An intensive outpatient program for suicidal college students

Abstract

Objective: College counseling centers (CCCs) have limited capacity to accommodate high-risk students who need more intensive care than traditional outpatient treatment. We describe an Intensive Outpatient Program (IOP) to meet the specialized needs of suicidal undergraduates. Participants: Suicidal undergraduates aged 18–24. Methods: Fact-gathering meetings with local universities confirmed high need for prompt access to IOP care for students presenting in crisis at CCCs and emergency rooms, and post-inpatient discharge. We thus iteratively designed and implemented the College Option Services for Teens at Risk (COSTAR) IOP. Results: The 6-week program includes initial diagnostic evaluation and risk assessment followed by weekly skills groups, individual therapy, and medication management. Between September 2017 and January 2020, 148 students (M age = 19.7) attended an average of 5.7 COSTAR group sessions (SD = 4.7). Conclusions: A specialty IOP for suicidal college students holds promise in a stepped care approach for at-risk college students.

Keywords:

• Suicide
• treatment
• undergraduates

Acknowledgments

The authors would like to acknowledge the faculty and staff at the STAR clinic.

Conflicts of interest

Dr. Goldstein receives grant funding from the NIMH, American Foundation for Suicide Prevention (AFSP), The Clinical and Translational Science Institute (CTSI) at the University of Pittsburgh, and the Brain and Behavior Foundation, and receives royalties from Guilford Press. Dr. Salk was supported by T32 MH018269-30 (PI: Goldstein). Dr. Chugani was supported by T32HD087162 (PI: Miller) and received grant funding from NIAAA, the University of Pittsburgh CTSI and the Citrone 33 Foundation. Dr. Moses-Kolko receives research support from NIMH. Dr. Sakolsky receives grant funding by the NIMH; she received an honorarium from the American Academy of Child & Adolescent Psychiatry for teaching at the 2012 Annual Review Course and from Northwell Health for child & adolescent lecture at Zucker Hillside Hospital in 2018. Dr. Sakolsky serves as an editorial board member of Child & Adolescent Psychopharmacology News, and has received consultant fees from L.E.K. Consulting. Dr. Brent receives research support from NIMH, AFSP, the Once Upon a Time Foundation, and the Beckwith Foundation, receives royalties from Guilford Press, from the electronic self-rated version of the C-SSRS from eRT, Inc., and from performing duties as an UptoDate Psychiatry Section Editor, and receives consulting fees from Healthwise. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States, and received approval from the Institutional Review Board of the University of Pittsburgh.

Note

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.

Linehan, M. M. (2015). DBT^® skills training manual (2nd ed.). Guilford Press.

Notes

1 Patients are given the option to provide consent for their data to be used for research purposes. The University’s Human Research Protection Office approved the collection of data for research purposes. Patients are informed that participating in the Research Registry will not affect their clinical treatment. If patients do not consent to the Research Registry, patients’ data are only used for treatment planning.

Additional information

Funding

The authors acknowledge the appropriation from the Commonwealth of Pennsylvania to the STAR Center via the University of Pittsburgh and the National Institute of Mental Health ALACRITY Center (P50 MH 115838; PIs: Brent Rollman).