Utilizing the Visual Arts to Decrease Suicide Risk and Promote Well-Being Among Diverse Youth: A Proof-of-Concept and Feasibility Study

Background: Youth suicidality is rising in the United States, with disproportionately elevated risk among Black, Indigenous, Latine, and Other People of Color (BILPOC) and sexual and gender diverse youth (SGDY). Risk is further exacerbated among youth survivors of suicide loss (SSL), yet culturally responsive suicide postvention interventions, or supports provided after a suicide death, remain scarce for this population. Centering BILPOC SGDY SSL lived experiences is critical for informing developmentally and culturally-relevant postvention practices, as suicide postvention is suicide prevention. Furthermore, the “arts participation” offers a developmentally appropriate approach to trauma-informed suicide prevention youth initiatives by elevating marginalized experiences, supporting trauma processing beyond verbal modalities, and fostering meaning‑making, connection, and resilience. Guided by the Queer Prevention of Youth Suicidality Model (Queer‑PRYSM) and a community steering committee, this study evaluates proof‑of‑concept evidence for the Transformational–Visual Intervention for Exposure With Suicide (Transformational‑VIEWS), a novel, visual arts‑based psychosocial group postvention intervention developed with and for diverse individuals coping with traumatic loss.

Methods: This initial pilot feasibility study employed a single‑group pretest/posttest design (N = 6) with an explanatory sequential mixed‑methods approach incorporating quantitative self‑report measures, visual arts data, and qualitative focus group data. Due to the small sample size (N = 6) and guidelines for examining proof-of-concept pilot feasibility studies, descriptive statistics (i.e., means, standard deviations, and measures of dispersion) were calculated for the final sample. The study examined changes in suicide risk, complex grief, interpersonal risk factors, and minority stress protective factors among a racially diverse sample of BILPOC SGDY SSL.

Results: Participants ranged in age from 19 to 21 years (M = 20.17, SD = 0.75) and represented diverse sex assigned at birth, gender, racialized, and sexual orientation identities. Findings provided preliminary proof‑of‑concept support for Transformational‑VIEWS. Overall suicide risk decreased from pre‑ to post‑intervention, including reductions in suicidal ideation, ideation rumination, and perceived likelihood of future suicide attempts, alongside increased help‑seeking intent. Complicated grief symptoms generally improved, with decreases in prolonged grief, avoidance, and feelings of disconnection; however, difficulty accepting the death and intrusive thoughts slightly increased. Personal resilience showed modest increases across total and domain scores. Qualitative findings contextualized these outcomes, suggesting that increased awareness and reflection within an affirming affinity‑based group may temporarily heighten some trauma and grief-specific concerns while supporting suicide risk reduction and resilience. Findings demonstrated high demand, acceptability, and usability. Youth participants described the group as a uniquely safe, SGD-affirming affinity space. Visual arts collage activities were acceptable across skill levels.

Conclusions: This small‑scale pilot feasibility study provides preliminary proof‑of‑concept evidence that trauma-informed arts-based group postvention modalities such as Transformational‑VIEWS may reduce suicide risk and increase help‑seeking intentions among BILPOC SGDY SSL. Findings highlight the importance of iterative intervention development and suggest that temporary increases in distress may reflect normative processes within trauma‑ and grief‑focused interventions. Arts‑based postvention interventions warrant further investigation with larger samples to further examine evidence and inform culturally-responsive suicide prevention and postvention efforts.