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Diaz AD. Assessment of Suicide Risk and Cultural Considerations in Forcibly Displaced Migrant Youth. Acad Pediatr 2024; 24:25-31. [PMID: 38991798 DOI: 10.1016/j.acap.2023.05.024] [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: 01/26/2023] [Revised: 04/10/2023] [Accepted: 05/26/2023] [Indexed: 07/13/2024]
Abstract
Migrant youth who face forced displacement from their home countries have an emergent mental health burden, placing them at increased suicide risk. As such, it is crucial for pediatric providers to include suicide screening and assessment in their care for this population. Migrant families seek safety but, in many cases, encounter adverse events and psychosocial inequities in the migration journey and in the host community. Factors such as trauma, acculturative stress, and intersectionality influence suicide risk in migrants. Summative traumatic events contribute to the mental health load and worsen suicidal outcomes in migrant youth. Acculturative stress can lead to social marginalization in the host country, further adding to the existing mental health burden. Finally, intersectionality encompasses complex sociocultural influences, which shape the development of cultural identity in migrant youth and influence suicide risk. By examining these factors, the author advances cultural considerations in screening and assessment for suicide risk in migrant youth through evidence-based tools in pediatric clinical practice. Barriers to access to mental health services, stigma, and distrust of the health care system within the host community are also addressed. The author establishes recommendations for early suicide screening and prevention within this population through trauma-informed care, active advocacy, and cultural sensitivity.
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Affiliation(s)
- Ailyn D Diaz
- Pennsylvania State University College of Medicine (AD Diaz), Department of Psychiatry and Behavioral Health
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Seff I, Bennouna C, Gillespie A, Ali A, Allaf C, Wessells M, Stark L. Meaning-focused coping as a cultural process: A mixed quantitative and PhotoVoice study of adolescents with Arab backgrounds overcoming stigma and harassment. Soc Sci Med 2024; 350:116921. [PMID: 38723586 DOI: 10.1016/j.socscimed.2024.116921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024]
Abstract
Poor mental health among U.S. adolescents has reach epidemic proportions, with those from the Middle East and North African region exhibiting increased risk for distress and suicide ideation. This mixed-methods study analyzes quantitative data from first- and second-generation Arab adolescents (n = 171) and qualitative data from a participatory study conducted with 11 adolescents of the same population to understand the role of cultural resources in coping. Drawing on the Intersectional Theory of Cultural Repertoires in Health, we show that: 1) cultural resources underlie meaning-making throughout coping; 2) coping strategies are inseparable from the influence of peer and familial relationships, as dictated through the social norms and other cultural resources; 3) collectively held repertoires of coping can promote belonging, affirm identity, and protect against discrimination; and 4) the outcomes of coping strategies, and the culturally informed meaning individuals make of these outcomes, influence their future coping behaviors.
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Affiliation(s)
- Ilana Seff
- Brown School at Washington University in St. Louis, St. Louis/Washington DC/Chicago, USA.
| | - Cyril Bennouna
- Brown University, Department of Political Science, Providence/Denver, USA.
| | - Alli Gillespie
- Brown School at Washington University in St. Louis, St. Louis/Washington DC/Chicago, USA.
| | - Ali Ali
- School of Social Work, The University of Michigan, Ann Arbor, MI, USA.
| | | | - Michael Wessells
- Columbia University, Program on Forced Migration and Health, New York City, USA.
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, St. Louis/Washington DC/Chicago, USA.
