Head Injury and Suicidal Behavior: An Examination of Multiple Resiliency Models Among Justice-Involved Youth

Suicide is one of the leading causes of death among justice-involved youth, yet the role of neurological injury in shaping suicide risk remains understudied. Head injuries are disproportionately prevalent among justice-involved youth and have been linked to elevated suicidality, but little research has examined how head injury operates alongside psychosocial risk and protective factors. Using longitudinal data from the Pathways to Desistance study, the current study explores how head injury, risk factors, and protective factors are associated with suicidal attempts and evaluates multiple resilience frameworks. Using logistic regression models, results indicate that youths with a history of a head injury had significantly greater odds of reporting a suicide attempt, even after accounting for psychosocial risks. Psychiatric distress and mental health service utilization were also associated with increased risk. Among protective factors, self-reliance was associated with lower suicide risk overall, whereas future outlook was more protective among youth with a prior head injury. These preliminary findings underscore the value of incorporating neurocognitive considerations into suicide prevention efforts within juvenile justice settings.