Optimizing the Zero Suicide Model for Juvenile Detention

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PROJECT SUMMARY/ABSTRACT This K23 Career Development Award will prepare the applicant to launch her career as an independent investi- gator with expertise in research at the intersection of implementation and mental health equity research, with a specialization in legal settings that serve youth, consistent with NIMH Strategic Objective 4. The University of Illinois at Chicago (UIC), under the expert mentorship of Drs. Marc Atkins, Jaleel Abdul-Adil, Lisa Saldana, and Greg Brown, is the ideal environment for the applicant’s career development. Faculty conduct extensive imple- mentation research with the goal of promoting youth mental health equity and have strong connections to the Chicago Department of Public Health and the NIH-funded UIC Center for Clinical and Translational Sciences. Training goals include: (a) foundational mental health equity research, (b) advanced implementation research, and (c) specialized training in suicide prevention research and practice. The research component of this appli- cation was developed to complement the training goals and provide opportunities to execute and refine newly developed skills. The research plan addresses the critical need to prevent suicide among youth in juvenile jus- tice settings. Youth in juvenile detention centers experience suicidal ideation at higher rates than their peers, and juvenile detention centers disproportionately serve African American and Black youth, a group experienc- ing an increase in suicide attempts nationally. Aligned with the Zero Suicide model, the applicant will optimize the clinical and implementation elements used within juvenile detention centers (i.e., screening, pathways of care, and brief treatment of suicidality via the Safety Planning Intervention). As the applicant’s goal is to be- come an expert in the implementation of a range of evidence-based practices for legal settings that serve youth, studying suicide prevention, given its large research base of evidence-based practices and its complex regulatory concerns, provides the ideal training platform. In Aim 1, formerly detained young adults (n=35) who identify as Black will be interviewed to understand their lived experiences and identify key barriers to and facili- tators of suicide prevention in juvenile detention. In Aim 2, using data from the applicant’s prior work and Aim 1, the applicant will refine the Zero Suicide clinical elements for detention to ensure they are culturally respon- sive and contextually appropriate and select and operationalize the implementation elements. In Aim 3, the ap- plicant will pilot the feasibility of the Zero Suicide model and R01 method in two local detention centers using a stepped wedge design and a convergent mixed method. The aim is to demonstrate the feasibility of the clinical and implementation elements as well as the recruitment, retention, and data collection procedures. This project will provide the necessary data and skills for the applicant’s future R01 hybrid type 2 effectiveness-implementa- tion trial of the Zero Suicide model for juvenile detention. The timing of this proposed study is critical. Prevent- ing youth suicide is a national priority, and NIMH has pledged to reduce the suicide rate by 20% by 2025 and has a special interest in research on risk and prevention of Black youth suicide (NOT-MH-20-055).