A 16-year-old showed up at the ER with a broken arm.
He left with a cast — and an appointment later that week at Lurie Children’s Suicide Prevention and Research Collaborative (L-SPARC).
No matter the reason they’re at Ann & Robert H. Lurie Children’s Hospital of Chicago, every patient age 10 and up is asked questions as part of a suicide risk assessment.
This teen revealed that he had considered suicide.
Misunderstood by his family and peers as aggressive and perpetually angry, the teenager had been silently suffering.
But within seven sessions at the L-SPARC clinic — including role playing stressful situations with his parent — he had learned to be more aware of his emotions and how to advocate for himself, no longer had suicidal thoughts, and had better relationships with his family and girlfriend.
“If our clinic hadn’t existed, he might have ended up on a long wait list for services, hospitalized in a higher psychiatric care level than necessary, or back in the ER — this time for behavioral health,” said Anthony Vesco, PhD, a pediatric psychologist and clinical lead of L-SPARC.
Instead, even before his cast was removed, he was discharged from the clinic without needing ongoing therapy.
Like this teen, most L-SPARC patients go to the hospital or pediatrician for a reason unrelated to mental health.
They typically only reveal having suicidal thoughts because they’re specifically asked during the standard assessment, Vesco says. And only patients at moderate risk of suicide are referred to L-SPARC.
Thanks to the clinic’s proactive, evidence-informed model, none have required emergency or inpatient psychiatric services after discharge, though often those are the only options available for youth regardless of their suicide risk level.
Collaborative care
L-SPARC’s treatment model is designed for patients with moderate risk is grounded in the therapeutic framework Collaborative Assessment and Management of Suicidality (CAMS).
Therapy includes developing a comprehensive safety plan and cognitive behavioral interventions such as:
- Building emotional awareness and mindfulness
- Increasing distress tolerance and cognitive flexibility
- Teaching social problem-solving and assertive communication
Families are actively involved in therapy sessions and in developing safety strategies, ensuring the treatment plan is both clinically sound and practically sustainable.
“If they had all the tools and support they needed, these kids wouldn’t be in crisis,” said Aron Janssen, MD, vice chair of Lurie’s Department of Psychiatry and Behavioral Health. “We empower the patients and families to recognize when kids are suffering and develop a plan to intervene, providing them with the skills to identify triggers and to help the child use effective coping skills.”
The clinic’s dual mission
L-SPARC was designed not only to offer immediate suicide intervention for children and teens but also to train the next generation of clinicians.
Clinical psychology and social work graduate students from Lurie Children’s Pritzker Department of Psychiatry and Behavioral Health work with three or four L-SPARC patients each, delivering in-person therapy designed to quickly stabilize suicidal thinking within six to eight sessions.
Most of them never had formal training in suicide, so their time at the clinic begins with workshops on suicide-specific interviewing and assessment and therapy skill delivery. The workshops combine lectures, case discussions, and role-play scenarios.
Following the workshops, trainees serve as patients’ primary therapists with in-person supervision by licensed clinicians who offer real-time and follow-up feedback as cases progress.
The students also watch attending clinicians and their fellow trainees conduct therapy and have weekly group debriefings.
By the end of their rotation that spans the academic year, Vesco says the trainees consistently report feeling confident and well-equipped to manage suicidal thinking in pediatric patients.
“Many tell us the training was a novel and essential supplement to their core clinical curriculum,” he said.
Increasing access
About 80% of young people visited a health care provider within the year before their death by suicide, according to the American Academy of Pediatrics.
That statistic and Lurie Children’s involvement in the 39-hospital Preventing Youth Suicide National Collaborative were the impetus for the L-SPARC pilot, which opened in 2023.
“Thanks to learning from other hospitals in the collaborative, we became incredibly successful at screening for risk,” Janssen said. “But when suicide risk was identified, there weren’t services or clinicians to treat them.”
The growing need paired with the clinic’s 100% suicide prevention success has sparked plans to expand from its current one-day-a-week schedule. Over the next couple of years, Janssen says they aim to increase the number of trainees to offer additional clinic hours.
The L-SPARC team also provides expert consultation, resources, and training to a variety of health care professionals, including advanced practice and community health providers.
They developed a simulation lab for medical residents to equip non-psychiatric providers to identify patients at risk for future suicide attempts and intervene at the time of the visit.
“The goal is to disseminate suicide-specific expertise where it’s needed: into communities to teach all providers around the region so all kids have access to immediate and effective intervention regardless of where they live,” Janssen said.
