InVita Research Program Examines Treatment for Suicidal Behavior Among Hispanic/Latinx Youth
Yovanska Duarte-Velez, PhD, a child and family psychologist at Bradley Hospital, is conducting research into effective treatment for suicidal behaviors in Hispanic and Latinx teens.
Suicide among youth is a global health problem, not only because of the lives lost, but also the pain and suffering inflicted on peers, family members, and the community.
According to a national survey, the Youth Risk Behavior Surveillance conducted by the federal Centers for Disease Control, around one of 10 high school students attempts suicide every year, two of 10 seriously consider suicide, and three of 10 feel depressed and hopeless.
Through the years, Hispanic/Latinx youth have disproportionately experienced depressed and hopeless feelings, and at times have been at higher risk of suicide attempt than their peers. Females and LGBTQ+ youth have been the most at risk for depression and suicide attempts, while males die more often of suicide than females.
A significant concern is the lack of scientific information about which psychosocial treatments work best for Hispanic/Latinx youth who exhibit suicidal behaviors.
Hispanic/Latinx Youth, Their Families, and Some of Their Challenges
Hispanic/Latinx families are diverse, based on their country of origin and socioeconomic status. However, many come to the United States looking for a better way of life or perhaps trying to escape violence and trauma. They confront several challenges relating to their culture and their time in the United States.
First-generation families are those in which both the child and the parent were born in a Latin country and second-generation are those in which the child was born in the United States and the parents were born elsewhere. Third-generation families are those in which the child and the parents were born in the United States but have ancestors from a Latin country and identify themselves as Hispanic/Latinx.
First- and second-generation families must adjust to a new culture, and many times experience acculturation conflicts between the child and the parents. Frequently, parents cling to their native culture while their children, as they grow and learn in the United States, identify more with American culture. These differences in cultural values may create tension between them that leads to conflict.
Language is a common barrier to medical treatment for many immigrant families because it is harder for those with limited English proficiency to navigate and connect with the health care system.
Furthermore, language could become a factor of disconnection between family members. In some cases, teens master the English language, but have little Spanish fluency, while their parents have little or no English proficiency.
Additional challenges that confront many families are discrimination, lack of resources due to poverty, violence, and alienation from quality health care services, among others.
Results from a Pilot Randomized Clinical Trial
The InVita research program conducted the first pilot randomized clinical trial (RCT) in the United States to compare two treatments in a community setting for Latinx youth who had a recent suicidal crisis.
The study was done in collaboration with the home-based program at Gateway Healthcare, a Lifespan affiliate. One group received treatment as usual (TAU) and the other a culturally centered CBT, the socio-cognitive behavioral therapy for suicidal behaviors (SCBT-SB). Forty-six teenagers were recruited from psychiatric inpatient, partial hospitalization, and emergency department services in Rhode Island and followed over time.
Both treatments yielded significant reductions in depressive symptoms and suicidal ideation. However, SCBT-SB achieved better outcomes than TAU at the one-year follow-up on reducing depressive symptoms and preventing suicide attempts.
The main outcome was a validation of the need to do a larger-scale trial to test if the findings of the pilot study could be replicated. To answer this question, a full RCT is currently taking place. Results from this study [the pilot study?] will be published soon in a peer-reviewed journal.
Current Research: A Randomized Clinical Trial
The InVita research program is currently enrolling participants for a randomized clinical trial.
The study is recruiting Hispanic/Latinx youth from 12 to 17 years old who have attempted suicide within the last two months or are currently experiencing severe suicidal ideation. After screening possible participants and completing assessments, the youth will be randomly assigned to TAU or SCBT-SB.
Both treatment options are delivered through the home-based program of Gateway Healthcare clinic. Treatment could represent a step down after a psychiatric inpatient or partial program or a step up for someone needing more intense care, coming from outpatient therapy, due to an increase in suicidality.