Comparisons of Suicidality in a Community Sample Including Adolescents with a History of Foster Care Involvement

Background: Evans et al. (2017) meta-analysis pointed to higher risk for suicidality among system involved youth but called for more research. This study involved a broader sample of young people (ages 14-24) all of whom had experienced some form of adversity including child welfare involvement in the past or present. We used baseline data from a larger intervention study to help vulnerable youth reduce high risk sexual, interpersonally violent and suicidal behavior. We added the suicide prevention module to the evidence based, Love Notes, curriculum intervention after a collaboration with youth to expand skills needed for well-being. This analysis sought to explore differences at baseline in suicidal thoughts and behaviors (STBs) between youth who had a past or current experience of out of home care (OOHC) with a matched sample of youth with no state involvement.

Methods: This sample of youth were affiliated with residential and community-based organizations serving system-involved and impoverished youth who completed the baseline and follow-up surveys and intervention. In this sample of youth (N=507), 34.12% had past or current experience with OOHC. Seventy-eight percent were Black or other races, 60% identified as female, 22.5% were LGBQ and 3.61% identified as nonbinary or transgender. Suicidal thoughts and behaviors were measured by using a modified version of the Columbia Suicide Severity Rating Scale (Posner et al., 2008). Youth were asked about their desire to die as well as suicidal ideation, planning, intent, and attempts in the past month and ever in their life. Chi-square analyses were run to examine differences in STBs in youth with past or current experience of OOHC and youth without state involvement.

Results: The initial analysis reveals differences in STBs for youth with past or current experience of OOHC and youth without state involvement. For youth in this sample, in their lifetime 42% had experienced a desire to die, 35% had suicidal ideation or had planned to die by suicide, 29% had ever intended to die by suicide and 26% had ever attempted suicide. System involved youth were significantly more likely than other youth to have had the desire to die (58% vs 34%), Chi Square = 25.49, p < .001, suicidal ideation (51% vs. 27%), Chi Square = 24.81, p< .001; developed a plan (48% vs. 28%), Chi Square 18,75, p < .001; had an intention to die (43% vs. 21%), Chi Square = 26.07, p < .001 or made a suicidal attempt (40% vs. 18%), Chi Square – 25.79, p < .001.

Implications: The findings confirm studies that find that system involved youth are at higher risk for suicidality but expands on previous research by comparing those with both past and current involvement from ages 14-24 to another highly oppressed and traumatized group of youth. More analyses will be conducted to assess system involved youth response to the intervention. This study is a testament to the importance of involving young people through collaboration in developing interventions aimed at giving them tools for empowerment.