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Richardson SC, Gunn LH, Phipps M, Azasu E. Factors Associated with Suicide Risk Behavior Outcomes Among Black High School Adolescents. J Community Health 2024; 49:466-474. [PMID: 38095815 PMCID: PMC11139428 DOI: 10.1007/s10900-023-01312-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 04/02/2024]
Abstract
There is an urgent need for youth suicide research, particularly among Black adolescents, for whom there have been significant increases over time. This study examines associations between eight covariates and suicide ideation, planning, and attempts among a national sample of Black high school adolescents to inform prevention efforts. Utilizing the 2019 National Youth Risk Behavior Survey data, a sample of N = 6225 Black high school participants was analyzed. A weighted classification tree and network analysis were used to visualize data features, and weighted multinomial ordered logistic regression analyses with multiple imputation pooled using Rubin's rules were performed. Suicide ideation rates of 16% were found in the sample and a higher reported rate of suicide attempts (56%) for those who have reported both ideation and planning. Interpersonal and multilevel factors, including suffering from bullying/cyberbullying, carrying a weapon, or being a sexual minority, were significantly associated with all three suicide behaviors. Findings support an interrelated and multilevel nature of suicide risk factors. Prevention programs for Black adolescents should consider the intersectionality of identities and experiences.
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Affiliation(s)
- Sonyia C Richardson
- School of Social Work, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA.
| | - Laura H Gunn
- Department of Public Health Sciences and School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, USA
- Department of Primary Care & Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Margaret Phipps
- School of Social Work, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA
| | - Enoch Azasu
- Department of Psychiatry, Saint Louis University, St. Louis, MO, USA
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2
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Richardson SC, Gunn LH. Factors Associated With Suicide Risk Behavior Outcomes Among Black Middle School Adolescents. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00237-5. [PMID: 38718976 DOI: 10.1016/j.jaac.2024.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/09/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE Early adolescent self-identifying Black youth present with high rates of suicidality. This study assesses associations among 7 explanatory variables (sex, weapon carrying, weight perceptions, grades, grade level, bullying at school, and cyberbullying) and suicide ideation, planning, and attempts, and identifies associations with suicidality as a composite measure among a sample of Black middle school adolescents (BMSA) in the United States. METHOD Data were extracted from the 2019 Middle School Youth Risk Behavior Survey. Descriptive statistics were calculated, and associations between suicide ideation, planning, and attempts were explored. A network graphical representation of polychoric and tetrachoric correlations across suicidality outcomes and explanatory variables was performed. A multivariable, multinomial logistic regression model estimated associations among explanatory variables and suicide ideation (with and without planning) and planning (with and without ideation). Both suicide attempt and a composite suicidality metric were explored using independent logistic models with multiple imputation. RESULTS The sample included 7,643 self-identifying BMSA. Our findings indicate that approximately 28% reported suicidality. Prevalence rates were found of about 1 in 4 BMSA for suicidal ideation, 1 in 6 for suicidal planning, and 1 in 10 for attempting suicide. Female BMSA, victims of cyberbullying, and BMSA carrying a weapon experienced significantly higher odds of all suicidality outcome measures. CONCLUSION Practical implications for identifying and screening suicidality among BMSA to guide suicide prevention efforts are necessary. Findings validate the need for informed cultural approaches to suicide screening and prevention efforts to reduce suicide risk outcomes, especially when identifiable environmental factors are strongly associated with those outcomes. DIVERSITY AND INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.
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Affiliation(s)
| | - Laura H Gunn
- University of North Carolina at Charlotte, Charlotte, North Carolina; Imperial College London, London, United Kingdom
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3
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Richardson SC, Williams JA, Vance MM, Phipps-Bennett M, Stevenson AP, Herbert R. Informing Equitable Prevention Practices: A Statewide Disaggregated Analysis of Suicide for Ethnoracially Minoritized Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:532-544. [PMID: 38429617 PMCID: PMC11093829 DOI: 10.1007/s11121-024-01654-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
The increase in adolescent suicide rates in the United States is a pervasive public health issue, and ethnoracial youth with diverse identities are disproportionately impacted, yet less studied. National planning efforts reinforce state-level approaches to suicide prevention through an equitable lens to prevent adolescent suicide. This study examined disaggregated state-level data over time to determine changes to suicide outcomes based on race/ethnicity, sex, sexual orientation, and the intersection of these identities and determined which sub-groups had higher odds of suicide outcomes. Data from the 1991-2019 Centers for Disease Control and Prevention Youth Risk Behavioral Surveillance System were analyzed for 17,419 ethnoracially minoritized high school adolescents in North Carolina. Descriptive analyses and multinominal logistic regression models were employed. Findings indicated that subgroups within categories of ethnoracial populations, specifically Black female adolescents unsure of their sexual orientation, reported higher rates of suicide attempts. Additionally, Multiracial adolescents reported higher means for suicide consideration and attempts over time. Recommendations for investigating state-level suicide data by focusing on diverse intersecting identities to illuminate areas for potential prevention efforts and support health equity are provided.
