Suicide

Homeless youth experience high rates of suicidal ideation and attempts, yet limited research has examined predictors of treatment engagement among this population. Suicidal homeless youth (N = 150) between the ages of 18 and 24 years were recruited from a drop-in center in Columbus, Ohio. Participants were randomly assigned to Cognitive Therapy for Suicide Prevention + treatment as usual through a local drop-in center (CTSP + TAU) (N = 75) or TAU alone (N = 75), and treatment attendance among those assigned to CTSP + TAU was examined in this study. As expected, among youth engaged in CTSP + TAU, those with a history of intimate partner violence (IPV) showed decreased odds of treatment attendance. Additionally, youth randomized into CTSP + TAU with higher acquired capability for suicide (ACS) scores and those identifying as Black were more likely to attend treatment sessions. Findings suggest that effective treatment implementation must consider youth’s trauma history, demographics and severity of suicidal ideation and behaviors.

LGBTQ+ individuals are at increased risk of suicide. Homelessness further increases the risk, as does family-of-origin rejection. A model that combines suicidal risk factors and minority stress theory is useful in clinical practice. An openness to “hearing” the lived experiences of LGBTQ+ individuals is essential to treatment. An LGBTQ+ affirming therapeutic approach is recommended. It is also frequently helpful to rebuild family relationships and support for the LGBTQ+ individual, particularly with younger youth. Principles of practice are described and illustrated.

Homeless youth have extremely high rates of suicidal ideation and attempts, but limited research has evaluated the efficacy of suicide prevention interventions. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a local drop-in center. Of interest was (1) whether the proposed sample of eligible youth could be identified, (2) whether youth could be engaged and retained in the prevention intervention, and (3) whether the intervention was associated with reduced suicidal ideation, our primary outcome measure. In particular, youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) (N = 75) or TAU alone (N = 75). Findings showed that the proposed sample of eligible youth could be identified and engaged in the study, and all youth showed a significant decline in suicidal ideation over time, with a faster decline among youth assigned to CTSP. These findings suggest that (1) at-risk suicidal youth can be identified and engaged outside of hospital emergency rooms, such as in drop-in centers, and (2) intervention added to TAU can strengthen reductions in suicidal ideation. Ultimately, attention towards reducing suicide risk among these youth has the potential to reduce premature mortality, hospitalization and loss of human capital.

Pages: 402-411

Objective: To examine the relation between homelessness and suicidality and to test bullying as a mediator and parental support as a moderator of these relations. Background: Youth from low-income families are more likely to be bullied and in turn experience negative mental health outcomes. Parental support has been reported to mitigate the effects of stressful events, such as being bullied. However, these relations are still undocumented among youth experiencing homelessness. Method: This study included a random sample of 2,049 stably housed and 64 homeless youth enrolled in the Delaware Public Schools, grades 9 through 12, who completed the 2015 Delaware Youth Risk Behavior Survey. Hayes's PROCESS macro was used to test for a moderated mediation relation between bullying, suicidality, and parental support for homeless youth. Results: Bullying mediated the relation between homelessness and suicidality, and parental support moderated the relation between bullying and suicidality. Youth experiencing homelessness reported more bullying, which was associated with more severe suicidality. For youth experiencing homelessness with low levels of parental support, bullying was associated with more severe suicidality. Conversely, for youth with high levels of parental support, bullying was not associated with more severe suicidality. Conclusion: This study indicates that bullying is a mechanism through which homelessness and suicidality are related, while also demonstrating the importance of parental support. Implication: The increased risk of suicidality among youth experiencing homelessness who are bullied, as well as the effects of parental support, warrant attention from school personnel and youth service providers.

This study utilizes data from the Youth Risk Behavior Survey to estimate the prevalence of adolescent homelessness and relations to five indicators of poor functioning among students attending public high school in eight states. About 3.27% of students experienced homelessness, and nearly 7% of teens who identified as lesbian, gay, or bisexual (LGB) experienced homelessness. Homelessness was related to higher rates of sexual/dating violence as well as having been bullied and feeling unsafe at school. Homelessness and LGB identification predicted higher rates of more-severe problems with alcohol, hard drug use, poor grades, suicidality, and risky sexual behavior, controlling for other factors. There was no interaction effect between homelessness and LGB status, suggesting that these risks are additive.

This journal article focuses on a qualitative study, grounded in the Youth Program Quality Assessment model, explored characteristics of higher quality organizations for RHY and gaps that remain from staff and RHY perspectives. A total of 29 diverse settings serving RHY in New York State were randomly selected for participation and ranked on a quantitative program quality index. Within settings, in-depth semi-structured interviews were conducted with program administrators (N=30) and other staff (N=24). Focus group interviews were conducted with RHY (N=13 focus groups; N=84 RHY). Data were analyzed using a systematic content analysis approach that was both theory-driven and inductive, comparing higher to lower quality settings. (author abstract modified)