Factors associated with long-term suicide risk severity among youth in community behavioral health care.

PURPOSE: We aimed to identify factors associated with long-term suicide risk severity among youth who received treatment in a community mental health setting.

METHOD: Participants were 100 adolescents who began outpatient behavioral health services between 2017 and 2019 (Initial Treatment) and completed a follow-up survey approximately five years later in 2023 (Survey). Suicide risk severity was measured by the Computerized Adaptive Test-Mental Health (CAT-MH) at time of Survey. Covariates included EHR-based sociocontextual, diagnostic, and service-related information at time of Initial Treatment, self-reports of social determinants of health and treatment experiences retrospective to time of Initial Treatment, and the frequency of behavioral health treatment sessions (≥4 vs <4 visits per 3-month quarter) during Initial Treatment. Exclusive LASSO and ordinary least square regressions identified covariates and estimated associations between covariates and suicide risk severity. We also tested interactions between treatment frequency and treatment experiences.

RESULTS: Emergency department use had a significant association with longer-term suicide risk severity.

DISCUSSION: Emergency department use, and its associated significant illness severity, may be associated with increased suicide severity risk for youth even multiple years later. Further research on the interaction between frequency of treatment and patient perceptions of care on future health outcomes would be valuable.