Stratified-Care School-Based Intervention for Adolescent Suicidal Ideation

Recruiting now · Not applicable

Conditions studied: Suicidal Ideation

In brief

Background. Suicidal ideation and depressive symptoms are highly prevalent among adolescents, with suicide representing a leading cause of death in this age group worldwide. School-based indicated prevention programs using cognitive behavioral therapy (CBT) have shown promise in addressing these mental health challenges. The Reframe-IT+ (Chile) and CARIBOU (Canada) programs are CBT-based, individually delivered interventions targeting adolescents at risk of suicide. This study aims to evaluate a culturally adapted stratified-care model using these two interventions, matched to depressive symptom severity. Methods. This is a quasi-experimental, single-arm study with pre-post assessments and follow-ups at 3, 6, 9, and 12 months. Six secondary schools with high socioeconomic vulnerability in Santiago, Chile, will participate. Students with suicidal ideation and mild/moderate depressive symptoms (PHQ-9 \< 20) will be offered Reframe-IT+, while those with severe symptoms (PHQ-9 ≥ 20) will be offered CARIBOU. Primary outcomes include the acceptability of CARIBOU, feasibility of the stratified-care model, and implementation fidelity. Secondary outcomes include reductions in suicidal ideation, depression, anxiety, hopelessness, and improvements in functioning, quality of life, behavioral activation, emotional regulation, and problem-solving skills. Discussion. This protocol addresses the need for scalable, culturally sensitive interventions for adolescent suicide prevention in school settings. By evaluating both the process and early outcomes of a stratified-care approach, this study will generate valuable evidence to inform future large-scale effectiveness trials and policy development in adolescent mental health.

Key facts

Study ID: NCT07063914
Run by: Universidad de los Andes, Chile
People needed: 60
Starts: 2025-06-25
Expected to finish: 2025-12-31
Last updated by the study team: 2025-08-01

Who can join

Age: 14 and older, up to 18. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Inclusion Criteria for Educational Institutions
Located in Santiago, Chile.
Secondary education level (grades I-IV Medio).
Coeducational schools.
At least two classes per grade level in secondary education.
A minimum of 30 students per class.
Socioeconomic vulnerability level of ≥ 50%, as measured by the School Vulnerability Index (Índice de Vulnerabilidad Escolar - IVE-SINAE), which includes factors such as parental education and total household income.
Inclusion Criteria for Students
Enrolled in grades I, II, or III Medio.
Suicidal ideation within the past month, defined as a score ≥ 3 on the Columbia-Suicide Severity Rating Scale (C-SSRS).
For the Reframe-IT+ program: mild or moderate depressive symptoms, defined as a PHQ-9 score < 20.
For the CARIBOU program: severe depressive symptoms, defined as a PHQ-9 score ≥ 20.

You may not qualify if…

Exclusion Criteria for Students
Participation in a structured suicide prevention program (Reframe-IT+) during 2024.
Severe psychotic symptoms, such as perceptual disturbances or delusional ideas, assessed during the eligibility interview.
Suicide attempt(s) in the past three months, assessed during the eligibility interview.

Where it is running

Universidad de los Andes — Santiago, Las Condes, Chile (enrolling)

Full record on ClinicalTrials.gov

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