African American adolescent suicidal ideation and behavior: The role of racism and prevention

Abstract

Suicide is one of the most devastating, yet preventable, health disparities for African American adolescents. African American adolescent suicidal ideation and behavior may have different manifestations and risk factors relative to those of adolescents from other ethnic backgrounds that impact prevention efforts.For example, in addition to more common manifestations of suicidal ideation and behavior, African American youth may engage in violent or high-risk behaviors, use more lethal means, or report ideation at lower depression levels. The Adapted-Coping with Stress Course (A-CWS), an adaptation of Gregory Clarke and colleagues' Coping with Stress Course, was developed to address the cultural nuances of African American adolescents. The A-CWS is a 15-session cognitive-behavioral, group-based preventive intervention that aims to enhance adaptive coping skills and reduce suicidal ideation, by incorporating strategies that counter stressors associated with systemic racism that burden African American adolescents.This study evaluated the feasibility and acceptability of the A-CWS intervention, using a sample of predominantly African American ninth-grade students. Results indicated that the adolescents were very favorable and receptive to the A-CWS intervention and that the intervention could be conducted feasibly. The A-CWS intervention serves as a model to advance culturally-grounded, evidence-based preventive intervention, for an underserved sector of adolescents.

Setting a Ground Zero Research Agenda for Preventing Black Youth Suicide

“…For example, common risk factors for suicidal behaviors may not apply equally to Black youth compared with those of other races or ethnicities. Indeed, Robinson et al 4 synthesize research showing there is a less consistent link between psychiatric illness and suicide attempts, and depression diagnosis may not be as strongly linked to Black youth suicidal ideation and behavior compared to other racial or ethnic groups.…”

Collaborative assessment and management of suicidality for teens: A promising frontline intervention for addressing adolescent suicidality.

“…The combination of our recruitment which was predominately conducted from within the hospital setting, and the barriers and stigma associated with accessing psychiatric care may account for lack of enrollment of Black youth in this small trial. Given the growing understanding of younger Black youth’s risk (Ruch et al, 2019) and racial disparity in mental health service utilization (Assari & Caldwell, 2017), culturally responsive suicide prevention efforts for Black youth ought to be integrated into community and religious settings (Molock et al, 2008) and explicitly address impact and risk associated with racism (Robinson et al, 2021).…”

Suicide in African American Adolescents: Understanding Risk by Studying Resilience

“…One racially, culturally, and contextually grounded suicide preventive intervention for African American adolescents has been examined on a large scale: the Adapted-Coping with Stress Course (A-CWS) (see Robinson et al 2021 for description). The A-CWS fills a gap in prevention programming to address the suicide crisis among African American adolescents.…”

“…Student consultants examined and provided input on all aspects of the A-CWS intervention, including the intervention curriculum content, delivery method, and goals (Robinson et al 2016a). Throughout the focus groups, student consultants guided the inclusion of key stressors for African American adolescents (Robinson et al 2021). In addition to common stressors such as economic stress, lack of access to neighborhood resources, and exposure to community violence, the most notable stressors identified by student consultants were racial discrimination and negative and unnecessary interactions with police.…”