An event hosted by Mental Health Partners took a hard look at suicide ideation and prevention in underresourced communities on Monday.
The webinar featured three nationally recognized experts who led a panel on the topic of suicide ideation, especially among youth in minority communities. Sara Anderson, vice president of Justice, Equity, Diversity and Inclusion for the mental health clinic serving Boulder County and Broomfield, moderated the discussion focusing on Black, Latino and LGBTQ+ mental health care.
Brandon Johnson, who has led numerous projects to prevent suicide among African American youth, spoke about the concerning rise in suicide rates of young Black children, ages 5-12, which has doubled since 1993. For comparison, for white youth of the same age bracket, there has been nearly a twofold decrease over the same span.
There has also been a significant increase in reported suicide attempts among Black youth, particularly Black girls between the ages of 13 to 17, according to Johnson. He noted that suicidal ideation among Black people has long been ignored even as these trends increased.
Johnson outlined some statistics that found that for Black youth, a crisis in the preceding two weeks was a significant precipitating factors among suicides while for white youth it’s usually precipitated by ongoing mental health problems.
“This really highlights the social determinative of health access,” he said. “Was it because the Black youth weren’t having any challenges around their mental health? Maybe not. But because they have less access to those things, it creates that divide.”
He added that understanding that difference is a key part of suicide prevention strategies for Black youth. Additionally, he emphasized that several risk factors for suicide in Black youth are directly related to racism, from repeated exposure to microaggressions to collective racial trauma from something like the video of George Floyd’s death.
Caroline Silva, from the University of Rochester School of Medicine and Dentistry, is currently developing suicide prevention interventions for at-risk individuals who identify as Hispanic/Latino. For the U.S. Hispanic/Latino population, which is the largest ethnic racial minority in the country, despite increased risk for things like a lower socioeconomic status, the population tends to have lower mortality rates and longer life expectancy than their non-Hispanic counterparts.
“This is sort of sometimes the reason that you see a decreased attention when it comes to suicide and the Latino population,” Silva said.
Notably, it is not immigrants but U.S. born Hispanic/Latino individuals who are at highest risk for suicide, with that risk increasing every generation until it reaches the same risk as non-Hispanic white counterparts. Risk varies by nationality as well, with Puerto Ricans at the highest risk of suicidal ideation followed by Mexicans.
Silva noted that members of the Hispanic/Latino community tend to have less favorable attitudes toward seeking help and accessing mental health services compared to the general population. During a suicide crisis, they’re less likely to call a crisis line.
Linguistic and cultural barriers are also important factors in providing mental health services to Hispanic and Latinos, Silva said. For example, some people seeking help but don’t speak English may be reluctant to communicate these sensitive issues not just to a therapist but also through a translator.
Kathryn Fox, from the University of Denver, focuses on LGBTQ+ youth. She highlighted the fact that the rate of suicide deaths in the U.S. has remained roughly the same since the 1980s.
“This suggests that we might be missing something,” Fox said. “There’s been so much research in this space and so much clinical care and a lot of effort put forward, and yet we’re not seeing big changes. To me that suggests that there are some key assumptions about these phenomena that aren’t quite right and that maybe our research has been ignoring some pieces of this puzzle.”
Fox said she believes that until minoritized communities start to also be centered in conversations about mental health, the world won’t see those big changes desired in terms of suicide prevention.
She noted that suicide risk is not uniform across all sexual orientation and gender identifies. For example, bisexual and pansexual people, who are attracted to more than one gender, tend to show higher risk compared to people who are attracted to only one gender.
Additionally, transgender and gender nonconforming people show higher risk for self injurious thoughts and behaviors compared to cisgender sexual minority peers. Black transgender and non-binary youth show the highest risk compared to all intersectional identities studied.
Fox pointed to structural, interpersonal and individual stressors that increase risk for mental health problems and suicidal thoughts and behaviors.
“This is critically important because it’s not that diverse sexualities and genders are a marker for psychopathology,” she said. “Instead, it’s that in our society we’ve disadvantaged and mistreated people in these communities in a way that increases their risk.”
Solutions proposed by the three speakers to help address mental health in these underrepresented communities included advocating for law and policy changes, training for working with members of these communities and the availability of affirming care.
Johnson and Silva emphasized the importance of clinicians and therapists to be open to understanding other cultures. While it’s difficult to be competent in every culture, entering the situation with humility can mean better care for underserved individuals.
“Our young people have a harder time finding a provider that can show cultural humility,” Johnson said. “To say, ‘I may not be confident in your culture, but I’m willing to learn what that means for you.’”
