Monday, June 28, 2021

Research to Prevent Suicide of Black Youth Must Take Ground Zero Approach, Say Experts

More research on the prevention of suicide among Black youth is urgently needed, yet clinicians can and should address suicidality within this population in their practices now, according to two viewpoints published today in JAMA Pediatrics.

Over the past several decades, data have clearly illustrated the rising trend of suicide among Black youth, wrote Arielle H. Sheftall, Ph.D., a principal investigator in the Center for Suicide Prevention and Research at the Abigail Wexner Research Institute at Nationwide Children’s Hospital in Ohio, and Adam Bryant Miller, Ph.D., a research assistant professor in the Department of Psychology and Neurosciences at the University of North Carolina at Chapel Hill. “[T]he rate of suicide in Black youth younger than 13 years is approximately 2 times higher compared with their White counterparts,” Sheftall and Miller wrote.

Following a report released by the Congressional Black Caucus in December 2019, the National Institute of Mental Health (NIMH) requested information on key points related to the prevention of suicide among Black youth. Sheftall, Miller, and colleagues responded to the request by outlining areas that require more research to address suicide prevention among this population, including culturally relevant risk factors and the developmental trajectory of suicidal ideation and behavior among Black youth.

Research on suicide in this population cannot be conducted through a “White-centric lens,” Sheftall and Miller wrote. Risk factors for suicide that commonly apply to other groups, like depression, may not be linked to suicide in Black youth. “Because of the lack of culturally sensitive theories, we have little information about how unique, race-related stressors may contribute to disparities in suicide rates among Black youth,” the authors wrote. They suggest a mixture of quantitative and qualitative methodology, such as interviews and focus groups with youth, families, and clinicians, to better understand culturally relevant risk and protective factors.

Further, to inform and identify effective prevention efforts, researchers must identify the factors relevant to suicidal ideation among Black youth, barriers for Black youth in sharing suicidal ideation, and unique features of ideation among this population.

Despite NIMH’s call for research, the urgency to address suicide among Black youth requires clinicians to act now through assessments, interventions, and advocacy, wrote Tennisha Riley, Ph.D., an assistant professor in the Department of Counseling and Educational Psychology at Indiana University, and colleagues in another viewpoint.

Riley and colleagues emphasized the importance of universal screenings for suicidality across health care settings, but they noted that clinicians should be aware that suicidality and risk factors may differ for Black youth compared with other groups. “Black youth are more likely to endorse symptoms of somatic complaints or relationship difficulties compared with White youth,” they wrote.

In terms of developing prevention interventions, Riley and colleagues emphasized the importance of culturally informed approaches; listening to Black youth’s views of the world; and collaborating with parents, teachers, and mentors. “Given the importance of connectedness, interventions implemented within community locations (eg, Black churches) might be useful in increasing access to evidence-based, culturally relevant approaches,” they wrote.

Finally, Riley and colleagues highlighted the unique role that clinicians play in advocating for Black youth. “Advocacy involvement is paramount in challenging current social, justice, and health care systems that are steeped in the systemic oppression of Black and African American individuals in the U.S.,” they wrote. “We encourage clinicians and researchers to continue learning about systems of oppression in the U.S. and other societies, engage in active discussions of racism with colleagues, and model these collective efforts for early career professionals.”

For related information, see the Psychiatric News articles “Alarming Black Youth Suicide Trend Must Be Addressed, Experts Say” and “Congress Considering Bills to Curb Black Youth Suicide.”

(Image: iStock/RyanJLane)

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