title: Development of practice principles for the management of ongoing suicidal ideation in young people diagnosed with major depressive disorder.
abstract: OBJECTIVE
  There is a lack of clear guidance regarding the management of ongoing suicidality in young people experiencing major depressive disorder. This study utilised an expert consensus approach in identifying practice principles to complement relevant clinical guidelines for the treatment of major depressive disorder in young people. The study also sought to outline a broad treatment framework for clinical intervention with young people experiencing ongoing suicidal ideation.
  
  
  METHODS
  In-depth focus groups were undertaken with a specialist multidisciplinary clinical team (the Youth Mood Clinic at Orygen Youth Health Clinical Program, Melbourne) working with young people aged 15-25 years experiencing ongoing suicidal ideation. Each focus group was audio recorded and transcribed verbatim using orthographic conventions. Principles of grounded theory and thematic analysis were used to analyse and code the resultant data.
  
  
  RESULTS
  The identified codes were subsequently synthesised into eight practice principles reflecting engagement and consistency of care, ongoing risk assessment and documentation, individualised crisis planning, engaging systems of support, engendering hopefulness, development of adaptive coping, management of acute risk, and consultation and supervision.
  
  
  CONCLUSIONS
  The identified practice principles provide a broad management framework, and may assist to improve treatment consistency and clinical management of young people experiencing ongoing suicidal ideation. The practice principles may be of use to health professionals working within a team-based setting involved in the provision of care, even if peripherally, to young people with ongoing suicidal ideation. Findings address the lack of treatment consistency and shared terminology and may provide containment and guidance to multidisciplinary clinicians working with this at-risk group.
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Centre of Excellence in Youth Mental Health, headspace - National Youth Mental Health Foundation, Melbourne, VIC, Australia.
authors.forename: Simon M
authors.initials: SM
authors.lastname: Rice
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Centre of Excellence in Youth Mental Health, headspace - National Youth Mental Health Foundation, Melbourne, VIC, Australia.
authors.forename: Magenta B
authors.initials: MB
authors.lastname: Simmons
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Centre of Excellence in Youth Mental Health, headspace - National Youth Mental Health Foundation, Melbourne, VIC, Australia.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Bailey
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Centre of Excellence in Youth Mental Health, headspace - National Youth Mental Health Foundation, Melbourne, VIC, Australia.
authors.forename: Alexandra G
authors.initials: AG
authors.lastname: Parker
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Centre of Excellence in Youth Mental Health, headspace - National Youth Mental Health Foundation, Melbourne, VIC, Australia.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hetrick
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Orygen Youth Health Clinical Program, Melbourne, VIC, Australia.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Davey
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Orygen Youth Health Clinical Program, Melbourne, VIC, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Phelan
authors.affiliation: Orygen Youth Health Clinical Program, Melbourne, VIC, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Blaikie
authors.affiliation: Orygen Youth Health Clinical Program, Melbourne, VIC, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Edwards
keywords: Early intervention; major depressive disorder; multidisciplinary; practice principles; suicidal ideation; suicide; treatment; youth mental health