Informing Suicide Risk Assessment Practices of High-Risk Preteens: Qualitative Insights from Youth and Caregivers.

Objective: This study marks the first phase of the development of a reliable and valid suicide risk assessment tool for preteen youth. In this phase, authors sought to understand the lived experiences of preteens with suicidal thoughts and behaviors (STBs) and their caregivers, with the goal of informing our understanding and improving the assessment of STBs in preteens. Method: We conducted qualitative interviews with youth in acute care settings who had onset of STBs during their preteen years (i.e., 8-12 years of age; Results: Youth and caregivers provided perspectives on the lived experiences of preteen STBs, identifying critical risk factors and warning signs (e.g., increasing isolation, major shifts in typical behaviors), barriers to communication of risk (e.g., fear of hospitalization, fear of punishment), importance of family-centered and individualized risk assessment that takes into consideration personal and cultural identities (e.g., minoritized identities, religious beliefs), and ways to better support preteens (e.g., asking direct questions about STBs, checking in on mood and well-being more regularly). Conclusion: Qualitative interviews provided valuable insights regarding the lived experiences of preteens reporting STBs and their caregivers. This research highlights the need for family-centered, individualized, and culturally sensitive approaches to understanding, assessing, and mitigating preteen STBs and the development and validation of comprehensive risk assessment tools and practices explicitly designed for preteens.