Barriers to and Facilitators of the Implementation of Suicide Prevention Practices in Juvenile Detention Centers

OBJECTIVE: The aim of this study was to examine stakeholder-perceived barriers to and facilitators of implementing suicide prevention practices across juvenile detention centers. METHODS: Informed by the Exploration, Preparation, Implementation, Sustainment framework, the authors conducted semistructured interviews with leaders and staff (N=14) from 10 juvenile detention centers in a northeastern U.S. state. Data were analyzed with a hybrid deductive-inductive qualitative approach. RESULTS: Quality and fidelity monitoring and support as well as professional training emerged as salient facilitators of the implementation of suicide prevention practices. Salient barriers included challenges with continuity of care, high facility staff turnover, reliance on youth self-report for risk identification, and limited availability of treatment facilities for youths with severe behavioral disorders. Funding emerged as both a facilitating and a hindering determinant, in that funding could facilitate or hinder implementation across multiple domains, including organizational staffing processes, training, and service delivery. CONCLUSIONS: Findings highlight the importance of addressing barriers and leveraging facilitators to support implementation of suicide prevention practices in juvenile detention centers. Future efforts should incorporate participatory methods to identify appropriate implementation strategies. Equity-centered approaches are warranted to improve implementation and sustainment of evidence-based suicide prevention practices in these settings to ensure timely and appropriate care for youths.