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Affiliation(s)
- Sonyia C Richardson
- School of Social Work, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA.
| | | | | | - Margaret Phipps-Bennett
- School of Social Work, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | | | - Rehaana Herbert
- University of North Carolina at Greensboro, Greensboro, NC, USA
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4
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Hammond CJ, Hyer JM, Boustead AE, Fristad MA, Steelesmith DL, Brock GN, Hasin DS, Fontanella CA. Association Between Marijuana Laws and Suicide Among 12- to 25-Year-Olds in the United States From 2000 to 2019. J Am Acad Child Adolesc Psychiatry 2024; 63:345-354. [PMID: 37385585 DOI: 10.1016/j.jaac.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE Cannabis use is associated with suicide-related outcomes in both adolescents and adults, and may be increasing amid shifting cannabis policies. However, little is known about the impact of medical marijuana legalization (MML) and recreational marijuana legalization (RML) policies on youth suicide. Using 20 years of national data, we examined associations between MML, RML, and suicide-related mortality among US individuals aged 12 to 25 years, and assessed whether they varied based on age and sex. METHOD Suicide deaths (N = 113,512) from the 2000-2019 National Vital Statistics System Multiple Cause of Death files for age groups 12 to 13, 14 to 16, 17 to 19, 20 to 22, and 23 to 25 years were examined in relation to time-varying cannabis law status using a staggered adoption difference-in-difference (DiD) approach with a negative binomial regression to determine associations between MML, RML, and suicide rates, controlling for individual- and state-level covariates and accounting for the varying effective dates of MML and RML by state. RESULTS The overall unadjusted annual suicide rate was 10.93/100,000, varying from 9.76 (states without marijuana laws (ML)) to 12.78 (MML states) to 16.68 (RML states). In multivariable analysis, both MML (incidence rate ratio [IRR] = 1.10, 95% CI: 1.05-1.15) and RML (IRR = 1.16, 95% CI: 1.06-1.27) were associated with higher suicide rates among female youth compared to those in states without ML. Youth aged 14 to 16 years had higher rates of suicide in states with RML compared to states with MML (IRR = 1.14, 95% CI: 1.00-1.30) and states without ML (IRR = 1.09, 95% CI: 1.00-1.20). Findings were consistent across sensitivity analyses. CONCLUSION MML and RML were associated with increased suicide-related mortality in female youth and 14- to- 16-year-old individuals of both sexes. Mechanisms through which cannabis policies are related to increased youth suicide warrant further study and should inform legislative reform.
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Affiliation(s)
| | - J Madison Hyer
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | - Mary A Fristad
- Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University, Columbus, Ohio
| | | | - Guy N Brock
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Deborah S Hasin
- Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Cynthia A Fontanella
- The Ohio State University Wexner Medical Center, Columbus, Ohio; Nationwide Children's Hospital, Columbus, Ohio
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5
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Sumlin E, Hill R, Asim N, Busby D, Brown JL, Sharp C. Quantifying the Representation of Black Adolescents in Suicide Intervention Research. Res Child Adolesc Psychopathol 2024; 52:159-168. [PMID: 37702875 DOI: 10.1007/s10802-023-01113-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/14/2023]
Abstract
This systematic review aimed to quantify the representation of Black youth in U.S. suicide intervention research. Specifically, we sought to evaluate Black youth representation in terms of (a) equity of inclusion (i.e., the inclusion of Black youth in research study samples at a rate consistent with the overall national rate of Black adolescents in the US) and (b) equity of intervention efficacy (i.e., evaluating the presence of racial disparities in intervention efficacy/effect sizes). In addition, we aimed to evaluate whether an association existed between funding status of research and representation of Black youth in studies, and to provide recommendations for future research in this area. To this end, the present study extracted and analyzed demographic information of studies included in recent meta-analyses conducted by Robinson and colleagues (2018), which were not previously analyzed, in addition to new literature published between September 2017 and January 2021. Results showed that the prevalence of Black youth included in studies was representative (14.67%; ntotal = 4451, nBlack = 664), with a median inclusion rate of 13%; however, absolute sample and group sizes were so small that it precluded comparison of differential treatment outcomes for Black youth. Thus, out of 22 studies identified, only one was able to investigate treatment outcomes for suicide in Black youth specifically. This study points to the conclusion that without adequately powered studies, disparities in treatment efficacy for Black youth cannot be compared or addressed, and the existing disparity in suicidal outcomes for Black youth will grow even larger.
