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Systems-Level Interventions for Detecting and Preventing Suicide and Suicidal Behavior in At-Risk Youth


Denise Juliano-Bult, M.S.W.
Division of Services and Intervention Research

Crystal Barksdale, Ph.D., M.P.H.
Office for Disparities Research and Workforce Development


This initiative aims to support the development and testing of systems-level interventions targeting high-risk youth to reduce or prevent suicide and suicidal behavior in these populations. Populations identified with high suicide risk and high unmet service need include but are not limited to: youth in public service systems, racial/ethnic minority youth, sexual and gender minority (SGM) youth, rural youth, and youth with intersectional risk. Relevant settings include but are not limited to: education or training programs, housing programs, juvenile justice, and child welfare.

Systems-level strategies should include coordination and collaboration within or across youth-serving systems and programs to enable risk identification and access to and rapid engagement in quality treatment, services, and preventive interventions. Such strategies should also account for individual- and provider-level factors to optimize 1) effectiveness, 2) feasibility, 3) rapid uptake, 4) implementation, and 5) sustained delivery, thereby accelerating benefit to vulnerable populations. These strategies should employ connection to preventive interventions with proven effectiveness in reducing suicidal ideation, suicide attempts, and death by suicide, to make these more broadly available to targeted populations, more easily accessed, more effectively delivered, and sustained in a coordinated way. This initiative would encourage services research on the effectiveness-implementation continuum to develop and test easily implemented approaches that foster systematic risk identification followed by coordinated referral and engagement in quality care to prevent suicide.


Consistent with the goals of the National Action Alliance for Suicide Prevention, NIMH seeks to support research on strategies designed to reduce the rate of suicide in the U.S. by 20% by the year 2025. Of note, suicide is the second leading cause of death for youth aged 10-24 years, and certain subgroups of youth are at significantly elevated risk. To realize the national suicide prevention goal, effective suicide prevention strategies targeting high-risk groups must be rapidly brought to scale, bridging the well-documented research-to-practice gap and designed to enhance the feasibility of implementation and acceptability to individuals, providers, settings, and systems that will deliver or receive care. This will include incorporating salient contextual and cultural factors that represent barriers or facilitators to the receipt of effective suicide prevention treatments and services.