screening is only the first step in a multistage process.¹ Conceptualizing suicide screening within a cascade-of-care framework offers a structured approach to defining success, identifying where breakdowns occur, and specifying measurable outcomes.^2,3

Objective: To propose a practical, evidence-grounded framework that evaluates pediatric suicide screening using a suicide-specific care cascade, with explicit attention to equity.

Approach: Guided by existing literature, we organize evidence and gaps into a cascade-of-care model encompassing: (1) screening feasibility, (2) detection and risk stratification, (3) brief assessment and disposition, (4) safety planning and referral, (5) follow-up engagement, and (6) patient outcomes, including suicidal thoughts, behaviors, and mortality, emphasizing equity-stratified cascade measurement by race/ethnicity, language, and other social indicators.²

Key Findings: Evidence consistently supports the feasibility and acceptability of validated screening tools to improve risk detection beyond chief complaint-driven evaluation in both ED and primary care settings, but downstream cascade completion is more variable and context-dependent.^4–6 Clinicians report time constraints, limited training, lack of standardized workflows, inadequate electronic health record decision support, and constrained referral resources as barriers to acting on positive screens.⁷ Downstream effectiveness further depends on the fidelity of post-screen interventions, such as safety planning, and on successful linkage to specialty mental health care, steps frequently hindered by workforce shortages, insurance barriers, and fragmented referral pathways.^3,8–10 Structural inequities in access to mental and behavioral health care underscore the need for equity-sensitive cascade evaluation to avoid widening disparities.^11,12

Conclusions: Pediatric suicide screening should be evaluated as a cascade, not a single intervention. This framework clarifies what “working” means, identifies where evidence is strongest (detection) versus where more evidence is needed (mortality), and prioritizes equity-stratified cascade metrics as targets for implementation and assessment.