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Affiliation(s)
- E Sumlin
- University of Houston, Houston, TX, USA
| | - R Hill
- Louisiana State University, Baton Rouge, LA, USA
| | - N Asim
- University of Houston, Houston, TX, USA
| | - D Busby
- University of Texas Medical Branch Galveston, Galveston, TX, USA
| | - J L Brown
- Purdue University, Lafayette, IN, USA
| | - C Sharp
- University of Houston, Houston, TX, USA.
- University of the Free State, Bloemfontein, South Africa.
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Junewicz A, Wachtel JM, Okparaeke E, Guo F, Farahmand P, Lois R, Li A, Stein CR, Baroni A. The persistent impact of the COVID-19 pandemic on pediatric emergency department visits for suicidal thoughts and behaviors. Suicide Life Threat Behav 2024; 54:38-48. [PMID: 37933542 DOI: 10.1111/sltb.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION We examined data from a large, high acuity, pediatric psychiatric emergency department (ED) to assess both the immediate and longer-term impact of the pandemic on ED visits for suicidal thoughts and behaviors (STBs) among youth. METHODS Youth ages 5-17 years presenting at a pediatric psychiatric ED in New York, NY from March 2019-November 2021 were included in this study. Visits were categorized as pre-pandemic, pandemic year 1, or pandemic year 2. We examined changes in demographic and clinical characteristics among patients presenting across the three time periods, as well as multivariable associations between these characteristics and STBs. RESULTS Over 32 months, 2728 patients presented at 4161 visits. The prevalence of a discharge diagnosis of STBs increased from 21.2% pre-pandemic to 26.3% (p < 0.001) during pandemic year 1, and further increased to 30.1% (p = 0.049) during pandemic year 2. Youth were 21% more likely to receive a discharge diagnosis of STBs in pandemic year 1 (RR 1.21, 95% CI 1.07, 1.36) and 35% more likely in pandemic year 2 (RR 1.35, 95% CI 1.19, 1.52) compared to pre-pandemic baseline. CONCLUSIONS In a large, high-acuity ED, STBs continued to increase 20 months after the initial COVID-19 lockdown. These findings highlight the persistent detrimental impact of the pandemic on youth mental health.
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Affiliation(s)
- Alexandra Junewicz
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Jonathan M Wachtel
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Eugene Okparaeke
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Fei Guo
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Pantea Farahmand
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Rebecca Lois
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Annie Li
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Cheryl R Stein
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Argelinda Baroni
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
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7
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Rahmani M, Silverman AL, Thompson A, Pumariega A. Youth Suicidality in the Context of Disasters. Curr Psychiatry Rep 2023; 25:587-602. [PMID: 37768444 DOI: 10.1007/s11920-023-01454-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the current literature regarding youth suicidality (suicidal ideation, suicidal behavior, and completed suicide) in the context of disasters. RECENT FINDINGS There are fewer studies that examine the effect of disasters on suicidality specifically in children and youth than studies that focus on adults or general population. Numerous studies have reported on the effect of disasters on youth mental health in general without zeroing in on suicide risk. Some variables that have shown to increase suicide risk in children and youth after disasters include female gender, age at the time of disaster exposure, dependence on adults, attachments to places and caregivers, family functioning, and vulnerability to mistreatment. Several studies have demonstrated that youth suicidality fluctuates in response to disasters, at times increasing immediately post-disaster and at other times decreasing immediately post-disaster followed by an increase later. Exposure to natural disasters (e.g., earthquakes, typhoons, hurricanes, wildfires, and extremes of temperature and humidity), man-made disasters (e.g., armed conflict, global warming, and pollution), and unique disasters (e.g., the COVID-19 pandemic) have had significant impact on suicidality in children and adolescents. Although there are several promising interventions to mitigate the post-disaster suicide risk among youth, there is no consensus on a single intervention that is superior to others. More research is needed to study youth suicide risk in the context of disasters and develop culturally appropriate and evidence-based interventions.
