Introduction Due to increasing suicide rates, treatment engagement among suicidal youth is paramount. Identification of factors that predict treatment dropout could aid in bolstering treatment engagement. In this study, we examine whether demographic factors, specific treatment referrals, and interactions among referrals predict treatment dropout in youth deemed at risk for suicide. Methods Youth (N = 3606) were screened for suicide using the Early Identification, Referral, and Follow‐up (EIRF) system across three community behavioral health centers. If considered at‐risk, all were provided mental health referrals and some were provided family support, crisis hotline, and/or school support referrals. Analyses were performed to analyze dropout patterns based on the binary logistic regression framework. Results Being older (OR = 1.06, p < 0.001) and being male (OR = 1.28, p < 0.001) were related to greater odds of dropping out from referrals, while being referred to family support (OR = 0.13, p < 0.001), and being referred to a crisis hotline (OR = 0.58, p < 0.001) were associated with smaller odds of dropping out. Interactions were also analyzed. Conclusion Monitoring utilization and referral patterns is essential to appropriately meet the needs of youth at‐risk for suicide. Specifically, referring youth for family support and to use a crisis hotline may be particularly helpful in retaining treatment engagement.

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