An Examination of the Florida Linking Individuals Needing Care Coordination Program for Racial and Ethnic Minority Females

Background and Purpose: Suicide accounts for close to 800,000 deaths each year, making it one of the leading causes of death in the United States. Currently, it is the 2^nd leading cause of death among young people ages 15-29, claiming more lives than homicide. Among Black and Hispanic youth (10 to 24), it is the 2^nd and 3^rd leading causes of death. This study examined the extent to which depression and suicidality outcomes change among racial and ethnic minority females (i.e., Black and African American, Hispanic) who participated in a care coordination intervention. This study also assessed whether participation in the care coordination program reduces re-admission rates of inpatient hospitalization. Further attention was given to the impact of age and length of stay on treatment outcomes (depression symptomology, suicidality, and readmissions). These subpopulations were chosen due to limited suicide prevention research on at-risk racial and ethnic minority females and to address health disparities.

Methods: This study employed a one-group pretest-posttest design utilizing secondary data from 76 youth participants enrolled in the care coordination program from three crisis stabilization units (CSU) in Florida. Almost 58% of the sample identified as African American or Black and 42% identified as Hispanic. Their mean age was 14.63. The baseline measure and posttest measure captured patient symptomology scores from the Patient Health Questionnaire (PHQ-9) and the Columbia-Suicide Severity Rating Scale (C-SSRS). To examine changes in depression symptomology, suicide risk, and readmission rates, an analysis of the data was conducted utilizing descriptive and bivariate statistics (e.g., paired sample t-tests). Further analyses were conducted using multivariate analysis of covariance (MANCOVA) and logistic regression to examine if age and length of stay influenced treatment outcomes.

Results: Key findings included significant decreases in depression symptomology (54%) and suicidality (82%). Of those enrolled in the program, 84% did not have a readmission to the CSU. Length of stay was a predictor of readmission in that a one unit (one day) increase lead to a 3% increase in odds of readmission to the CSU. Further exploratory analysis revealed that Black females had higher depression and suicidality scores than Hispanic females.

Conclusion and Implications: Results of this study can guide the design and implementation of community-based suicide prevention programs for racial and ethnic minority females. The significant decrease in depression symptomology and suicide risk at posttest suggests that components of the intervention (i.e., enhancing protective factors and therapeutic alliance) are important for improving mental health outcomes. The low readmission rates suggest that intense engagement during follow up is critical in reducing suicide risk and preventing rehospitalization. The difference in depression and suicidality scores between the multicultural group of females justify the need to further explore the intersection of gender and race on suicide risk factors and outcomes. This study highlights the importance of culturally responsive suicide prevention and interventions to meet the unique needs of multicultural youth populations.