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Affiliation(s)
- Mariam Rahmani
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.
| | - Andrew L Silverman
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andrew Thompson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andres Pumariega
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
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Acker J, Aghaee S, Mujahid M, Deardorff J, Kubo A. Structural Racism and Adolescent Mental Health Disparities in Northern California. JAMA Netw Open 2023; 6:e2329825. [PMID: 37594761 PMCID: PMC10439477 DOI: 10.1001/jamanetworkopen.2023.29825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023] Open
Abstract
Importance Understanding how structural racism is associated with adolescent mental health is critical to advance health equity. Objective To assess associations between neighborhood privilege, measured by the Index of Concentration at the Extremes (ICE) and adolescent depressive symptoms, suicidality, and related racial and ethnic disparities. Design, Setting, and Participants This was a retrospective cohort study using electronic health records of adolescents aged 12 to 16 years who attended well-teen visits between 2017 and 2021. Kaiser Permanente Northern California is an integrated health care delivery system serving 4.6 million members. The cohort included 34 252 individuals born singleton at an affiliated facility from January 1, 2005, to December 31, 2009, and who had completed at least 1 mental health screener during a well-teen visit by November 23, 2021. Exposures American Community Survey 2016 to 2021 5-year estimates were used to calculate ICE scores for adolescents' residential census tract at ages 10 to 11. Three ICE measures were used as proxies of structural racism: racial privilege (ICE-race and ethnicity; hereinafter ICE-race), economic privilege (ICE-income), and combined economic and racial privilege (ICE-income plus race and ethnicity; herinafter ICE-income plus race). ICE scores were categorized into quintiles based on California statewide distributions. Main Outcomes and Measures Depressive symptoms and suicidality were assessed through self-report screeners during well-teen visits. Depressive symptoms were considered to be present if patients had a score on the Patient Health Questionnaire-2 of 3 or higher (the tool uses a Likert scale to determine the frequency [0 = not at all; 3 = nearly every day] that they had depressed mood and lack of pleasure in usual activities in the past 2 weeks; responses were summed and dichotomized). Results Analyses included 34 252 adolescents (12-16 years of age; mean [SD] age, 13.7 [0.8] years; 17 557 [51.3%] male, 7284 [21.3%] Asian or Pacific Islander, 2587 [7.6%] Black], 9061 [26.5%] Hispanic, 75 [0.2%] American Indian or Indigenous, 12 176 [35.5%] White, and 3069 [9%] other or unknown). Risks of depressive symptoms and suicidality generally increased with each level of declining neighborhood privilege. Adjusted risk ratios comparing adolescents from neighborhoods with the least to most racial and economic privilege were 1.37 (95% CI, 1.20-1.55) for depressive symptoms and 1.59 (95% CI, 1.23-2.05) for suicidality. Racial disparities between Black and White youth and Hispanic and White youth decreased after adjusting for each ICE measure, and became nonsignificant in models adjusting for ICE-race and ICE-income plus race. Conclusions and Relevance In this cohort study, lower neighborhood privilege was associated with greater risks of adolescent depressive symptoms and suicidality. Furthermore, adjusting for neighborhood privilege reduced mental health disparities affecting Black and Hispanic adolescents. These findings suggest that efforts to promote equity in adolescent mental health should extend beyond the clinical setting and consider the inequitable neighborhood contexts that are shaped by structural racism.
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Affiliation(s)
- Julia Acker
- School of Public Health, University of California, Berkeley
| | - Sara Aghaee
- Kaiser Permanente Northern California Division of Research, Oakland
| | | | | | - Ai Kubo
- Kaiser Permanente Northern California Division of Research, Oakland
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Hughes JL, Horowitz LM, Ackerman JP, Adrian MC, Campo JV, Bridge JA. Suicide in young people: screening, risk assessment, and intervention. BMJ 2023; 381:e070630. [PMID: 37094838 DOI: 10.1136/bmj-2022-070630] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Suicide is the fourth leading cause of death among young people worldwide and the third leading cause of death among those in the US. This review outlines the epidemiology of suicide and suicidal behavior in young people. It discusses intersectionality as an emerging framework to guide research on prevention of suicide in young people and highlights several clinical and community settings that are prime targets for implementation of effective treatment programs and interventions aimed at rapidly reducing the suicide rate in young people. It provides an overview of current approaches to screening and assessment of suicide risk in young people and the commonly used screening tools and assessment measures. It discusses universal, selective, and indicated evidence based suicide focused interventions and highlights components of psychosocial interventions with the strongest evidence for reducing risk. Finally, the review discusses suicide prevention strategies in community settings and considers future research directions and questions challenging the field.
