Grant: Operating Grant: SickKids-CIHR-IHDCYH New Investigator Grants

Intentional self-harm is a leading cause of injury and mortality among Canadians aged 12-25, resulting in nearly 2,500 hospital admissions and 500 deaths each year. Most studies use follow-up periods of six months or longer to identify predictors of self-harm. Clinical decision-making, in contrast, requires mental health professionals to judge a young person’s risk over the coming hours, days, and weeks to make care recommendations. To address this gap and improve care, we need to identify near-term predictors of self-harm thoughts or behaviours. The recent proliferation of personal digital technologies such as smartphones and wearables offers unprecedented opportunity to understand health behaviours in daily life. Sensitive accelerometers, electrodermal and heart rate sensors, and imbedded utilization and health metrics can provide momentby- moment information regarding the contexts of youths’ behaviours. This project will harness these technologies to: (a) test and refine current models of self-harm with a focus on identifying near-term predictors of self-harm thoughts and behaviours, and (b) develop risk-detection algorithms via machinelearning to evaluate the potential utility of digital self-monitoring for youth who are at-risk of self-harm. Because self-harm is an important concern in adolescents and young adults, I will recruit two community samples: Sample 1 will be 70 adolescents (aged 12-17) and their caregivers; Sample 2 will be 70 young adults (aged 18-25). Inclusion criteria will require past-month self-harm thoughts or behaviours, and ongoing mental health care. Youth will complete five brief surveys per day, and wear a wristband sensor to assess physical activity, sleep quality, and physiological arousal. Caregivers in Sample 1 will respond to a single daily survey regarding their child’s mood and behaviour. Analyses will combine multilevel modelling and machine-learning to test self-harm theories and create algorithms to classify self-harm risk. Knowledge translation activities will share new knowledge and tools with youth, caregivers, and healthcare professionals.