# Suicide Prevention with Substance Using Youth Experiencing Homelessness

> **NIH NIH R01** · OHIO STATE UNIVERSITY · 2024 · $750,722

## Abstract

Project Summary/Abstract
While research on substance using youth experiencing homelessness (YEH) is increasing, there is a dearth of
information regarding effective prevention interventions for these youth. This is of significant concern because
studies indicate that 66% to 89% of YEH have a mental health disorder (Cauce et al., 2004) and 68% report at
least one suicide attempt (Gewitz et al., 2020). In fact, suicide is the leading cause of death among YEH
(Rotheram-Borus & Milburn, 2004; Yoder et al., 2010). Among those who have attempted suicide, an average
of 6.2 attempts is reported, and lifetime suicidal ideation rates range from 14% to 66.5% (Yoder et al., 2010)
with no clear evidence of effective interventions for YEH. This study uses general cognitive theory (Beck,
1967), complemented with concepts from two suicide specific theoretical models, to guide our intervention and
conceptual change model. Our goal is to test strategies to extend delivery and uptake of a cognitive therapy
intervention for YEH. Prior studies focus on service-connected youth, but research suggests that most street
living YEH do not access services meant to assist them (Kelly & Caputo, 2007). We overcome prior sampling
limitations through engaging service-disconnected youth in addition to service-connected youth through a local
drop-in center. As such, three hundred substance using YEH with recent suicidal ideation or a recent
suicide attempt will be randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Services
as Usual (SAU) (N=150) or to SAU alone (N=150). CTSP has previously shown efficacy for YEH through a
RCT pilot feasibility study (Slesnick et al., 2020; Wu et al., 2020). SAU includes outreach, advocacy and
service linkage which are typical services offered by agencies serving those experiencing homelessness (Ober
et al., 2012). Follow-up assessments will be conducted at 3, 6, 9 and 12-months post-baseline. It is
hypothesized that youth receiving CTSP+SAU will show greater reductions in suicidal ideation (primary
outcome), substance use and depressive symptoms (secondary outcomes) over time compared to SAU alone,
as well as improved risk and protective factors. Theoretically-derived mediators will be tested to shed light on
mechanisms associated with change, and the moderating effects of sex, race, sexual orientation and baseline
service connection will be examined. In order to ease future dissemination of the intervention to agencies
serving YEH, we will rigorously assess acceptability, feasibility, fidelity and cost associated with the delivery of
our intervention approach using a mixed-methods approach. Ultimately, the goal of this research is to provide
support for the use of a suicide prevention intervention for substance using YEH that reduces premature
mortality, hospitalization, and loss of human capital and which can be easily adopted by agencies serving YEH.

## Key facts

- **NIH application ID:** 10862766
- **Project number:** 5R01DA058627-02
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** NATASHA SLESNICK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $750,722
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10862766

## Citation

> US National Institutes of Health, RePORTER application 10862766, Suicide Prevention with Substance Using Youth Experiencing Homelessness (5R01DA058627-02). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10862766. Licensed CC0.

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