Adult Outcomes of Youth Suicide Prevention: In Their Own Words

Recent findings corroborating the positive long-term effects of preventive intervention in youth have energized the field of preventive intervention, and reinforced the value of focused, early life intervention.  While understanding long-term effects of any intervention is advantageous to public health, it is particularly so for the health of young persons who were formerly at risk of suicide.  However, following youth who have struggled during adolescence into adulthood offers many challenges related to both participant status and research methodology, limiting the number of such longitudinal studies.  Along those lines, non-intervention studies of early adverse experiences may claim that their findings have implications for preventive intervention, but are nonetheless limited by the lack of an actual intervention to examine.  In this study, we sought to investigate those implications by interviewing young adults who had been participants in a targeted suicide prevention program found to be both acceptable to participants and effective at reducing risk.   Young adults who were former adolescent participants in a suicide prevention program were asked about their experiences during and after the intervention, as well as about their conclusions regarding their critical ‘life changing’ experiences.

615 youth, identified as suicide vulnerable, participated in the Promoting CARE suicide prevention program and were followed for five years.  At age 21, over 400 former participants completed an adult survey regarding psychosocial status, risk behaviors, coping and support and their achievement of adult markers, followed by an in-depth interviews. The interviews, grounded in life calendar method, explored in depth events, moods, risk behaviors, support and mental health over the five to seven year period.  Results. Using growth mixture modeling, four distinct trajectories from pre-intervention to young adulthood were determined for depression and two for suicide risk.  Participants were sampled from each of the six trajectories to participate in an in-depth interview.    Examining both quantitative and qualitative data, preliminary analyses identify key events that not only affected the course of the intervention outcomes, but events that affected the course of life from intervention to adulthood.  Important among negative factors were exposure to trauma, including physical harm, sexual abuse and witnessing of violence or victimization behavior.  Positive influences included activating support networks, family involvement, and specific coping abilities.  Conclusions.  Adult interviews of former at-risk youth provide insight into how early intervention and specific life events account for later well-being.