Chat-based Crisis Response Planning Shows Promise for Preventing Teen Suicide

An Ohio State-led pilot shows chat-based crisis response improved accessibility and usability for adolescents with suicidal thoughts—reaching youths who often decline or miss in-person safety planning.

In a pilot across emergency department and outpatient clinic settings, investigators enrolled adolescents and evaluated feasibility, crisis-plan completion, and downstream behavioral indicators collected in follow-up. The intervention used brief, structured chat sessions to guide youths through personalized coping strategies and support contacts. Compared with conventional workflows, the chat workflow yielded higher rates of plan completion and greater plan use after discharge; feasibility was supported by high session completion and low attrition. Because primary endpoints emphasized acceptability and process measures rather than long-term suicide-attempt reduction, the evidence indicates operational feasibility and promising proximal effectiveness while underscoring the need for longer-term outcome studies.

Patient-reported satisfaction favored the chat workflow: adolescents described greater comfort and a higher willingness to reuse the tool than during traditional face-to-face planning. The chat format also produced greater uptake and adherence to safety planning, with users more often reporting they could locate and use their written plans after the encounter. While satisfaction alone does not prove reduced suicidal behavior, higher acceptability is clinically relevant because increased engagement with plans and resources is a plausible mechanism for improved safety.

Operational barriers aligned with common ED and clinic constraints: triage integration, consent and privacy verification for minors using chat, clinician oversight for asynchronous exchanges, and documentation of plans in the electronic health record. Mitigations tested or proposed included protocolized triage pathways that route eligible youths to staffed brief chats, standardized consent scripts for minors and guardians, parallel clinician oversight with rapid escalation triggers, and EHR templates that import chat-generated plans. Because staff training affects fidelity, brief scenario-based training modules and checklists were recommended to support adoption while preserving patient safety.