Understanding Youth Suicide Risk Through Changes in Protective Strength Factors

Adolescent suicide remains a critical public health concern, with rates continuing to rise globally. This study examined the role of strength development in mitigating suicide risk among youth receiving behavioral health services. Utilizing administrative data from a Midwestern state's behavioral health authority, the study analyzed 391 adolescents aged 13-19 years (M = 16.34, SD = 1.51), including 244 girls (62.4%) and 147 boys (37.6%), who presented with recent suicidal ideation or behavior. Strength indicators included family strengths, interpersonal skills, optimism, educational support, vocational skills, talents and interests, spiritual or religious strengths, community involvement, relationship permanence, youth involvement in care, and natural supports. Latent Profile Transition Analyses identified two distinct strength groups: "usable strengths," representing readily accessible protective factors, and "buildable strengths," representing strengths requiring further development. Findings indicated that adolescents who transitioned from buildable to usable strengths experienced significantly lower suicide risk. Youth who maintained usable strengths across treatment also demonstrated substantially lower odds of suicide risk. Longer treatment duration was associated with lower suicide risk, whereas shorter treatment stays corresponded with elevated risk. Logistic regression analyses confirmed that maintaining or developing strengths related to social relationships, community connections, and supportive environments served as significant protective factors. These findings underscore the importance of integrating strength-based, relationship-centered, and community-informed approaches into behavioral health services to support resilience and reduce suicide risk among adolescents.