The goal of this study is to conduct research that will integrate and harmonize existing large prevention trial datasets. The included randomized clinical trials were delivered before adulthood (prior to age 18) and did not explicitly target suicidal thoughts and behaviors. Each trial consists of well-characterized participant-level prospective data with consent that allows for the harmonized data to be submitted to the National Institute of Mental Health Data Archive and allows for National Death Index searches.

This study will examine ‘cross-over effects’ (e.g., unanticipated beneficial effects) of the intervention trials in reducing risk for later fatal and nonfatal suicidal thoughts and behaviors, and related outcomes such as overdose, Substance Use Disorders (SUD), Opioid Use Disorders (OUD), accidents, and all-cause mortality. This study includes 29 existing prevention trial data sets with collaboration of the principal investigators and data custodians who have rights to the original data. We will de-identify, aggregate, and harmonize the prevention trial datasets and utilize advanced computational/analytic strategies to examine whether intervening early reduces the risk for suicidal thoughts, behaviors, and related outcomes. We will identify the most potent aspects by examining the various components of each intervention as well as the proximal and distal targets, format, setting, dose/duration, developmental timing, and quality of implementation. This project has the potential to inform the refinement and development of future preventive intervention strategies delivered early and scaled to address suicide and overdose in the US.