Outpatient mental health treatment initiation and response in at-risk youth after suicide screenings.
Suicide screening programs have dramatically expanded over the past two decades, partially due to government support of screening initiatives. However, little is known about the outcome of suicide screening programs, particularly in relation to youth mental health treatment utilization and treatment response over time, as only a handful of studies of screening programs have included follow-up components. This follow-up study of school-based screening programs in a large sample of high school students (N = 2,342) sought to identify psychosocial and treatment-related predictors of outpatient treatment initiation following the screening. Follow-up occurred approximately two years after the screening programs first identified 317 youth as at-risk for suicide and subsequently informed parents and, in most cases, provided treatment recommendations. This study targeted psychosocial and treatment-related predictors of treatment initiation and response among a subset of youth who were not already receiving mental health services at the time of the screening (N = 151). The findings indicate that youth exposure to suicide attempts or deaths among immediate or extended family members doubled the odds of treatment initiation, while the provision of a specific referral (i.e., recommendation of one or two providers) from the screening program tripled the odds of treatment initiation. Further, a specific referral also increased the likelihood of timely treatment initiation. A greater number of recent stressful life events predicted poorer clinical outcomes at follow-up, but contrary to expectation, treatment initiation also predicted poorer outcomes. The reasons for this counterintuitive finding remain unclear, and warrant further research in the important area of the effectiveness of youth mental health treatment out in the community.^