Preteen Suicidal Ideation and Adolescent Academic Well-Being Among Child Welfare-involved Youth

School Mental Health https://doi.org/10.1007/s12310-024-09726-x ORIGINAL PAPER Preteen Suicidal Ideation and Adolescent Academic Well‑Being Among Child Welfare‑involved Youth Nathaniel W. Anderson1 Lynsay Ayer3 · Gabriel W. Hassler2 · Elie Ohana3 · Beth Ann Griffin3 · Arielle H. Sheftall4 · Accepted: 20 October 2024 © The Author(s) 2024 Abstract Background Youth involved in the U.S. child welfare system (CWS) are at risk for mental health problems, including suicidal ideation (SI). However, the relationship between preteen suicidal ideation and academic outcomes has not been considered. Methods This study uses data from two nationally representative longitudinal surveys of CWS-involved youth to examine the association between preteen suicidal ideation (ages 7–11) and subsequent academic well-being (ages 12–17) among CWSinvolved youth in the United States. Suicidal ideation was assessed using a single self-report item. Academic well-being was assessed through a number of constructs related to young people’s ability to thrive in the present and future, including school engagement, academic achievement, and expectations of what their lives would look like in adulthood. Linear regression models with person-level random effects were estimated. Results Findings indicate CWS-involved youth with a history of preteen suicidal ideation performed worse across all measures of adolescent academic well-being compared to their peers without a history of suicidal ideation. Conclusions These findings, though associational, have potentially broad implications for understanding how early life suicidal ideation may impede CWS-involved youths’ ability to thrive academically. Keywords Suicidal ideation · School · Well-being · Adolescent health Introduction Youth involved in the U.S. child welfare system (CWS) are at especially high risk for mental health problems, including suicidal ideation (SI) (Evans et al., 2017). By some estimates, roughly a quarter of CWS-involved youth report SI, compared to approximately one-in-ten among the general population (Anderson, 2011; Evans et al., 2017). Amidst a backdrop of increases in SI and other suicide-related outcomes in young people (Bridge et al., 2023; Ruch et al., * Lynsay Ayer 1 Department of Health Policy and Management, University of California Los Angeles, Los Angeles, USA 2 RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA 3 RAND Corporation, 1200 South Hayes St, Arlington, VA 22202, USA 4 Department of Psychiatry, University of Rochester Medical Center, Rochester, USA 2019; Xiao et al., 2021), a continued focus on SI among CWS-involved youth is essential for public health strategies emphasizing health equity (Braveman, 2014; Harris et al., 2020). Researchers have attributed the higher risk for SI among CWS-involved youth to several factors. First, their experiences of maltreatment, including higher rates of physical and sexual abuse, directly increase their risk for adverse mental health outcomes, including SI and other suicide-related outcomes (Dunn et al., 2013; Miller et al., 2013). The timing of the exposure to maltreatment may also influence risk of suicidal ideation. For instance, findings from a nationally representative longitudinal study of youth found that participants first exposed to sexual abuse during early childhood had a 146% increase in the odds of suicidal ideation compared to respondents maltreated as adolescents (Dunn et al., 2013). Second, CWS-involved youth experience other adversities such as disruption of social and familial relationships that can elevate their risk of SI and other suiciderelated outcomes (Conn et al., 2015; Sheftall et al., 2016). For instance, a recent retrospective matched case-control Vol.:(0123456789) School Mental Health study found that CWS-involved youth that experienced outof-home placements were twice as likely to die by suicide (Ruch et al., 2021). Suicidal Ideation Amongst Preteens Research examining SI and other suicide-related outcomes in young people tends to focus on adolescence, but increasingly there is a need to expand the scope to include preteens (Ayer et al., 2020). Several population-based analyses have documented worrying increases in SI and related outcomes among the younger child population, particularly among children of minoritized racial/ethnic backgrounds (Ayer et al., 2020; Bridge et al., 2023; Liu et al., 2022). Furthermore, risk factors appear to be different for SI experienced in preteen years relative to when it occurs in adolescence. For instance, preteens with SI are more likely to be boys and more likely to have experienced attention deficit/hyperactivity disorder (ADHD) symptoms, while adolescents with SI are more likely to be girls and more likely to exhibit depressive symptoms (Adrian et al., 2016; Geoffroy et al., 2022). Lastly, the impacts of SI at earlier stages of development have particularly important implications for future health and flourishing. Lifecourse theory suggests that acute mental distress experienced in earlier phases of life can have severe consequences on development and thriving (Halfon & Hochstein, 2002; Halfon et al., 2014). Thus, documenting adverse long-term impacts of earlier exposure to SI is a critical component for building support for future programs and policy that seek to address this issue. considering interactions between the two over time (Racine et al., 2019). Thus the potential for SI to impact academic well-being is worrisome, particularly since constructs like school engagement, academic performance, and achievement-oriented future expectations are highly predictive of positive outcomes in adulthood, including higher educational attainment (Abbott-Chapman et al., 2014; Fraysier et al., 2020; Symonds et al., 2022), increased healthy behaviors (Brumley et al., 2017; McDade et al., 2011; Prince et al., 2019; Sipsma et al., 2015), and improved physical and mental health (Chen et al., 2023; Kim & Kim, 2020). This is a particularly salient issue for CWS-involved preteens, who tend to fare worse across each of these outcomes (Bruskas, 2008; Pears et al., 2013; Zetlin & Weinberg, 2004). The Current Study This observational study addresses this gap in the literature using data from a longitudinal study of CWS-involved youth. Our aim was to investigate how children experiencing SI in their preteen years (ages 7–11) performed on several measures of academic well-being assessed during adolescence (ages 12–17) relative to their peers who did not experience SI. We hypothesized that preteens who experienced SI would subsequently be less engaged in school, perform worse on tests assessing their skills in reading and mathematics, and have reduced expectations for their future. Methods Suicidal Ideation and Academic Well‑Being Participants Academic well-being, which we define as a set of education- and achievement-related measures corresponding to how young people “experience and evaluate their lives (...truncated)