• By Laura Whybra
  • Posted on Monday 27th October, 2014

Can HOPE help with youth suicidal thoughts?

strong>Many homeless young people think about suicide. Does working with them and their parents on communication, parenting, and stress management make a difference? A recent study of 11-14 year olds in New York City finds that it might.A large part of the US homeless population consists of families with children and teenagers. The parents show high rates of mental health problems and substance abuse. They are most likely to be single mothers, and their experience in emergency shelters and other temporary housing is, in many cases, characterized by high risks of durable poverty, domestic violence, and increased involvement with the child welfare system.It’s a big problem. By some calculations, there are more than 150,000 homeless children in the country. Because of the challenges that families face in shelters, there is much concern about how such conditions affect young people’s way of thinking about their lives.Young people who experience homelessness are more likely to consider self-harm and suicide than their peers. So a study by New York-based researchers tested whether a program that aims to teach parenting and communication skills to homeless parents would reduce the prevalence of suicidal thoughts amongst sheltered youth living with their families. The results, although based on a small sample of only 28 early adolescents, were encouraging. Youth in the two-month family program were much more likely to report a decrease in suicidal ideation than those who received only health education. The HOPE studyHIV Outreach for Parents and Early Adolescents (HOPE) is a study conducted in New York City that sought to prevent risk-taking behavior among early adolescents who lived with their families in shelters. HOPE uses two prevention strategies.One strategy, HOPE Family, focuses on improving family functioning such as parenting practices, monitoring, and parent-child relationships. This program runs for eight weeks, for one hour each week. It involves both separate and joint sessions with parents and children. The second strategy, HOPE Health Educational Program, runs for three two-hour sessions. In separate groups, caregivers and youth receive information about preventing sexually transmitted infection, the effects of substance abuse, and meaningful developmental periods during adolescence. The larger study involved more than 200 urban parents and their school-aged children living in the city’s family homeless shelters. The shelters were randomly assigned either to the HOPE Family Program or to the HOPE Health Educational Program. The current study included 28 youth who reported suicidal thoughts at the start of the program. By chance, half of them had been assigned to the Family program and half to the Educational program. The children were between 11-14 years old. More than 90% of their caregivers were women. Information was collected at baseline and at the end of the program. Either youth or parents reported on their demographics, characteristics of shelters, family support, communication, parental supervision, violence exposure, youth substance abuse, and youth suicidal ideation. What came out of HOPE? The American research team estimated that about 20% of youth HOPE participants had suicidal thoughts when the study began. The young people who took part in the HOPE Family Program reported significantly less suicidal ideation after the program than did those in the HOPE Health Education Program. However, young people who reported using an illicit substance in the previous month were much less likely to report improvements in suicidal thoughts. For these youth, suicidal ideation and substance abuse may be wrapped up in a more complex bundle of needs that requires more than a brief parenting program. A puzzling caveat is that – contrary to the researchers’ expectations – improvements were not necessarily driven by better family support. On average, better family support did not change suicidal thoughts in youth. Which aspects of the HOPE program did cause the improvement? This remains an open question.Better HOPE and HOPE in policyThe study is limited by the small sample size of 28, which limits the generalizability of the study. In addition, suicidal thoughts were measured using a single item on a questionnaire. The researchers recommend using additional measures in future research. Also, family support was measured by parental report, while children may well have felt differently about family processes. Despite its limitations, this study highlights the need to address youth mental health in family shelters, the crucial role that family relationships may play for youth in this context, and the importance of disentangling which family components make this impact. *********Reference: Lynn, C. J., Acri, M. C., Goldstein, L., Bannon, W., Beharie, N., & McKay, M. M. (2014). Improving Youth Mental Health through Family-Based Prevention in Family Homeless Shelters. Children and Youth Services Review.

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