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Platt R, Alvarez K, Vasquez MG, Bancalari P, Acosta J, Caicedo MR, Polk S, Wilcox H. Suicide prevention programming across ecological levels: Recommendations from Latinx immigrant origin youth and their parents. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2024; 42:101-115. [PMID: 37616106 PMCID: PMC10891300 DOI: 10.1037/fsh0000835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Latinx immigrant-origin youth (IOY) have unique risks for suicidal thoughts and behaviors. It has been suggested that these risks should be addressed from an ecological perspective, addressing cultural and family context as well as structural and systemic barriers to prevention. This study sought to explore perspectives of immigrant-origin Latinx adolescents and their caregivers on suicide and its prevention, including the potential impact of stressors specific to immigrant status. METHOD Focus groups were conducted in 2018-2019 with Latinx immigrant-origin caregivers (N = 41, 97.5% female) and adolescents (ages = 14-19, N = 56, 50% female). Participants were recruited from community-based organizations in two different cities. A codebook approach to thematic analysis was used to identify themes, which were subsequently mapped onto levels of the Center for Disease Control's Social-Ecological Framework for Violence Prevention. RESULTS Participants identified both contributors to suicidal behavior and potential components of prevention programming across ecological levels. Specific recommendations for suicide prevention included engaging in recreation, parenting education and support, enhancing academic supports for adolescents, and enhancing school-family communication. Structural barriers (e.g., caregiver work schedules) to implementing recommendations were described. DISCUSSION Our results highlight the potential role of access to school and community-based supports as public health-oriented suicide prevention strategies and suggest a need to address barriers faced by immigrant families in accessing these supports alongside addressing barriers to mental health treatment. Policies impacting immigrant families' financial stability and increasing the availability of recreational and academic opportunities may promote mental health and prevent suicidal thoughts and behavior among IOY. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kiara Alvarez
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Pilar Bancalari
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- NYC Administration for Children’s Services, New York, NY
| | - Jennifer Acosta
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
- Maryland Department of Health, Baltimore, MD
| | - Mariana Rincon Caicedo
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Psychology, University of Kansas, Lawrence, KS
| | - Sarah Polk
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Holly Wilcox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Tuda D, Stefancic A, Lam P, John D, Sadaghiyani S, Choo TH, Galfalvy H, Coronel B, Gil R, Lewis-Fernández R. Life is precious: A quasi-experimental study of a community-based program to prevent suicide among Latina adolescents in New York City. Suicide Life Threat Behav 2023. [PMID: 38050824 PMCID: PMC11150327 DOI: 10.1111/sltb.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/09/2023] [Accepted: 11/18/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Rising rates of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents urgently need attention. Life is Precious (LIP) is a culturally responsive, community-based, afterschool-model program offering wellness-support services to supplement outpatient mental health treatment for Latina adolescents experiencing STB's. This 12-month quasi-experimental pilot study explored LIP's impact on clinical outcomes. METHODS Latina adolescents newly enrolled in LIP and receiving outpatient treatment (n = 31) and those newly starting outpatient treatment only (n = 12; Usual Care) were assessed for Suicidal Ideation (Suicidal Ideation Questionnaire; SIQ) and depressive symptoms (Patient Health Questionnaire-9). We estimated differences in mean scores using longitudinal linear mixed models and adjusted risk ratios (ARRs) of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements using exact logistic models. RESULTS The direction of the estimated impact of LIP was positive [differences (95% CIs): -15.5 (-34.16, 3.15) for SIQ; -1.16 (-4.39, 2.07) for PHQ-9], with small-to-moderate nonsignificant effect sizes (0.19-0.34). LIP participants saw two to three times higher prevalence than controls of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements; ARRs (95% CIs) were 1.91 (0.61, 3.45), 3.04 (0.43, 11.33), and 1.97 (0.44, 5.07), respectively. Suicidal behaviors also decreased in LIP. CONCLUSION The effects of LIP were in positive directions across clinical outcomes, warranting further research on its effectiveness in decreasing STBs.
