Long-term stability of suicidal ideation among young adults residential care leavers: a prospective 10-year study

Juveniles in residential care systems have high rates of suicidal ideation (SI). This study aims to expand knowledge of the prevalence and stability of SI, as well its associated factors among young adult care leavers.

Swiss juveniles in residential care (N = 179; non-Swiss origin: 12,29%; N = 22) were followed up into young adulthood (34% female/66% males; Age_Baseline (16.41, 2.86, 11-16); Age_Follow-Up (26.64, 3.22, 20-38 years)). SI was assessed at baseline and 10-year follow-up. Statistics included descriptives, proportion of enduring cases (categorical mean-level stability), tetrachoric correlation (Rtet; categorical rank-order stability), χ²- and Kruskal-Wallis tests (to test differences between SI pathways), and multinomial logistic regression analyses (RRR; to investigate risk and protective factors for SI pathways).

SI prevalence was 45.25% (baseline) and 31.84% (follow-up). Females showed higher rates. SI appeared moderately stable (43.2%) with higher estimates in females. Participants with remitted and persistent SI experienced more NSSI, internalizing/ externalizing symptoms, lower self-directedness, and lower quality of life than those without SI. Higher self-directedness, cooperativeness and quality of life predicted a lower likelihood of persistent SI.

Results suggest a higher risk and moderate stability of SI for young adult care leavers. Residential care practitioners should watch for risk factors, especially among females, and encourage self-directedness and cooperativeness.