Safe Alternatives for Teens and Youth: A Community Partnership for Suicide Prevention

OBJECTIVES:
1. To identify the variation of YSPP implementation across high schools in the Los Angeles Unified School District.
2. To examine how the variation of YSPP implementation is related to the key dimensions of the school environment.
3. To explore how the dimensions of the school environment facilitate and impede the implementation of the YSPP.
4. To explore how the YSPP may be undergoing reinvention and how the dimensions of the school environment are associated with reinvention.

METHODS: To study factors affecting the implementation and reinvention of the school suicide prevention program, we propose using quantitative and qualitative research methodologies. First we plan to evaluate a unique resource, the records generated by the YSPP that document all the suicide crisis interventions conducted in LAUSD high schools in the most recent 2 years, to examine implementation of the YSPP across all high schools in the district. We will then interview key informants including school administrators, crisis intervention staff, and teachers to develop a richer understanding of how this program is being implemented in high schools across the district, what types of reinvention may be occurring, and what the barriers to appropriate implementation of the program are. Key dimensions of the school environment that we will explore that likely play a role in implementation of this program will include: 1) characteristics of the YSPP intervention (complexity, relative advantage, compatibility), 2) characteristics of the service system in which the school resides (linkages to community mental health services, financing, impact of legal mandates), 3) characteristics of the school's organization (e.g. structure, climate, culture, norms, policies, resources), and 4) characteristics of the students and families who are engaged by the program (prior mental health problems, socio-demographic characteristics, insurance status, parent engagement and participation in the process).

FINDINGS/RESULTS: Our preliminary findings show that strong administrative support and having large numbers of school personnel aware of an organized system and process for responding to students in crisis consistently distinguished between those schools that appeared to be responding well to the needs of students at-risk for suicide and those schools not responding well. The importance of having an effective school level crisis response process to meet the needs of students at-risk of suicide was another point emphasized by participants from all schools. Knowledge of the process wasn't limited to individuals who would play active roles in intervening with at-risk students; teachers and administrators also appeared to be familiar with how the school would respond to students at-risk of suicide. In contrast, even individuals who were responsible for actively intervening with at-risk students in poorly responding schools discussed the absences of a systematic response.

STATUS: We are in the process of preparing a manuscript for publication outlining our findings in these high schools and recommendations for improvement efforts of this program and future research needed. In addition, because of our earlier findings in looking at administrative data from the YSPP that showed the implementation of this program also occurring in middle schools as well as high schools, we have obtained a supplemental grant to evaluate the implementation of this program in the middle school population through focus groups with a wide variety of school staff. This additional study will be assessing what organizational factors may be different in middle school compared to high schools in the implementation of the YSPP and what unique needs middle school students may have from the perspective of school staff. The results of those focus groups are currently being analyzed.

IMPACT: These studies will result in a better understanding of which factors, in the multitude of potential school environmental factors, most significantly influence the implementation and re-invention of the YSPP in LAUSD. Understanding the key domains that facilitate or impede implementation is an important first step in a research agenda designed to improve a school-based youth suicide program across a large and diverse public school district.