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Affiliation(s)
- Daniela Tuda
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
- Center for Mental Health Services Research, Brown School, Washington University, St. Louis, Missouri, USA
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
| | - Ana Stefancic
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Peter Lam
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Dolly John
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Shima Sadaghiyani
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Tse-Hwei Choo
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York City, New York, USA
| | | | - Rosa Gil
- Comunilife, Inc., New York City, New York, USA
| | - Roberto Lewis-Fernández
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
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Querdasi FR, Bacio GA. Suicidal behaviors among Latina adolescents: An ecodevelopmental approach and narrative review. J Adolesc 2021; 93:161-176. [PMID: 34785380 DOI: 10.1016/j.adolescence.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 08/10/2021] [Accepted: 10/31/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION For the past several decades, Latina adolescents have consistently shown high rates of suicidal behaviors (i.e., suicidal ideation, planning, and attempts), higher than Latino adolescents and adolescents of most other ethnic groups. Yet, progress toward establishing evidence-based intervention efforts to address this urgent public health issue has been slow. The purpose of this narrative review is to summarize empirical findings on etiological factors associated with Latina adolescent suicidal behaviors using an ecodevelopmental, gender-specific framework that contextualizes Latina adolescent development. METHODS To be included, peer reviewed empirical manuscripts had to focus on suicidal behaviors (i.e., suicide attempts, suicide plan, and/or suicidal ideation) of adolescents (ages 11-19 or in grades 7-12) who self-identified as either Latina or Hispanic and a girl in the United States. RESULTS A total of 19 studies met review criteria and focused on microsystemic and intrapersonal predictors. Microsystemic predictors included family (i.e., family-adolescent discrepancies in acculturation, family functioning, family-daughter interactions), peer (i.e., victimization, friendships), and school (i.e., functioning, achievement) factors, while intrapersonal predictors were emotional vulnerability, psychosocial functioning, and substance use. CONCLUSIONS Family-related phenomena were the most widely studied. Research on school and peer microsystems was comparatively sparse, and several promising intrapersonal development factors have been underexplored. A notable limitation of existing studies is that samples consisted primarily of U.S.-born adolescents living in urban areas. Additional research is needed to characterize factors on other ecodevelopmental levels, identify resilience processes, and examine within-group diversity among Latina adolescents. Implications for intervention and future directions are discussed.
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Affiliation(s)
- Francesca R Querdasi
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA.
| | - Guadalupe A Bacio
- Departments of Psychological Science and Intercollegiate Chicana/o-Latina/o Studies, Pomona College, 647 N College Way, Claremont, CA, 91711, USA.
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Positive Relationships with Adults and Resilience to Suicide Attempt among New Mexico Hispanic Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910430. [PMID: 34639736 PMCID: PMC8508296 DOI: 10.3390/ijerph181910430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 12/02/2022]
Abstract
Suicide is a leading cause of adolescent death and has increased in recent years. The purpose of this study was to examine the effect that relationships with adults at home and in the community had on the probability of suicide attempts of Hispanic teenagers in New Mexico. Data from the 2019 New Mexico Youth Risk and Resiliency Survey were analyzed to identify the ways in which relationships with adults influenced suicide attempts among Hispanic adolescent students. The examined factors included: relationships with adults in the home and in the community and with same-age friends, and participation in hobbies or organizations outside of school. The resiliency factors were similar for male and female Hispanic students. As positive relationships with adults at home or in the community increased, the probability of suicide attempts decreased by 37–54%. Positive relationships with same-age friends were also associated with reduced suicide attempts. Community organization involvement and hobbies affected males and females differently. Adults at home and in the community can decrease the risk of suicide for Hispanic teenagers through supportive relationships. Hybrid programs focusing on adolescent health, positive communication, and academic support, which integrate adults from home and community environments, show promise in reducing suicidal thoughts and other risk behaviors.