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de Oliveira Gracini CL, Nascimento GG, Vidigal MTC, de Oliveira MN, Herval ÁM, Blumenberg C, Vieira WA, Lima RR, Paranhos LR. Suicide ideation and psychotropic recreational drug use by adolescents: a systematic review and meta-analysis. SAO PAULO MED J 2024; 142:e2022641. [PMID: 38655989 PMCID: PMC11034886 DOI: 10.1590/1516-3180.2022.0641.r2.23012024] [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: 12/29/2022] [Revised: 12/23/2023] [Accepted: 01/23/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited. OBJECTIVE To investigate the relationship between suicide ideation and psychotropic recreational drug use among adolescents. DESIGN AND SETTING Systematic review with meta-analysis developed at Universidade Federal de Uberlândia (UFU) and Universidade Estadual de Campinas (UNICAMP), Brazil. METHODS A search across eight electronic databases for observational studies, without language or publication year restrictions, was conducted. The Joanna Briggs Institute tool was used to assess the risk of bias. Random-effects meta-analyses and odds ratios were used to measure the effects. RESULTS The search yielded 19,732 studies, of which 78 were included in the qualitative synthesis and 32 in the meta-analysis. The findings indicated that suicidal ideation was 1.96 times more likely (95% confidence interval, CI = 1.47; 2.61) for adolescents who used some drug recurrently and 3.32 times more likely (95%CI = 1.86; 5.93) among those who abused drugs. Additionally, adolescents who used cannabis were 1.57 times more likely (95%CI = 1.34; 1.84) to experience suicide ideation compared with non-users, while cocaine users had 2.57 times higher odds (95%CI = 1.47; 4.50). CONCLUSIONS Psychotropic recreational drug use is associated with suicidal ideation among adolescents regardless of current or previous use, abuse, or type of substance used. SYSTEMATIC REVIEW REGISTRATION Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.
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Affiliation(s)
- Cássia Lima de Oliveira Gracini
- MSc. Nurse, Master’s student, Postgraduate Program in Management and Public Health, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Gustavo Giacomelli Nascimento
- PhD. Dentist, Principal Investigator, National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore; Professor, Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Maria Tereza Campos Vidigal
- MSc. Dentist, Master’s student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Murilo Navarro de Oliveira
- MSc. Dentist, Doctoral student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Álex Moreira Herval
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Cauane Blumenberg
- PhD. Computer Scientist, Collaborative Researcher, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Walbert A. Vieira
- MSc. Dentist, Doctoral student, Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Rafael Rodrigues Lima
- PhD. Dentist, Professor, Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém (PA), Brazil
| | - Luiz Renato Paranhos
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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Smith-Appelson J, Belgrade A, Saleem N, Ali A, Seff I, Stark L. "Hope for a better tomorrow": Using photovoice to understand how Arab adolescents enact critical consciousness. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2537-2562. [PMID: 36961413 DOI: 10.1002/jcop.23031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
We explore how Arab adolescents enact critical consciousness to improve their lives and better their community. Eleven first- and second-generation Arab adolescents participated in a Photovoice study and were asked to reflect on and take photos that represented their well-being, daily life, and sense of belonging and community. The participants discussed their photos over multiple group reflection sessions. Thematic analysis highlights how Arab adolescents make positive change in their community, aided by their connections to community, their awareness of structural challenges they and their communities face, and their sense of agency to make positive change. We contribute to the literature by offering a window into the lived experiences of critical consciousness among Arab adolescents, an underrepresented group in the critical consciousness literature. We also add to the growing body of evidence that highlights the importance of "everyday activism" when considering social change actions.
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Affiliation(s)
| | - Andrea Belgrade
- Method4Change, USA
- Institutional Research and Academic Planning, Office of the President, University of California, Oakland, California, USA
| | - Noor Saleem
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ali Ali
- The Arab Community Center for Economic and Social Services (ACCESS), Dearborn, Michigan, USA
- School of Social Work, The University of Michigan, Ann Arbor, Michigan, USA
| | - Ilana Seff
- Brown School at Washington University in St. Louis, St. Louis, Missouri, USA
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, St. Louis, Missouri, USA
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Polanco-Roman L, Ebrahimi CT, Mafnas KSW, Hausmann-Stabile C, Meca A, Mazzula SL, Duarte CS, Lewis-Fernández R. Acculturation and suicide-related risk in ethnoracially minoritized youth in the US: a scoping review and content analysis of the empirical evidence. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1121-1137. [PMID: 37270726 PMCID: PMC10366293 DOI: 10.1007/s00127-023-02494-0] [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: 08/30/2022] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE Among Asian-American/Pacific Islander, Hispanic/Latinx, and Black youth, the US born have higher risk of suicidal thoughts and behaviors (attempts and death-by-suicide) than first-generation migrants. Research has focused on the role of acculturation, defined as the sociocultural and psychological adaptations from navigating multiple cultural environments. METHODS Using content analysis, we conducted a scoping review on acculturation-related experiences and suicide-related risk in Asian-American/Pacific Islander, Hispanic/Latinx, and Black youth (henceforth described as "ethnoracially minoritized adolescents"), identifying 27 empirical articles in 2005-2022. RESULTS Findings were mixed: 19 articles found a positive association between acculturation and higher risk for suicide ideation and attempts, namely when assessed as acculturative stress; 3 articles a negative association; and 5 articles no association. Most of the research, however, was cross-sectional, largely focused on Hispanic/Latinx youth, relied on demographic variables or acculturation-related constructs as proxies for acculturation, used single-item assessments for suicide risk, and employed non-random sampling strategies. Although few articles discussed the role of gender, none discussed the intersections of race, sexual orientation, or other social identities on acculturation. CONCLUSION Without a more developmental approach and systematic application of an intersectional research framework that accounts for racialized experiences, the mechanisms by which acculturation may influence the risk of suicidal thoughts and behavior remain unclear, resulting in a dearth of culturally responsive suicide-prevention strategies among migrant and ethnoracially minoritized youth.
