Cognitive Therapy for Suicide Prevention: A Randomized Pilot with Suicidal Youth Experiencing Homelessness

Homeless youth have extremely high rates of suicidal ideation and attempts, but limited research has evaluated the efficacy of suicide prevention interventions. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a local drop-in center. Of interest was (1) whether the proposed sample of eligible youth could be identified, (2) whether youth could be engaged and retained in the prevention intervention, and (3) whether the intervention was associated with reduced suicidal ideation, our primary outcome measure. In particular, youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) (N = 75) or TAU alone (N = 75). Findings showed that the proposed sample of eligible youth could be identified and engaged in the study, and all youth showed a significant decline in suicidal ideation over time, with a faster decline among youth assigned to CTSP. These findings suggest that (1) at-risk suicidal youth can be identified and engaged outside of hospital emergency rooms, such as in drop-in centers, and (2) intervention added to TAU can strengthen reductions in suicidal ideation. Ultimately, attention towards reducing suicide risk among these youth has the potential to reduce premature mortality, hospitalization and loss of human capital.