Using Implementation Outcomes to Inform Implementation of Suicide Risk Screening with Juvenile Legal-Involved Youth: Considerations for Task-Shifting Suicide Screening to Juvenile Legal Staff

Abstract

Background: Youth in the juvenile legal system (JLS) are at increased risk for suicidal thoughts and behaviors. Objective: Examine the acceptability, feasibility, and appropriateness of imbedding suicide screening and intervention in the JLS. Method: The current study involved formative semi-structured interviews with key JLS stakeholders (n = 37) from two states, one in the Northeast and one in the Midwest, to determine whether suicide screening and intervention could be integrated into the role of juvenile probation officers. Stakeholders discussed perspectives on the acceptability (perceived JLS staff comfort with suicide screening and a brief intervention), feasibility (improving comfort of staff, youth, and families), and appropriateness (perceived impact on youth and families). Results: Qualitative data suggested acceptability of suicide screening was mitigated by staff comfort and perceived support of available clinical resources. Feasibility of improving staff comfort to conduct suicide screening and a brief intervention revolved around logistical, training, and supervisory support. Barriers to the appropriateness of suicide screening and intervention with youth in the JLS suggest concerns about how youth's distrust of the JLS and mental health stigma might impact engagement in suicide screening and intervention efforts. Discussion: We conclude with implementation strategy considerations to enhance successful suicide screening and intervention by JLS staff.