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Affiliation(s)
- Jennifer L Hughes
- Big Lots Behavioral Health Services at Nationwide Children's Hospital, Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lisa M Horowitz
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - John P Ackerman
- Big Lots Behavioral Health Services at Nationwide Children's Hospital, Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Molly C Adrian
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - John V Campo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffrey A Bridge
- Departments of Pediatrics and Psychiatry and Behavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital and The Ohio State University Wexner Medical Center College of Medicine, Columbus, OH
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10
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Adams LB, Thorpe RJ. Achieving mental health equity in Black male suicide prevention. Front Public Health 2023; 11:1113222. [PMID: 37064715 PMCID: PMC10098101 DOI: 10.3389/fpubh.2023.1113222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
Despite a steady decrease in suicide rates in the United States, the rate among Black males has increased in recent decades. Moreover, suicide is now positioned as the third leading cause of death in this population, signaling a public health crisis. Enhancing the ability for future suicide prevention scholars to fully characterize and intervene on suicide risk factors is an emerging health equity priority, yet there is little empirical evidence to robustly investigate the alarming trends in Black male suicide. We present fundamental areas of expansion in suicide prevention research focused on establishing culturally responsive strategies to achieve mental health equity. Notably, we identify gaps in existing research and offer future recommendation to reduce suicide death among Black males. Our perspective aims to present important and innovative solutions for ensuring the inclusion of Black males in need of suicide prevention and intervention efforts.
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Affiliation(s)
- Leslie B. Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Roland J. Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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11
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Quinn CR, Waller B, Hughley A, Boyd D, Cobb R, Hardy K, Radney A, Voisin DR. The Relationship between Religion, Substance Misuse, and Mental Health among Black Youth. RELIGIONS 2023; 14:325. [PMID: 38009108 PMCID: PMC10673626 DOI: 10.3390/rel14030325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Studies suggest that religion is a protective factor for substance misuse and mental health concerns among Black/African American youth despite reported declines in their religious involvement. However, few studies have investigated the associations among religion, substance misuse, and mental health among Black youth. Informed by Critical Race Theory, we evaluated the correlations between gender, depression, substance misuse, and unprotected sex on mental health. Using multiple linear regression, we assessed self-reported measures of drug use and sex, condom use, belief in God, and religiosity on mental health among a sample of Black youth (N = 638) living in a large midwestern city. Results indicated drug use, and sex while on drugs and alcohol, were significant and positively associated with mental health symptoms. Belief in God was negatively associated with having sex while on drugs and alcohol. The study's findings suggest that despite the many structural inequalities that Black youth face, religion continues to be protective for Black youth against a myriad of prevalent problem behaviors.
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Affiliation(s)
- Camille R. Quinn
- Center for Equitable Family & Community Well-Being, School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA
| | - Bernadine Waller
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Ashura Hughley
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | - Donte Boyd
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | - Ryon Cobb
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NY 08901, USA
| | - Kimberly Hardy
- School of Social Work, Fayetteville State University, Fayetteville, NC 28301, USA
| | - Angelise Radney
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | - Dexter R. Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
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12
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Lee PH, Doyle AE, Silberstein M, Jung JY, Liu R, Perlis RH, Roffman J, Smoller JW, Fava M, Kessler RC. Associations Between Genetic Risk for Adult Suicide Attempt and Suicidal Behaviors in Young Children in the US. JAMA Psychiatry 2022; 79:971-980. [PMID: 36044238 PMCID: PMC9434482 DOI: 10.1001/jamapsychiatry.2022.2379] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Suicide rates have been increasing among youth in the US. While the heritability of suicide risk is well established, there is limited understanding of how genetic risk is associated with suicidal thoughts and behaviors in young children. OBJECTIVE To examine whether genetic susceptibility to suicide attempts (SAs) is associated with suicidal thoughts and behaviors in children. DESIGN, SETTING, AND PARTICIPANTS This case-control study examined data from the Adolescent Brain Cognitive Development (ABCD) study, a population-based longitudinal study of 11 878 US children enrolled at age 9 and 10 years from September 2016 to November 2018. Youth reports of suicidal ideation (SI) and SAs were obtained from the Kiddie Schedule for Affective Disorder and Schizophrenia at baseline and 2 subsequent years. After conservative quality control of genotype data, this analysis focused on 4344 unrelated individuals of European ancestry. Data analysis was conducted from November 2020 to February 2022. MAIN OUTCOMES AND MEASURES Children's lifetime experiences of SI and SAs were assessed each year from ages 9 to 10 years to ages 11 to 12 years. Polygenic risk scores (PRSs) for SAs were calculated for ABCD study participants based on the largest genome-wide association study of SA cases and controls of European ancestry (total sample n = 518 612). RESULTS Of 4344 children of European ancestry (2045 [47.08%] female; mean [SD] age, 9.93 [0.62] years), significant associations were found between children's SA PRSs and their lifetime SAs with the most robust association in the follow-up year 2 (odds ratio, 1.43 [95% CI, 1.18-1.75]; corrected P = 1.85 × 10-3; Nagelkerke pseudo R2 = 1.51%). These associations remained significant after accounting for children's sociodemographic backgrounds, psychopathology symptoms, parental histories of suicide and mental health, and PRSs for major depression and attention-deficit/hyperactivity disorder (likelihood ratio test P < .05). Children's depressive mood and aggressive behavior were the most significant partial mediators of SA genetic risk on SAs (mediation analysis P < 1 × 10-16). Children's behavioral problems, such as attention problems, rule-breaking behavior, and social problems, also partially mediated the association of SA PRSs with SAs (mediation analysis false discover rate < 0.05). CONCLUSIONS AND RELEVANCE This study's findings indicate that there may be genetic factors associated with SA risk across the life span and suggest behaviors and conditions through which the risk could be mediated in childhood. Further research is warranted to examine whether incorporating genetic data could improve the identification of children at risk for suicide.
