Family network satisfaction moderates treatment effects among homeless youth experiencing suicidal ideation

Objective: Limited research has evaluated the efficacy of suicide prevention interventions among homeless youth, especially considering how their connectedness with their family would impact treatment outcomes. Method: Suicidal homeless youth (N = 150) between the ages of 18-24 years were recruited from a local drop-in center. Youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or Treatment as Usual alone. Youth reported their family network satisfaction at the baseline assessment, whereas their suicidal ideation, perceived burdensomeness and thwarted belongingness were assessed at baseline and three additional times during a nine-month period. Results: A multiple-group autoregressive cross-lagged model suggests that CTSP was associated with lower suicidal ideation and lower thwarted belongingness only among those with high family network satisfaction. Among both groups, perceived burdensomeness predicted higher suicidal ideation, which in turn predicted lower perceived burdensomeness and thwarted belongingness. Additionally, only among youth with low family network satisfaction, thwarted belongingness predicted lower suicidal ideation. Conclusions: Findings suggest that family network satisfaction may be an important factor when considering cognitive interventions with homeless youth, with implications to improve treatment efforts and to reduce premature mortality, hospitalization and loss of human capital in a very high-risk population.