Abstract
Background: Addressing suicidal behaviors (i.e., ideation or thoughts, planning, or attempt) among youth is increasingly complex and often requires a comprehensive and integrated approach to care. Integrated youth services (IYS) are a growing model of care in which youth can access a range of non-stigmatizing health and social services all delivered within a single location. In British Columbia (BC), Foundry is one of the largest IYS networks in Canada. To date, little is known about the demographics and help-seeking behaviors among youth experiencing suicidal behaviors in IYS. In this study, we examine service patterns and characteristics of youth reporting suicide ideation to better understand and address their IYS care needs.
Methods: We used cross-sectional data from Foundry from May 2018 to January 2023, which includes linked demographic, health, and physician-reported survey data aggregated from 13 IYS centres across BC. Survey data is collected during an initial visit to Foundry. Descriptive statistics and bivariate analyses by various demographics, geographic, and service use variables were compared by youth who reported having suicide ideation (SI) within the ‘past month’ of their visit as compared to youth who reported ‘never’ having SI. Standardized differences (SD) were calculated to determine statistical significance between groups. We examined the proportion of youth reporting SI coming to Foundry by month over the study period. We also examined these trends by certain subpopulations such as gender, sexual identity, race, and age group.
Results: A total of 8,347 individuals were included in the study. Of this sample, a total of 6,021 (72%) had reported any lifetime SI. A total of 2,975 (36%) individuals reported having SI in ‘the past month’. We found that youth experiencing SI were more likely to be gender diverse (13% with SI vs. 4% without SI), identified as sexual minorities (45% vs. 22%), Indigenous (11% vs. 8%), insecure housing (8% vs. 4%), and reported as having ‘not always lived with their parents’ (42% vs. 30%) as compared to youth who never had SI. On average, youth reporting SI in the past month had more contact with Foundry services than those without SI (9.1 vs. 5.5 visits), and had accessed other mental health services in the last year (43% vs. 21%). Youth with SI in the past month also had higher distress scores (as measured by the Kessler Psychological Distress score), with 77% having a score over 30 (i.e., ‘likely to have a severe mental health disorder’). We found no substantial change in the overall proportion of youth reporting suicide ideation over the study period, but trends by subpopulations revealed slight increases in the proportion of ‘past month’ suicide ideation among girls and visible minority groups in the last 1-2 few years.
Discussion: Many youth seeking IYS services reported having suicide ideation (or thoughts), particularly within the past month of the visit, indicating a major opportunity for low-barrier, early intervention. Our findings characterize those who may be disproportionately impacted and their current help-seeking behaviors within IYS to identify service gaps and needs for targeted intervention.