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Affiliation(s)
- Phil H. Lee
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Alysa E. Doyle
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | | | - Jae-Yoon Jung
- Department of Pediatrics, Stanford University, Stanford, California
| | - Richard Liu
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston,Depression Clinical & Research Program, Massachusetts General Hospital, Boston
| | - Roy H. Perlis
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Joshua Roffman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Jordan W. Smoller
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
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13
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Reliford A, Berry OO, Burgos JJ, Liaw KRL. Holding Space for Facilitated Dialogues on Antiracism in Academic Medicine. J Am Acad Child Adolesc Psychiatry 2022; 61:953-956. [PMID: 35364252 DOI: 10.1016/j.jaac.2022.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 02/19/2022] [Accepted: 03/21/2022] [Indexed: 11/19/2022]
Abstract
The year 2020 brought unprecedented challenges and renewed focus on racial disparities and inequities in the United States. For racial and ethnic minority groups, and in particular African Americans, racial disparities have been a constant presence and threat from the time of slavery through the present day. These racial disparities, sanctioned and maintained by institutional racism, manifest in all aspects of life for African Americans-segregated and unequal education and housing systems, health and mental health care disparities, disproportionally elevated incarceration rates, and, as painfully highlighted this past year, continued vulnerability to acts of violence at the hands of law enforcement. In addition, most recently, there has been a renewed focus on the increased suicide rate for Black youth and its relationship to these racial disparities.1 In a large urban environment, our academic Child Psychiatry Department recognized that progress toward addressing racial disparities would be impeded without raising awareness and taking individual and collective action to identify implicit bias, power, and privilege differentials, and systemic racism inherent within academic medicine and our own lived experiences. This letter describes the development of such examination through facilitated dialogues on race and antiracism in our department.
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Affiliation(s)
- Aaron Reliford
- NYU Grossman School of Medicine, New York; Family Health Centers at NYU Langone Brooklyn, New York
| | - Obianuju O Berry
- NYU Grossman School of Medicine, New York; Office of Behavioral Health, NYC Health + Hospitals, New York.
| | | | - K Ron-Li Liaw
- NYU Grossman School of Medicine, New York; University of Colorado School of Medicine, Aurora
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14
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Alvarez K, Polanco-Roman L, Breslow AS, Molock S. Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems. Am J Psychiatry 2022; 179:422-433. [PMID: 35599542 PMCID: PMC9765395 DOI: 10.1176/appi.ajp.21101001] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Suicide rates among ethnoracially minoritized youth (i.e., youth of color) peak before the age of 30, and striking disparities in access to mental health services have been identified in this age group. However, suicide prevention strategies have yet to fully address structural racism as a mechanism in producing disparities in risk, protective factors, and access to quality effective intervention for youth of color. Such an approach is critical to provide more culturally responsive mental health care. Through an adapted socio-ecological model, the authors propose the Structural Racism and Suicide Prevention Systems Framework and illustrate pathways through which structural racism impacts suicide prevention and intervention for youth of color in the United States. The authors contextualize the impact of structural racism in three key settings where youth suicide prevention occurs: mental health services, schools, and the interface between crisis care and law enforcement. The authors posit that critical attention must be paid to the intersection of mutually reinforcing, interdependent systems rather than to systems in isolation. The authors then propose recommendations to address structural racism in suicide prevention, including macro-level interventions to improve societal conditions, research strategies to inform structural solutions, training approaches to address institutional racism, and clinical approaches to address the impact of racism and racial trauma on youths and families.