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Affiliation(s)
- Lillian Polanco-Roman
- The New School, Department of Psychology, 80 Fifth Avenue, Room 617, New York, NY, 10011, USA.
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
| | - Chantel T Ebrahimi
- The New School, Department of Psychology, 80 Fifth Avenue, Room 617, New York, NY, 10011, USA
| | - Katherine S W Mafnas
- The New School, Department of Psychology, 80 Fifth Avenue, Room 617, New York, NY, 10011, USA
| | | | - Alan Meca
- Department of Psychology, University of Texas at San Antonio, San Antonio, USA
| | - Silvia L Mazzula
- Department of Psychology, John Jay College for Criminal Justice, CUNY, New York, NY, USA
| | - Cristiane S Duarte
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Roberto Lewis-Fernández
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
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Andrade AS, Roca JS, Pérez SR. Children's Emotional and Behavioral Response Following a Migration: A Scoping Review. J Migr Health 2023; 7:100176. [PMID: 37034241 PMCID: PMC10074795 DOI: 10.1016/j.jmh.2023.100176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/03/2023] [Accepted: 03/08/2023] [Indexed: 03/22/2023] Open
Abstract
Background Migration is a present and pressing global phenomenon, as climate change and political instability continue to rise, more populations will be forced to relocate. Efficient strategies must be in place to aid the transition of vulnerable populations - such as children - and strategic interventions designed based on an understanding of their particular needs and risks. Aim of the review This article reviewed recent research regarding the mental health of migrant children identifying a wide array of common characteristics to their emotional and behavioral responses following a migration, and compiled an extensive list of protective and risk factors. 48 studies were selected from Proquest, WOS, SCOPUS, and Pubpsych published between 2015 and 2022 covering studies of children around the world. Findings The migration-related factors that most negatively impacted children's mental health were experiences such as discrimination, loss of access to governmental and educational resources, premigration trauma, loss of community, cultural distance and acculturation, the burden on the family unit, and socioeconomic difficulties. Thus, with the right interventions and policy changes, it is possible to make migration a non-traumatic experience in order to avoid the common emergence of depressive symptoms, PTSS (post-traumatic stress symptoms), anxiety, and other mental health issues. Supporting the family unit's transition, encouraging peer connections, and directing government aid to expedite resources upon arrival will serve as protective factors for children while they integrate into their new environment.
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Affiliation(s)
- Alejandra Salazar Andrade
- Universitat Autònoma de Barcelona Department of Basic, Developmental and Educational Psychology, Spain
- Corresponding author.
| | - Josefina Sala Roca
- Department of Educational Theories and Social Pedagogy, Universitat Autònoma de Barcelona, Spain
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Goldstein EV, Wilson FA. Hispanic Immigrants and Suicide: Overcoming Data Challenges in an Anti-immigrant Climate. AJPM FOCUS 2022; 1:100038. [PMID: 37791237 PMCID: PMC10546600 DOI: 10.1016/j.focus.2022.100038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Affiliation(s)
- Evan V. Goldstein
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
| | - Fernando A. Wilson
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
- Department of Economics, University of Utah, Salt Lake City, Utah
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, Utah
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