PROJECT SUMMARY Young adults (ages 18-24) have the highest and fastest growing rates of suicidal thoughts and behaviors, but the lowest rates of mental health care. Attitudinal barriers, such as a low perceived need for treatment, time constraints, and preferences for self-management, are the primary reasons for low rates of mental health treatment among this age group. Despite low utilization of traditional mental health care, young adults are interested in using self-directed digital technologies to help manage their mental health symptoms. Digital suicide prevention interventions represent a key opportunity to overcome many of the major attitudinal barriers young adults face when seeking suicide-specific care. They can be short, private, and provide on-demand preventive care in the context of an individual’s everyday life. My career goal is to become a leading clinical scientist with an independent research program focused on designing and evaluating technology-enabled suicide prevention interventions that increase access to suicide prevention care. This proposal builds on my experience in depression intervention and suicide assessment research. It includes training and research activities that will enable me to develop: (1) expertise in formative and summative user centered design methods and scalable intervention designs, (2) expertise in suicide prevention interventions for adults, (3) expertise in efficient trial designs for digital mental health interventions, and (4) aptitude in implementation science research methods. In partnership with Mental Health America, the nation’s largest mental health advocacy organization, and individuals with lived experience of suicidal thoughts and behaviors, I will design an automated text message-based safety-planning intervention for young adults. My proposed intervention will operate by targeting suicide-related coping via a highly used communication pathway. To design this intervention, I will pursue the following specific aims: (1) conduct user centered design research activities, including elicitation workshops, design surveys, and usability testing to develop and refine the text message-based safety planning intervention. I will also produce an implementation plan to ensure that the developed safety planning intervention is sustainable and scalable within Mental Health America’s organizational infrastructure. (2) I will conduct a feasibility randomized controlled trial of my text message- based safety planning intervention among 60 young adults with current suicidal thoughts and behaviors. Results from this study will provide the data necessary for an R01 that tests the efficacy of the text message- based safety planning intervention in online community settings. The training achieved through this award will allow me to develop the necessary specialized knowledge that will launch my career as an independent investigator of technology-enabled suicide prevention interventions for adults.

PROJECT NARRATIVE Young adults in the U.S. (ages 18-24) have the highest and fastest growing rates of suicidal thoughts and behaviors, but the lowest rates of mental health care. This project aims to design and pilot an automated interactive safety planning service delivered via SMS that yields highly personalized safety plans and supports use over time. By accomplishing the proposed training goals and research project, this project will generate data to support an efficacy trial.