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Affiliation(s)
- Kiara Alvarez
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA,Correspondence: Kiara Alvarez, Massachusetts General Hospital Disparities Research Unit, Department of Medicine, 50 Staniford Street, Suite 830, Boston, MA 02114; ; Phone: 617-724-1237; Fax: 617-726-4120
| | | | - Aaron Samuel Breslow
- PRIME Center for Health Equity, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY,Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, USA
| | - Sherry Molock
- Department of Psychological & Brain Sciences, The George Washington University, Washington, DC
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15
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Musci RJ, Ballard ED, Stapp EK, Adams L, Wilcox HC, Ialongo N. Suicide attempt endophenotypes: Latent profiles of child and adolescent aggression and impulsivity differentially predict suicide attempt in females. Prev Med Rep 2022; 28:101829. [PMID: 35620051 PMCID: PMC9126944 DOI: 10.1016/j.pmedr.2022.101829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/06/2022] [Accepted: 05/10/2022] [Indexed: 01/07/2023] Open
Abstract
Suicide is a leading cause of death in young adulthood. Identifying early prevention targets to reduce later suicide is a public health priority. Impulsivity and aggression in early childhood may represent actionable early prevention candidate endophenotypes for later suicidal behavior. Our objective is to to understand the association of aggression and impulsivity trajectories with mental health outcomes to inform future prevention efforts. Participants were part of a longitudinal cohort of a preventative intervention trial (n = 597) and predominantly Black. They were assessed for aggressive and impulsive behaviors yearly in 1st-3rd and 6th-12th grades, and provided mental health data via self-report beginning in 6th grade. Longitudinal latent profiles of aggressive and impulsive behaviors were derived for males and females and used to determine whether profiles was associated with lifetime suicide attempt and meeting diagnostic criteria for major depressive disorder. Two impulsivity and aggression classes were found for males, characterized by low behaviors or moderate to high behaviors across development. Three classes were found for females, one of which was characterized by an undulating pattern of behaviors. For females, the class of severe behaviors was associated with significant risk of suicide attempt (Wald = 6.01, p = 0.05). No relationship was found for males or for MDD diagnosis. An endophenotype model of impulsivity and aggression in predicting later suicide attempt was supported in females, but not males. Results underscore the importance of evaluating sex differences in suicide research and the potential identification of females at risk for later suicidal behavior in school settings.
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Affiliation(s)
- Rashelle J. Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author.
| | - Elizabeth D. Ballard
- Experimental and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA,Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Emma K. Stapp
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA,Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Leslie Adams
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Holly C. Wilcox
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA,Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas Ialongo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Vidal C. Editorial: Racial Discrimination as a Stressor Related to Suicidality Among Pre-Adolescents. J Am Acad Child Adolesc Psychiatry 2022; 61:606-607. [PMID: 35158038 DOI: 10.1016/j.jaac.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/21/2022] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
Suicide is a rising phenomenon among most racial, ethnic, and age groups in the United States.1 The increase in suicide among Black preadolescent children is particularly concerning, with suicide rates now doubling those in their White peer group.2 This increase has sparked an interest in understanding the specific mechanisms and causes contributing to suicide in Black individuals of such a young age to provide more tailored and effective interventions. Many factors are suspected to contribute to the increase in suicide rates among Black children, including racial discrimination, disparities in access to care, poverty, trauma exposure, and family and school problems.3 In addition, despite the number of important initiatives delivered through the mental health system, primary care, and schools, the rates of suicide among Black preadolescents have continued to increase, perhaps in part because of the absence of culturally relevant preventive interventions focused specifically on their strengths and needs.
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Affiliation(s)
- Carol Vidal
- Johns Hopkins University School of Medicine, Baltimore, Maryland.
