Supporting suicidal minoritized patients begins with the recognition and acknowledgment that racism and discrimination are contributors to psychological distress and suicidality. Establishing therapeutic communication will support effective engagement in treatment planning, effectiveness of safety planning and other interventions, and greater engagement in follow-up care. Can you share clinical advice about a culturally informed approach to supporting minoritized patients who may be suicidal? Nationally, it is estimated that up to 20% of maternal deaths are suicides, making maternal suicide deaths more common than deaths from postpartum hemorrhage or hypertensive disorders. The Department of Veterans Affairs’ (VA’s) 2023 National Suicide Prevention Annual Report states the unadjusted suicide rate among Veterans in 2021 was more than double that of non-Veteran adults (102% higher).. Suicide risk among service members and Veterans is greater than that of the general population.
However, current recommendations and best practices are based largely on research conducted predominantly by White research groups with predominantly White samples and on guidelines that are developed without considering unique factors for youth of color. Dispositions of cases are typically made based on level of assessed risk (e.g., low, medium, high, imminent) and can range from recommendations for monitoring to creating a safety plan to Drexel Latinx Cultural Identity Resources stepping up to a higher level of care (e.g., intensive outpatient treatment or hospitalization). Youth may be screened for suicide risk through a combination of self-report instruments and clinical interviews. Even when risk factors are similar across ethnoracial groups, the mechanism for STBs may be different. Risk assessment is a specific clinical skill set used to methodically assess imminent risk, which involves examining additional risk and protective factors.
Absolute suicide rates
The authors acknowledge that much of the literature is underdeveloped and collapses across the rich diversity within ethnoracial groups (e.g., Black youth, Latine youth). Throughout this manuscript, the term “youth of color” comprises youth in Black, Asian, Latine, Native American/Indigenous, and multicultural communities. The first part of this manuscript describes the current state of assessment tools and techniques available for youth of color. Latine females reported the next highest suicide attempt rate at 11.9%, compared to 9.4% for White non-Latine females (Ivey-Stephenson et al., 2020). A suicide attempt is often characterized as self-injurious but nonlethal behavior that has some degree of intent to end one’s life. The term “suicide,” often used synonymously with “suicide death,” involves intentional self-injurious behavior that results in a fatality (Silverman et al., 2007).
A meta-analysis of 30 cross-sectional studies from high-income countries reported prevalence of lifetime suicide attempts among sexual minority adults ranging from 10% in population surveys to 20% in community surveys compared to 4% for heterosexual respondents . • Sexual minority populations had a lower prevalence of social support and health care access; the presence of social support and health care access was related to lower prevalence of recent suicidal ideation. • More than 40% of sexual minority populations aged 15 to 44 years had lifetime suicidal ideation; two thirds and one third of the gender minority population had lifetime suicidal ideation and suicide attempts, respectively.
- The report references research indicating that Black children ages 5–12 years old have nearly twice the rate of suicide as White youth the same age (9, 10), which runs counter to the long-held perception that suicide rates are uniformly higher among White than Black individuals in the United States (9).
- They suggested such a shift because interventions developed for Western populations sometimes do not align with Native worldviews and traditions.
- Sampling weights were used for all statistical analyses to account for individual-level sampling factors (i.e. non-response and unequal probabilities of selection).
- As we continue to understand how culture influences suicidal behavior, we enhance our ability to design more effective prevention programs for all groups.
- OHA’s access to a variety of data sources enables it to crosswalk data and make evidence-informed decisions on suicide prevention needs and strategies.
Participants
Students were asked to select their demographic group(s) by race, sex, and sexual orientation. The racial composition of youth in the state denotes that approximately 25% are Black, 18% are Hispanic/Latino, 4.5% are Multiracial, 3.5% are Asian, 1.2% are American Indian, and 0.1% are Pacific Islanders. Approximately 459,628 youth attend public high schools (North Carolina Department of Public Instruction, n.d.), and 28,794 attend private high schools (North Carolina Department of Administration, 2022). This data is comprised of high school adolescent responses from 1991 until 2019 in North Carolina.
Statistical Analysis
This approach includes viewing STBs through a lens of justice, equity, diversity, and inclusion in the conceptualization and data collection for research and practice (Bath & Njoroge, 2021). A culturally unresponsive interviewer might interpret the youth’s anxiety as an individual factor instead of considering it a response to societally sanctioned heterosexism that is both racialized and discriminatory aggression. A contextualized approach may be particularly important in these communities because risk assessment is often the first step in the treatment process. In assessing racial socialization of youth of color, researchers and clinicians should gather information about each parent, as well as family racial socialization messages and strategies, while also considering the youth’s age and developmental stage. Although there is paucity of research directly measuring family ethnoracial socialization and youth STBs, it is an important construct in youth development and a potential protective factor. Families of color socialize their children in regard to race/ethnicity, and this socialization includes preparing their children to encounter and cope with racism and discrimination (e.g., Anderson & Stevenson, 2019).
We had pre-specified two additional analyses by method of suicide and ethnic density, but data were not consistently reported, nor enough variability presented to allow for a meaningful analysis. Some studies reported multiple estimates, for example representing rates or RR in several different ethnic groups. There are clearly differences between ethnic minority groups and those who are migrants, or indigenous peoples in terms of certain rights and histories. Suicidal behaviour is a major public health concern and variation in suicidal behaviour is likely to be observed between culturally distinct populations within nations. The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. Some people have mental health symptoms that are strong, long-lasting, and make it hard to function day to day.
Write a comment: