Characteristics of youth reporting suicidal ideation in an integrated youth services initiative in British Columbia, Canada (2018–2023): a retrospective cohort study

BACKGROUND: Integrated youth services (IYS) are a growing model of care where youth can access a range of youth-friendly health and social services within a single location. Located in British Columbia (B.C.), Foundry was the first IYS initiative established in Canada. In this study, we examine service utilization patterns and characteristics of youth reporting suicidal ideation (SI) to better understand and address their care needs. METHODS: We conducted a retrospective analysis of linked health survey and service data collected at Foundry from 2018 to 2023. Descriptive statistics and bivariate analyses compared groups of youth who reported having SI within the past month vs. youth who reported never having SI at the time of their initial visit. Standardized mean differences (SMD) and p-values were calculated to identify statistically significant differences between groups. We plotted monthly proportions of overall youth reporting SI accessing Foundry over the study period and by sex/gender, sexual identity (i.e., LGBTQ+), and age group. RESULTS: A total of 8,347 individuals were included in the analysis, of which 6,021 (72.1%) reported any lifetime history of SI and 2,975 (35.6%) reporting past-month SI. Youth with past-month SI were more likely to identify as gender diverse (13.3% of youth with SI vs. 4.9% of youth with no SI; SMD: 29.7), and LGBTQ+ youth (45.2% vs. 22.3%; SMD: 52.7). Youth with past-month SI also had higher distress scores (as measured by the Kessler Psychological Distress Scale; 36.7 vs. 27.0 mean score for past-month SI vs. never SI youth, respectively; SMD: 138.5).Youth with past-month SI had more service contact with IYS than those without SI [7.0 (SD: 16.8) vs. 11.2 (SD: 23.2) mean visits; p < 0.0001] and had accessed other mental health/substance use services in the last year (43.4% vs. 20.9%; SMD: 49.7). We found no substantial change in the overall proportion of youth reporting SI over the study period, and by subpopulations, we found a slight increase among females in the last two years. CONCLUSIONS: Many youth accessing Foundry reported having SI, indicating an important opportunity for early intervention. Our findings also shed light on health inequities of self-reported SI, particularly among gender and sexually diverse youth.