Life Is Precious: Culturally-Responsive Interventions for Latina Adolescents at Risk of Suicide

Background and Purpose: The increasing prevalence of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents requires greater attention to promising stakeholder-informed, culturally-responsive, community-based interventions. Life is Precious (LIP), a treatment-adjunctive afterschool-model program, was designed to provide creative arts therapy, educational supports, family and wellness support, and case management to Latina adolescents experiencing STBs. This quasi-experimental pilot study explored the impact of LIP on clinical and school-related outcomes.The 12-month study explored the impact of LIP on suicidal ideation, depressive symptoms, class grades, and school functioning.

Methods: Latina adolescents ages 12-18 who were newly enrolled in LIP and receiving outpatient treatment (n=31) were compared with those in usual care (UC) receiving outpatient treatment only (n=12). The Suicidal Ideation Questionnaire (SIQ), Patient Health Questionnaire-9 (PHQ-9), class performance (mean grade), and school functioning (Youth Social Adjustment Scale) were administered longitudinally. Longitudinal linear mixed models were used to estimate intervention effect sizes, and exact logistic models were used to calculate adjusted risk ratios for SIQ-25%, SIQ-50%, and 5-point PHQ-9 clinically significant improvements.

Results: The direction of the estimated impact of LIP was toward greater reduction in suicidal ideation and depressive symptoms, and greater improvement in mean grades and school functioning, compared to UC, with small-to-moderate but nonsignificant effect sizes (0.19-0.51) favoring LIP. Additionally, almost twice as many LIP participants compared to UC achieved clinically significant improvements on the SIQ and PHQ-9, and were significantly more likely to avoid failing a class when measured as a categorical outcome.

Conclusion and Implications: The positive impact of LIP on clinical and school-related outcomes offers preliminary support for this treatment-adjunctive community-based program to supplement outpatient mental health treatment and improve outcomes. Additional research is needed to further evaluate its effectiveness in reducing STBs and improving school-related outcomes among Latina adolescents, as well as to explore factors that may influence program effectiveness.