Racism and Poverty are Barriers to the Treatment of Youth Mental Health Concerns.

OBJECTIVE: Traditional studies of treatment moderators have focused largely on psychological factors such as clinical severity. Racial and economic inequity exert large effects on youth mental health, on treatment efficacy, and on the likelihood of receiving treatment altogether. Yet, these factors are studied less often by clinical psychological scientists. METHOD: We conducted a narrative review of literature on racial and economic inequities and their impact on youth mental health. RESULTS: First, systemic problems such as racism and poverty increase the risk of developing complex health issues and decrease the likelihood of benefiting from treatment. Second, attitudinal barriers, such as mistrust associated with treatments provided by researchers and government agencies, decrease the likelihood that minoritized groups will engage with or benefit from evidence-based treatments. Third, minoritized and underserved communities are especially unlikely to receive evidence-based treatment. CONCLUSION: Clinical psychological science has unique insights that can help address systemic inequities that can decrease treatment efficacy for youth mental health treatment. Psychological scientists can help eliminate disparities in accessing evidence-based treatment and help end violent policies in underserved minoritized communities by at the very least (1) building and supporting scalable community-based treatments as well as (2) publicly advocating for an end to violent policies that impose negative social costs.

Consensus Statement on Ethical & Safety Practices for Conducting Digital Monitoring Studies with People at Risk of Suicide and Related Behaviors.

OBJECTIVE: Digital monitoring technologies (e.g., smart-phones and wearable devices) provide unprecedented opportunities to study potentially harmful behaviors such as suicide, violence, and alcohol/substance use in real-time. The use of these new technologies has the potential to significantly advance the understanding, prediction, and prevention of these behaviors. However, such technologies also introduce myriad ethical and safety concerns, such as deciding when and how to intervene if a participant's responses indicate elevated risk during the study? METHODS: We used a modified Delphi process to develop a consensus among a diverse panel of experts on the ethical and safety practices for conducting digital monitoring studies with those at risk for suicide and related behaviors. Twenty-four experts including scientists, clinicians, ethicists, legal experts, and those with lived experience provided input into an iterative, multi-stage survey, and discussion process. RESULTS: Consensus was reached on multiple aspects of such studies, including: inclusion criteria, informed consent elements, technical and safety procedures, data review practices during the study, responding to various levels of participant risk in real-time, and data and safety monitoring. CONCLUSIONS: This consensus statement provides guidance for researchers, funding agencies, and institutional review boards regarding expert views on current best practices for conducting digital monitoring studies with those at risk for suicide-with relevance to the study of a range of other potentially harmful behaviors (e.g., alcohol/substance use and violence). This statement also highlights areas in which more data are needed before consensus can be reached regarding best ethical and safety practices for digital monitoring studies.

Inconsistencies in self-reports of suicidal ideation and attempts across assessment methods.

Suicide researchers commonly use a variety of assessment methods (e.g., surveys and interviews) to enroll participants into studies and assign them to study conditions. However, prior studies suggest that different assessment methods and items may yield different responses from participants. This study examines potential inconsistencies in participants' reports of suicidal ideation (SI) and suicide attempt (SA) across commonly used assessment methods: phone screen interview, in-person interview, self-report survey, and confidential exit survey. To test the reliability of the effects, we replicated the study across two samples. In both samples, we observed a notable degree of inconsistent reporting. Importantly, the highest endorsement rates for SI/SA were on a confidential exit survey. Follow-up assessments and analyses did not provide strong support for the roles of purposeful inaccuracy, random responding, or differences in participant experiences/conceptualizations of SI. Although the reasons for such inconsistencies remain inconclusive, results suggest that classification of suicidal/control participants that uses multiple items to capture a single construct, that uses a Graded Scale to capture a broad spectrum of thoughts and behaviors, and that takes into account consistency of responding across such items may provide clearer and more homogenous groups and is recommended for future study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).