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17
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Sheftall AH, Vakil F, Ruch DA, Boyd RC, Lindsey MA, Bridge JA. Black Youth Suicide: Investigation of Current Trends and Precipitating Circumstances. J Am Acad Child Adolesc Psychiatry 2022; 61:662-675. [PMID: 34509592 PMCID: PMC8904650 DOI: 10.1016/j.jaac.2021.08.021] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/10/2021] [Accepted: 09/01/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Suicide among Black youth is a significant public health concern, yet research investigating the epidemiology of suicide in this population is limited. This study examines current trends and precipitating circumstances of suicide by sex and age group in Black youth 5 to 17 years of age, using 2 national databases. METHOD Data from the Web-based Injury Statistics Query and Reporting System (WISQARS) and the National Violent Death Reporting System (NVDRS) were used to investigate trends and precipitating circumstances of Black youth suicide from 2003 to 2017. We hypothesized suicide rates would increase over time for both sexes and all age groups (5-11, 12-14, and 15-17 years), and precipitating circumstances would differ by sex and age group. Trend analyses were conducted using Joinpoint regression software, version 4.8.0.01 (Surveillance Research Program, National Cancer Institute). Sex and age group comparisons of characteristics and precipitating circumstances were conducted using standard univariate statistical tests. RESULTS From 2003 to 2017, Black youth experienced a significant upward trend in suicide with the largest annual percentage change in the 15- to 17-year age group and among girls (4.9% and 6.6%, respectively). Mental health problems, relationship problems, interpersonal trauma and life stressors, and prior suicidal thoughts/behavior were the most common clinical characteristics and precipitating circumstances, with several varying by sex and age group. CONCLUSION Increases in Black youth suicide calls for the prioritization of research aimed at identifying specific risk and protective factors as well as developmental mechanisms associated with Black youth suicidal behavior. To implement effective suicide prevention programming, understanding targets for intervention is necessary.
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Affiliation(s)
- Arielle H Sheftall
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University College of Medicine, Columbus.
| | - Fatima Vakil
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Donna A Ruch
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Rhonda C Boyd
- Children's Hospital of Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Michael A Lindsey
- Silver School of Social Work, New York University, New York; McSilver Institute for Poverty Policy and Research, New York
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University College of Medicine, Columbus
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18
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Meza JI, Patel K, Bath E. Black Youth Suicide Crisis: Prevalence Rates, Review of Risk and Protective Factors, and Current Evidence-Based Practices. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:197-203. [PMID: 37153125 PMCID: PMC10153500 DOI: 10.1176/appi.focus.20210034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Suicide is the second leading cause of death among adolescents and young adults. Historically, Black youths have experienced lower rates of suicide; however, recent data point to significant racial disparities. In this article, the authors review current suicide rates, including alarming new data suggesting that suicide rates are two times higher among Black children ages 5-12 compared with White children in that age range. A clinically focused summary of socioecological risk and protective factors associated with suicide among Black youths, with particular attention on structural drivers and culturally relevant factors, is provided. Current evidence-based reviews suggest that dialectical behavior therapy is the only well-established treatment against self-harm and suicide among youths. However, it is unknown whether current established treatments work for Black youths, because Black youths are rarely included in randomized controlled trials. The authors conclude by reviewing emerging treatments developed and tested specifically for Black youths.
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Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Meza, Bath); Graduate School of Psychology, California Lutheran University, Thousand Oaks (Patel)
| | - Katie Patel
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Meza, Bath); Graduate School of Psychology, California Lutheran University, Thousand Oaks (Patel)
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Meza, Bath); Graduate School of Psychology, California Lutheran University, Thousand Oaks (Patel)
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19
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Marraccini ME, Lindsay CA, Griffin D, Greene MJ, Simmons KT, Ingram KM. A Trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-Informed Approach to Suicide Prevention in School: Black Boys' Lives Matter. SCHOOL PSYCHOLOGY REVIEW 2022; 52:292-315. [PMID: 37484214 PMCID: PMC10358449 DOI: 10.1080/2372966x.2021.2010502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/23/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
Black boys have been dying by suicide at an increasing rate. Although the reasons for this increase are unknown, suicide in Black boys is likely influenced by multiple, intersecting risk factors, including historical and ongoing trauma. Schools can serve as an important mechanism of support for Black boys; however, without intentional anti-racist frameworks that acknowledge how intersecting identities can exacerbate risk for suicide, schools can overlook opportunities for care and perpetuate a cycle of racism that compromises the mental health of Black youth. By recognizing their own implicit biases, modeling anti-racist practices, listening to and recognizing the strengths and diversity of Black youth, and fostering school-family-community partnerships, school psychologists can help transform the school environment to be a safe and culturally affirming place for Black youth. This paper outlines how school psychologists can apply a trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-informed approach to suicide prevention in order to more holistically support Black boys, disrupt patterns of aggressive disciplinary procedures, and improve school-based suicide prevention programs. By applying this lens across a multitiered systems of support (MTSS) framework, school psychologists can help to prevent the deaths of Black boys and begin to prioritize the lives of Black boys.
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Affiliation(s)
| | | | - Dana Griffin
- School of Education, University of North Carolina at Chapel Hill
| | - Meghan J Greene
- School of Education, University of North Carolina at Chapel Hill
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