OBJECTIVES: To determine if racial and ethnic subgroups of adolescents are at high risk for engagement in suicidal behaviors.METHODS: Using the nationally representative school-based Youth Risk Behavior Survey from the years 1991 to 2017, we conducted logistic regression analyses to examine trends by different racial and ethnic groups, with each suicide indicator serving as a dichotomous outcome. Participants included 198 540 high school students.RESULTS: Across all sex and race and ethnic groups, there were significant linear decreases in self-reported suicidal ideation and suicide plans from 1991 to 2017. Female adolescents (odds ratio [OR], 0.98; P , .001) had significant decreases in attempts over time. Black adolescents had positive linear trends for suicide attempts among both boys (OR, 1.04; P , .001) and girls (OR, 1.02; P = .003). Black adolescent boys (OR, 1.04; P = .048) had a significant linear increase in injury by attempt. CONCLUSIONS:The results suggest that, over time, black youth have experienced an increase in suicide attempts, which is troubling because attempts are the most prominent risk factor associated with suicide death. For black boys, a significant increase in injury by attempt occurred, which suggests that black boys may be engaging in increasingly lethal means when attempting suicide. Examining trends of suicidal thoughts and behaviors over time by sex and race and ethnicity allow us to determine where to focus prevention and intervention efforts. Future research should examine the underlying reasons for these changes observed in US high school students.WHAT'S KNOWN ON THIS SUBJECT: Suicide is the second leading cause of death among adolescents. Racial and ethnic disparities have been discovered in suicide deaths. Racial and ethnic differences in trends of youth suicidal ideation, plans, and suicide attempts, however, remain understudied.WHAT THIS STUDY ADDS: This study uncovered racial and ethnic differences in trends of suicidal behaviors. Suicide ideation and suicidal plans decreased among US adolescents between 1991 and 2017. Subgroup findings indicate suicide attempts increased only among black adolescents.

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.

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Objective Provide nationally representative data on the prevalence and psychiatric correlates of suicidal ideation and attempts among African American and Caribbean black adolescents in the United States. Method Data on nonfatal suicidal behavior among 1,170 African American and Caribbean black adolescents aged 13 to 17 years are from the National Survey of American Life-Adolescent, a nationally representative household survey of adults with an attached adolescent sample conducted between February 2001 and June 2003. Results Nationwide black adolescents reported having a lifetime prevalence of 7.5% for suicidal ideation and 2.7% for attempts. The 12-month prevalence of suicidal ideation and attempt was 3.2% and 1.4%, respectively. Among all respondents, 4% of black American adolescents and 7% of female subjects were projected to attempt suicide by age 17 years. African American adolescents were approximately five times more likely than Caribbean black adolescents to attempt suicide. Almost half of the National Survey of American Life-Adolescent respondents who reported a suicide attempt had never met criteria for any of the DSM-IV disorders by the time of their attempts. Conclusions Clinicians should be trained to screen for suicidal behavior, even among those without DSM-IV disorders, when treating black adolescents, particularly female subjects. In addition, preventive efforts should consider ethnic differences in suicide risk and targeting nonclinical settings.

The association between adolescents' and young adults' attitudes toward suicide and their own suicidality across five racial-ethnic classifications was studied in a nationally representative sample of 3,301 youth ages 14 to 22 years from the National Annenberg Risk Survey of Youth. Results indicate that adolescents and young adults who most strongly believe that it is acceptable to end one's life are more than fourteen times more likely to make a plan to kill themselves as those who do not have such beliefs (p < .001). Future behavioral prevention and intervention research should take into consideration adolescents' and young adults' approval of suicide as a risk factor for taking their own lives.