Pilot Program Demonstrates Significant Decrease in Suicide-Related ED Visits

A comprehensive dialectical behavior therapy (DBT) program piloted at Cincinnati Children’s is reporting significant successes, specifically in decreased suicide-related emergency department visits, suicide attempts and psychiatric admissions. 

The six-month pilot program began in December 2024. It included 14 high school-aged adolescents and their families or caregivers.  

This summer, program leaders and Division of Behavioral Medicine and Clinical Psychology pediatric psychologists Claire Aarnio-Peterson, PhD, and Aubrey Coates, PhD, described the preliminary outcomes of metrics they’d measured, including: 

• A 43% decrease in suicide-related ED visits 
• A 73% decrease in psychiatric admissions 
• An 86% decrease in suicide attempts 

A Unique Framework 

Dialectical behavioral therapy, of course, isn’t new. The evidence-based psychotherapy was originally developed to provide skills to adults who struggled with navigating intense emotions or situations. The four components—individual psychotherapy, group skills training, crisis coaching calls and a therapist consultation team—have since been adapted to address issues like self-harm, suicidal thoughts and difficulties with emotional regulation in adolescents and children. 

Still, the challenge has been establishing an effective program for a pediatric patient population that does all four things well. That’s what makes our program unique. 

“We’re offering comprehensive dialectical behavioral therapy,” Aarnio-Peterson says. “This four-part model is what is empirically supported to reduce suicidality in teens and improve emotion regulation and distress tolerance.” 

Coates adds that the fourth component of the program—consultation meetings for clinicians—means the eight psychologists on the team work together as a community. 

“Each week, we meet for two hours to consult on patients and what we can do to better help them,” she says. “And that’s unheard of in healthcare. But working together, we ensure each patient is served well.” 

Improving Access to Care

Aarnio-Peterson attributes the program’s successes to “our talented and compassionate team of dialectical behavioral therapy psychologists and support from leadership to make it a reality."

Aarnio-Peterson and Coates had each been hosting skills groups for adolescents before the pilot program began. But they’d also been noticing the rise of mental health needs in the area and discussing implementing a program that could help increase access to those most at risk.  

“Those pieces came together [at the end of last year], and hospital leadership told us it was a good time to give it a try,” Coates says. 

Early in the summer, the program also received funding—an internal grant called the Place Outcomes Research Award (PORA), which encourages hospital teams to work on improving access to care.  

“That’s why we’re looking at clinical outcomes such as reducing visits to the emergency department, psychiatric hospitalization, suicide attempts, reduced mental health symptoms and, also, potential barriers to accessing care for the families, as well as the feasibility of the program for our providers,” Coates says. 

Growth Potential 

In the future, Coates notes that there is room for the program to grow.  

“Since we started, we’ve received more and more interest in the framework,” she says. “It’s been, ‘Can we do this for older kids?’ and ‘How about younger ones?’” 

Coates adds there’s also an opportunity to add locations for the program in different parts of the community. For now, though, she says: “The big takeaway is that we’ve seen we can be successful at helping kids in the community who really need it.” 

If you want more information or know of an adolescent who could benefit from the program, contact the Division of Behavioral Medicine and Clinical Psychology. Also, if you or someone you know is dealing with suicide or self-harm, reach out to the Psychiatric Intake Response Center (PIRC) team or dial 988, the Suicide and Crisis Lifeline. 

(Published November 2025)

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