PROJECT SUMMARY/ABSTRACT
The risks of ideating, suicide attempt (SA), and dying by suicide have never been greater for Mexican
teens. In the past two decades, the rates of suicidal behaviors (SB) among Mexican youth have shown a 3.4-
fold increase. Today, 2.8% of Mexican teens ages 15 to 19 report SA (3.8% females, 0.3% boys). Even though
reported SA are lower in Mexican youth compared to their U.S. counterparts, this has become a critical issue
given its increase in Mexico, the lack of Evidence Based Practices (EBP), and its future clinical implications.
SB have sobering implications for the future well-being of Mexican youth, as they are associated with a myriad
of short- and long-term negative outcomes, including premature death. Suicidal youth in Mexico, 50% of them
who are or were in contact with providers, do not have access to the quality treatments developed in and
available to their counterparts in high-income nations. This access disparity is not unique to Mexico; most
suicidal youth in other middle and low-income nations (LMIC) are not treated with quality interventions
available in rich nations. Moreover, youth in LMIC have high rates of SB and 75% of all suicides occur in these
nations. This is a mental health care injustice that demands urgent resolution.
This NIMH R34 award application proposes to conduct an adaptation, implementation, and pilot testing of
the culturally centered CBT protocol, the Socio-Cognitive Behavioral Therapy for Suicidal Behaviors (SCBT-
SB), among suicidal youth in Mexico City, Mexico. SCBT-SB is a psychosocial treatment developed with the
support of the NIMH specifically for suicidal Latinx youth. SCBT-SB is available in Spanish, has an established
training model, and has yielded promising results in intent to treat analyses in reducing SA and depressive
symptoms in comparison to treatment as usual (TAU). Furthermore, it is the CBT protocol with the most
empirical evidence for Latinx youth with SB. SCBT is attuned to the cultural needs of Latinx suicidal youth in
real-world service settings. This will be the first time that SCBT-SB, and for that matter, any suicidal ideation
and behaviors evidence-based treatment, will be used in Mexico to treat suicidal youth in contact with mental
health services in the public health sector. By implementing and pilot testing SCBT-SB with suicidal Mexican
youth, this project addresses profound gaps in services for this population and of training for clinicians.
The research plan will (a) culturally adapt and contextualize the SCBT-SB for its implementation in the
Mexican public health system, (b) pilot test the protocol through an RCT (SCBT-SB vs TAU; 60 patients and
caregivers) and (c) evaluate the implementation process of the SCBT-SB and assess qualitatively possible
factors that may promote or hinder its future uptake. The short and long-term knowledge and research
implications include (a) its potential to improve the lives of suicidal Mexican youth; (b) the knowledge about
transnational implementation of EBTs in the Mexican public health sector; and (c) the understanding of the
implementation and treatment effect of SCBT-SB in Mexico.
