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Youth Suicide Prevention Initiative
Youth-Nominated Support Team
The U-M Medical School Department of Psychiatry's Youth-Nominated Support Team (YST) is an evidence-based adjunctive intervention for young people with elevated suicide risk. The program is designed by our faculty to strengthen connections between at-risk youth and supportive adults from their family, school, or community, supplementing traditional treatments like therapy and medication.
With guidance from a licensed specialist, nominated adults attend an orientation and maintain regular contact with the adolescent. Research shows that youth who participate in YST experience faster reductions in suicidal thoughts, higher engagement in treatment, and lower rates of overall and self-injury mortality—including suicide and overdose—over the long term.
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For More Information
Program Overview
Adolescents nominate supportive adults, with help from a licensed YST Intervention Specialist. Parent or guardian approval is required for nominated adults.
Invited adults attend an orientation and education session led by the YST Intervention Specialist, focused on the adolescent’s mental health history, treatment plan, suicide risk factors, and emergency resources. Support Persons are encouraged to maintain regular contact with the adolescent, encourage treatment adherence, and help support individual goals.
After the orientation and education session, Support Persons maintain regular contact with the adolescent for three months. The YST Intervention Specialist keeps weekly contact with each Support Person during the three months, offering guidance and resources as needed.
Learn more about the program in a TEDMED talk by Dr. Cheryl King
Eligibility & Participation
- YST can be offered by licensed mental health providers who have completed the YST training and consultation.
- Adolescents recruited at select psychiatric hospitals or emergency departments, and who have a history of suicidal thoughts or attempts, may be invited to participate.
- Support Persons are nominated by adolescents and approved by parents or guardians.
- The program can be implemented in various settings, including outpatient clinics, psychiatric hospitals, emergency departments, or virtually.
Contact
For additional information, feel free to contact Program Lead and YST Trainer Alejandra Arango, PhD.
Outcomes
- Two published studies (King et al., 2009 and 2019) demonstrated the benefits of YST.
- Among adolescents with multiple suicide attempts, YST led to a greater decrease in suicidal thoughts after discharge.
- YST was linked to improved functioning at 3 and 12 months following discharge for adolescents with no history of multiple attempts.
- Participants in YST attended more therapy, medication follow-up, and drug treatment sessions than those receiving usual care.
- Long-term, YST participants were less likely to die (including by suicide or overdose) 11 to 14 years after participation compared to those who did not receive YST.
Frequently Asked Questions
Adolescents nominate adults from their family, school and community to serve the role of YST Support Persons. YST Intervention Specialists (mental health professional) help adolescents nominate adults. Once parents/guardians approve of the nominations, the nominated adults are invited to participate. This is facilitated by the YST Intervention Specialist. Adults who accept the role of a Support Person attend an individual education session.
The education session focuses on the adolescent’s mental health history, treatment plan, and suicide risk factors. Information regarding how to access emergency services is also discussed.
Following the education session, each Support Person is encouraged to maintain regular contact with the adolescent. This contact is meant to encourage treatment adherence and behaviors that align with individual goals. The YST Intervention Specialist maintains regular telephone contact with each Support Person, provides additional resources and is available to help address concerns.
The primary role of the Support Person is to attend the education session and maintain regular contact with the adolescent and the Intervention Specialist. Contact between the Support Person and the adolescents is meant to be supportive as they encourage treatment adherence and behaviors that align with adolescent goals.
YST is meant to supplement usual services (e.g., medication, therapy) and Support Persons are not expected to serve in a professional capacity. It is important to remember that though Support Persons are meant to encourage positive behavioral choices; they are not responsible for the choices that youth make.
YST is meant to supplement usual care. Usual care for adolescents who have a history of suicidal thoughts and/or suicide attempts includes (but is not limited to) medication, psychotherapy, group intervention, or partial hospitalization programs.
The idea behind the YST intervention is to complement these traditional interventions by building adolescents’ support network through the nomination of Support Persons.
As the YST intervention is still being tested, only adolescents recruited at select psychiatric hospitals and emergency departments who have a history of suicidal thoughts and/or suicide attempts may be invited to participate.
Support Persons who are nominated by adolescents and approved by parents/guardians are invited to participate.
The nomination of Support Persons by adolescents occurs at the recruitment site (psychiatric hospital or emergency department). The psychoeducation meeting with Support Persons occurs either in person or through a secure video conferencing platform.
Following the education session, each Support Person is encouraged to maintain regular contact with the adolescent for three months. The YST Intervention Specialist will also remain in regular contact with each Support Person during these three months.
Program Leadership
