Suicide Prevention Programming Across Ecological Levels: Recommendations From Latinx Immigrant Origin Youth and Their Parents.

Introduction: Latinx immigrant-origin youth (IOY) have unique risks for suicidal thoughts and behaviors. It has been suggested that these risks should be addressed from an ecological perspective, addressing cultural and family context as well as structural and systemic barriers to prevention. This study sought to explore perspectives of immigrant-origin Latinx adolescents and their caregivers on suicide and its prevention, including the potential impact of stressors specific to immigrant status. Method: Focus groups were conducted in 2018–2019 with Latinx immigrant-origin caregivers (N = 41, 97.5% female) and adolescents (ages = 14–19, N = 56, 50% female). Participants were recruited from community-based organizations in two different cities. A codebook approach to thematic analysis was used to identify themes, which were subsequently mapped onto levels of the Center for Disease Control's Social-Ecological Framework for Violence Prevention. Results: Participants identified both contributors to suicidal behavior and potential components of prevention programming across ecological levels. Specific recommendations for suicide prevention included engaging in recreation, parenting education and support, enhancing academic supports for adolescents, and enhancing school–family communication. Structural barriers (e.g., caregiver work schedules) to implementing recommendations were described. Discussion: Our results highlight the potential role of access to school and community-based supports as public health-oriented suicide prevention strategies and suggest a need to address barriers faced by immigrant families in accessing these supports alongside addressing barriers to mental health treatment. Policies impacting immigrant families' financial stability and increasing the availability of recreational and academic opportunities may promote mental health and prevent suicidal thoughts and behavior among IOY. Public Significance Statement: This study highlights actionable recommendations from immigrant-origin Latinx youth and their caregivers for community-based suicide prevention programming. Results suggest a role for upstream interventions targeting positive youth development, caregiver–child communication, school-based supports, and neighborhood resources. [ABSTRACT FROM AUTHOR]