Stepped-Care School-Based Intervention for Adolescent Suicidal Ideation

Launched by UNIVERSIDAD DE LOS ANDES, CHILE · Jul 2, 2025

Keywords

ClinConnect Summary

This clinical trial is studying a new school-based program designed to help teenagers in Santiago, Chile, who are struggling with thoughts of suicide and depression. The program uses two types of counseling based on cognitive behavioral therapy (CBT), which helps young people change negative thinking and develop coping skills. Depending on how severe their depression is, students will receive either the Reframe-IT+ program for mild to moderate symptoms or the CARIBOU program for more severe symptoms. The goal is to see if this stepped approach is practical, well-accepted, and helpful in reducing suicidal thoughts, depression, anxiety, and other related challenges.

Teenagers in certain vulnerable secondary schools in Santiago may be eligible if they are in specific grades (I to III Medio), have had recent suicidal thoughts, and meet the criteria for either mild/moderate or severe depression. Students with recent suicide attempts, very severe psychotic symptoms, or those already in similar programs this year cannot join. Participants will be followed for up to a year to see how well the programs work and how they affect their mental health and daily life. This study hopes to find effective ways to support at-risk teens in schools and help guide future mental health programs.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 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.
• Exclusion Criteria:
• • 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.