This framework relies on an ecological systems perspective, which describes how individuals are embedded within social, political, and economic systems that shape behaviors and access to resources necessary to promote health (23, 29). Youth are embedded in multiple ecological contexts (family, schools, neighborhoods), within which adverse conditions (e.g., family stress, reduced social support, economic disadvantage) can impact risk for suicidal thoughts, behaviors, and deaths. Latina girls have reported the highest rates of suicidal ideation and attempts for decades in the national Youth Risk Behavior Survey, while in the last two surveys the highest rates of attempts have been reported by Black girls (18–20). Among Black youth suicide decedents, behavioral disorders (not depression) were the most prevalent mental disorders, and hanging/suffocation (not firearms) was the most common method. It should be noted that comparative estimates of suicide rates for children of this age are based on small sample sizes and therefore should be cautiously interpreted. In this context, culture is defined more broadly, considering race, age, ethnicity, gender identity, sexual orientation, disability, or any other identity of individual patients, including those with overlapping oppressed identities.
Figure 2. Crude Suicide Rate Among Male Youth Aged 15 to 24 Years by Race/Ethnicity, 1999 to 2019.
- Addressing suicide in marginalized communities requires strategies that reflect the unique cultural and social realities of these groups.
- We argue that addressing problems as complex and societally rooted as structural racism and suicide prevention requires the integration of macro-level population health perspectives with expertise in microsystem-level mental health interventions.
- We did not find evidence of effect modification by race; however, the differences observed across racial groups in the extant literature may speak to the different variables used across the different studies.
- Missing data was not imputed as MCARs were conducted, and the results indicated that responses were missing at random.
SPRC’s online offerings for state suicide prevention leads (such as online trainings, resources, webinars, Drexel Latinx Cultural Identity Resources communities of learning, and listservs) allow leaders from states with limited travel funding to engage in education with national experts and network with peers from across the United States. In addition, state suicide prevention leads can engage in suicide prevention networking and training opportunities through SPRC and other national organizations. Many states send their suicide prevention coordinators and other key program staff to the American Association of Suicidology Annual Conference to learn about the latest research and network with national and international suicide prevention professionals. The New Hampshire DHHS also supports the dissemination of best practices in suicide prevention, intervention, and postvention to communities, and responds to requests through its Public Information Office.
National Strategy for Suicide Prevention Internet.
Racial and ethnic groups differ in their access to culturally appropriate behavioral health treatment, experiences of discrimination and historical trauma, and other factors that may be related to suicide risk. To the best of our knowledge, this is the first systematic review reporting suicide mortality rates amongst individuals from an ethnic minority background. A total of 51 studies of moderate-high quality rating provided RR of suicide in individuals from an ethnic minority background compared to the majority ethnic population. Absolute suicide rates per 100,000 in individuals from an ethnic minority background by continent, migrant status, and region of ancestral origin To our knowledge, there has been no previous systematic review which has aimed to comprehensively identify and synthesise original research to estimate the absolute rates and rate ratios (RR) of suicide in individuals from an ethnic minority background. Yet, they all share common challenges and many of the risk factors which elevate suicide risk (e.g., discrimination, deprivation, social fragmentation).8,14,15 Whilst there is general recognition that these groups are different, non-majority ethnic individuals are often grouped and considered together.
The inclusion of an older adolescent sample, with a mean age of 16.20 years, also limits the representation of, and generalizability for, younger pre‐adolescent Black youth, for whom suicide risk is particularly disproportionate (Bridge et al., 2015). Perhaps as a result, even well‐supported risk factors appear more predictive of suicide attempts in girls than boys (King et al., 2014), and others have called for increased attention to suicide among Black adolescent boys (Marraccini et al., 2021). Of note, the current sample was predominantly made up of boys, despite adolescent girls reporting suicidal ideation at greater rates among Black high school youth in the Youth Risk Behavior Survey (16.9% of girls vs. 10.7% of boys; Ivey‐Stephenson et al., 2020).
A brief, multi-modal gatekeeper training is efficacious in promoting positive gatekeeper behaviors and self-efficacy for suicide prevention in an at-risk ethnic minority population of Japanese Americans. The purpose of this study is to assess the efficacy of a brief, multi-component gatekeeper intervention in promoting suicide prevention in a high-risk Asian community in the United States. Providing affirming environments, promoting acceptance and offering accessible mental health resources tailored to LGBTQ+ individuals are crucial steps in reducing suicide rates within this community. Cultural mistrust must be considered when designing suicide prevention initiatives for ethnic minority populations (Poussaint & Alexander, 2000). Rather, research should confirm these associations, their strengths, and whether the presentation of known suicide risk factors (e.g., depression) may apply to ethnic minority populations. This is not to suggest that many of the known suicide risk factors are not applicable to ethnic minority populations.
