1 - (SYM 121) Barriers and Facilitators to the Implementation of Suicide Prevention in Juvenile Detention Settings: A Contextual Inquiry

Abstract Body
Suicide is the second leading cause of death in youth. Specifically, juvenile justice-involved youth are 3-4 times more likely to experience suicidal behaviors compared to their non-systems involved peers. With rising suicide rates in Black youth, implementation of evidence-based suicide prevention in juvenile settings is crucial to support Black youth who are at increased risk and to ensure existing disparities in mental health are not exacerbated. A statewide evaluation of suicide prevention in juvenile detention centers found that quality of implementation of suicide prevention was highly variable and poor on average (Rudd et al., 2024). Given the poor quality of implementation of suicide prevention, contextual inquiry is warranted to identify the contextual factors impacting the implementation of suicide prevention in juvenile justice settings in order to improve implementation quality. Thus, the objective of the current study is to identify stakeholder-perceived barriers and facilitators of implementing suicide prevention in juvenile detention settings. Additionally, we sought to identify where in the context the strongest barriers to and facilitators of implementing suicide prevention in juvenile detention exist.

Semi-structured interviews focused on the current contextual determinants of implementing suicide prevention were conducted with various stakeholders (N=13) from 10 juvenile detention centers in a Northeastern state. Given the diversity of positions the legal stakeholders hold in detention centers, ranging from the director of the facility to case managers, in-depth qualitative data was collected on the perceived barriers and facilitators of implementation of suicide prevention programming in their facility. Data are being analyzing using a hybrid inductive-deductive coding approach informed by the Exploration, Preparation, Implementation, and
Sustainment framework (EPIS; Aarons et al., 2011) and valence ratings (Damschroder et al., 2022). Preliminary results suggest that a lack of access to behavioral health clinicians within detention and within the outer context is a barrier to suicide prevention. Results will be ready by the November convention.

Our study will identify contextual determinants of suicide prevention in juvenile detention. Findings will inform future initiatives to improve the implementation of suicide prevention in juvenile detention settings and minimize existing health disparities within juvenile justice settings for at-risk youth.