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Cramer RJ, Crow BE, Kaniuka AR. Introduction to the public health approaches to suicide prevention special issue. Suicide Life Threat Behav 2021; 51:185-188. [PMID: 33876489 DOI: 10.1111/sltb.12692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Bruce E Crow
- Department of Veterans Affairs Suicide Prevention Program
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Immigrant Disparities in Suicide Ideation: Variation Across Age of Migration, Gender, and Nativity. J Immigr Minor Health 2020; 22:881-887. [DOI: 10.1007/s10903-020-00993-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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How is Participating in Suicide Prevention Activities Experienced by Those with Lived and Living Experiences of Suicide in Australia? A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134635. [PMID: 32605104 PMCID: PMC7369788 DOI: 10.3390/ijerph17134635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/04/2022]
Abstract
People with a lived experience of suicide are commonly included within suicide prevention research. This includes participation in conferences, policy development, research and other activities. Yet little is known about the impact on the person in the long term of regularly sharing one’s experience to different audiences and, in some cases, to a schedule not of your choosing. This qualitative study asked twenty people to share their reflections of being lived experience representatives within suicide prevention. Participants varied in the length of time they had been sharing their stories, and how they shared with different audiences. These narratives were thematically analysed within a reflective framework, including field notes. Four broad themes were noted that highlighted participants’ recommendations as to how the lived experience speaker training could grow alongside suicide prevention activities to facilitate safe activities that include a shared understanding of the expected outcome from participation. The environment for people with lived experience of suicide to tell their stories already exists, meaning that the suicide prevention sector needs to move quickly to ensure people understand the variety of spaces where lived experience needs to be incorporated, evaluated and better supported. When lived experience is a valued inclusion in the creation of effective and appropriate suicide prevention research and interventions, those who share their experience must be valued and supported in a way that reflects this. This study recommends strategies to practically and emotionally support speakers, including ways to ensure debriefing and support, which can enhance the longevity of the speakers in the suicide prevention space by valuing the practical and emotional labour required to be suicide prevention representatives, with an outcome recommendation for best practice guidelines for those who engage people with lived experience in suicide prevention activities.
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Humensky JL, Gil RM, Mazzula S, Diaz S, Lewis-Fernández R. Life Is Precious: Views of Adolescents and Their Mothers on Methods to Reduce Suicidal Behavior in Latinas. J Sch Nurs 2017; 33:426-433. [PMID: 28750573 DOI: 10.1177/1059840517722590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Life is Precious (LIP) was developed to help reduce suicidal behavior in Latina adolescents. As part of an external evaluation of the LIP program, we conducted focus groups with adolescent participants and mothers to learn whether participants and families believe that the activities of LIP address risks for suicidal behavior. Four focus groups were conducted: three with Latina adolescent LIP participants ( n = 31) and one with mothers ( n = 8). Transcripts were analyzed using ATLAS.ti. A grounded theory approach was used to identify themes and subthemes. The following themes emerged: (1) challenges contributing to suicidal behavior and self-harm among Latina adolescents, (2) how respondents believe that LIP is helping to reduce suicidal behavior, and 3) ongoing challenges. Participants say that the LIP program helps adolescents feel better and improve social relationships, academic performance, and relationships with their family. School nurses may wish to identify community-based programs offering similar services.
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Affiliation(s)
- Jennifer L Humensky
- 1 Columbia University, New York, NY, USA.,2 New York State Psychiatric Institute, New York, NY, USA
| | | | - Silvia Mazzula
- 4 John Jay College, City University of New York, New York, NY, USA
| | - Samantha Diaz
- 2 New York State Psychiatric Institute, New York, NY, USA
| | - Roberto Lewis-Fernández
- 1 Columbia University, New York, NY, USA.,2 New York State Psychiatric Institute, New York, NY, USA
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