Non-suicidal self-injury (NSSI) is an increasingly common self-harming behavior among adolescents and young adults, with current estimates of NSSI in youth ranging from 12-37%. Although NSSI is associated with other mental health problems (e.g., depression, anxiety, disordered eating) and is a risk factor for suicide and severe unintended injury, evidence-based treatment and prevention models for NSSI are scarce. In addition, few resources are available for parents despite evidence of their important role in youth's recovery from self- harming behaviors. Factors such as parents'basic knowledge of NSSI and youth developmental processes, as well as parents'own emotion and communication skills, have a direct impact on a young person's recovery process. However, engaging parents in their child's recovery process can be challenging due to barriers for families (e.g., time, stigma regarding the self-injury behavior) and clinicians (e.g., balancing youth and parent needs). A web-based psychoeducation program provides a mechanism for overcoming these barriers in order to provide parents with education, skills and support to help their children. The proposed SBIR project will develop and test Parent Education and Resources for Self-injurious Youth (PERSY), a specialized web-based program for parents of youth who are receiving treatment for NSSI. Through this SBIR Phase I grant, we will develop a prototype of PERSY and conduct feasibility and usability testing to gather feedback from key stakeholders prior to full product development.
Three specific aims will be accomplished in this Phase I project: (1) creating the PERSY prototype including three web-based modules and outlines of the accompanying program materials;(2) conducting stakeholder feasibility and usability tests of the PERSY prototype to assess the feasibility, usability, innovation, and quality with 30 mental health professionals and 30 parents of 12-20 year olds in clinical treatment for NSSI;and (3) establish final prototype specifications using data compiled and analyzed from the feasibility testing. PERSY will include a range of web-based modalities including video presentations, didactic education, interactive self-assessments, social skill modeling, and personalized feedback. To our knowledge, no other product exists that provides this type of knowledge enhancement, skill development, and support to parents of youth with NSSI. Phase I research is expected to demonstrate strong support for the proposed product across stakeholders and provide the necessary foundation for full product development. Once the PERSY program is finalized in Phase II, we will conduct a randomized clinical trial to examine treatment effects for (1) parenting knowledge, skills, and positive engagement with their child, (2) youth self-injury recovery, and (3) youth positive engagement with parents. This SBIR project will be instrumental in establishing PERSY as an efficacious competitor in the psychoeducation marketplace. The final product will serve as a valuable resource for parents and mental health professionals with the potential to have a significant impact on the lives of youth with NSSI and their families.

Public Health Relevance

Non-suicidal self-injury (NSSI) such as cutting, burning, and embedding objects under the skin is an increasingly common self-harming behavior among adolescents and young adults. Current estimates of rates of NSSI in youth range from 12-37% in secondary school populations and 12-25% in young adult populations. NSSI is associated with other serious mental health problems including depression, anxiety, and disordered eating and is a potent risk factor for suicide and severe unintended injury. Mental health problems come with a devastatingly high financial cost and are thus considered a serious public health issue. In the U.S., the annual direct costs associated with mental health treatment are estimated at $57.5 billion, with the overall costs of mental illness significantly higher (e.g., disability, unemployment). Each year, about 4.6 million children receive some form of mental health (MH) care, with higher average costs of care for youth as compared to average costs for the general population. The President's New Freedom Commission on Mental Health specifically calls for the identification and early treatment of youth who may experience mental health problems to prevent the onset of co-occurring disorders and other negative outcomes. In addition, multiple research studies have shown that parents play a critical role in youth mental health care. Parents'roles are both instrumental (i.e., detecting a problem, seeking out a treatment provider, coordinating treatment) and supportive (i.e., monitoring youth between sessions, reinforcing therapy concepts outside of the session). Given the direct costs associated with psychiatric disorders and use of mental health services, it is especially important to develop and test innovative programs for parents. These programs can support parents in promoting optimal outcomes in their youth in order to overcome NSSI and reduce overall mental health treatment costs. Despite its increasing prevalence, the known negative outcomes associated with NSSI, and knowledge of parents'role in youth recovery, evidence-based treatments for parents of youth with NSSI are lacking. The proposed SBIR project directly addresses this critical treatment gap by developing and testing a web-based psychoeducation program designed to meet the education and support needs of parents of adolescents and young adults with NSSI.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Business Innovation Research Grants (SBIR) - Phase I (R43)
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Special Emphasis Panel (ZRG1-BBBP-V (10))
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Haverkos, Lynne
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3-C Institute for Social Development
United States
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