1 - (IOP 22) Enhancing Culturally Competent Suicide Care: Lessons Learned and Adaptations to a Brief Crisis Care Intervention for Youth with Suicidality

Suicide is a leading cause of death among young people and there is a dire need for effective interventions to reduce suicidal thoughts and behaviors. While research on suicide care is growing, a major remaining gap in suicide care is that most interventions fail to adequately consider cultural factors that may influence intervention engagement and outcomes. Different communities and cultures have unique views and language around mental health and suicide. However, suicide care interventions have typically been developed without substantial consideration of cultural influence and may be stigmatizing to patients and families from diverse communities who hold different beliefs and views of mental health, suicide, and the role of mental health treatment providers.

When working with patients and families who have experienced suicidality, it is imperative that clinicians seek to understand how the patient’s background and culture impact views, perceptions, and goals for treatment. As presented in the Cultural Model of Suicide (Chu et al., 2022), cultural background can influence stressors leading to suicide, the meaning associated with these stressors, and the expression of suicidal thoughts and overall distress. Unfortunately, consideration of these cultural factors is often missed in the delivery of brief, outpatient crisis interventions.

This presentation will first describe the Seattle Children’s Hospital Crisis Care Clinic (CCC) model. The CCC is a brief, outpatient stabilization program that uses the Collaborative Assessment and Management of Suicidality (CAMS; Jobes, 2006) to facilitate therapy with youth and caregivers for up to 4 sessions before transitioning to longer-term care. Following this, we will review case examples of two youth and families seen for suicidal thoughts and behaviors in this clinic. First, we will describe a case of an 11-year-old female patient who identified as a refuge from the Middle East seen for suicidal ideation in which limited adaptations to the treatment procedures were made. We will discuss clinician and intervention pitfalls, challenges, and lessons learned from implementation. Next, we will discuss a second case of a 16-year-old female patient, also originally from the Middle East, who was seen following a suicide attempt. We will discuss how we applied lessons learned from the first case to adapt the intervention, as well as additional challenges and lessons learned. Finally, we will discuss suggestions for improvement for culturally competent care when providing suicide care for diverse patients and families, in addition to how the CAMS intervention could be implemented within the context of cultural models of suicide.