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Background: Youth suicide is a public health crisis. In addition to suicide mortality, many youth experience and live with suicidal thoughts and behaviors (STBs). STBs have serious consequences for youth mental health and are associated with suicide. Despite recognition of the incidence and severity of STBs, barriers to accessing support are prevalent. Digital mental health (DMH) and digitally delivered measurement-based care (MBC) may improve access to treatment among youth and enhance clinical response to suicide risk and crises. Objective: This study aimed to explore clinician perceptions of the barriers and facilitators to using DMH and MBC with youth experiencing STBs. Methods: As part of a larger implementation science project, a DMH and MBC platform was implemented in youth-serving mental health service settings in communities across Alberta, Canada. The platform included a multidimensional assessment package and embedded an automated suicide escalation protocol that notified clinicians when youth reported STBs. In participating service settings, 32 interviews were conducted with clinicians using DMH and MBC. We used the Consolidated Framework for Implementation Research and theoretical thematic analysis to identify barriers, facilitators, and relevant themes. Results: Four overarching themes were identified that described barriers and facilitators to using DMH and MBC with youth experiencing STBs: (1) service setting and professional practice barriers, (2) DMH platform barriers, (3) service setting and professional practice facilitators, and (4) DMH platform facilitators. Clinicians' recommendations were presented in alignment with the identified barrier themes. Conclusions: Given the association between STBs and suicide, attending to STBs is a critical component of suicide prevention. Our findings suggest that the assessment of STBs using DMH may address the youth suicide crisis by facilitating disclosure and rapid clinical action. Moreover, multidimensional assessment may reveal important information about STBs and risk factors, with advantages for personalized care and system-level improvement. Clinicians delivering DMH and MBC must be supported by applying their recommendations and continuously strategizing to mitigate barriers and leverage facilitators for sustained implementation.
Norman et al. (Fri,) studied this question.