Suicide prevention for substance using youth experiencing homelessness: study protocol for a randomized controlled...

Area of Science:

• Mental Health Research
• Clinical Psychology
• Public Health Interventions

Background:

• Youth experiencing homelessness (YEH) face a high risk of suicide, the leading cause of death in this population.
• Effective suicide prevention interventions for YEH are lacking, despite increasing research.
• Many YEH do not access available support services, highlighting the need for accessible interventions.

Purpose of the Study:

• To identify an effective suicide prevention intervention for YEH that can be easily adopted by community services.
• To directly address suicidal ideation in YEH, rather than focusing solely on underlying conditions.
• To evaluate the efficacy of Cognitive Therapy for Suicide Prevention (CTSP) combined with Services as Usual (SAU) for YEH.

Main Methods:

• Recruitment of 300 YEH with recent substance use and suicidal ideation or attempts from street outreach and a drop-in center.
• Random assignment of participants to either CTSP + SAU (n=150) or SAU alone (n=150).
• Follow-up assessments at 3, 6, 9, and 12 months to measure outcomes, mediators, and moderators (sex, race, sexual orientation, service connection).
• Mixed-methods assessment of intervention acceptability, feasibility, fidelity, and cost for dissemination.

Main Results:

• Hypothesized greater reductions in suicidal ideation (primary outcome) for the CTSP+SAU group compared to SAU alone.
• Expected significant reductions in substance use and depressive symptoms (secondary outcomes) in the CTSP+SAU group.
• Anticipated improvements in risk and protective factors for suicide among YEH receiving CTSP+SAU.

Conclusions:

• This clinical trial addresses a critical gap in suicide prevention for high-risk YEH.
• The study aims to provide evidence for an intervention directly targeting suicidal ideation in this vulnerable population.
• Findings will inform the development and implementation of scalable suicide prevention strategies for community-based agencies serving YEH.