Understanding the Experience of Suicide Risks among Black Adolescents: A Qualitative Inquiry

Black youth suicides in the US have increased at alarming rates in recent years. The American Academy of Pediatrics and other national organizations declared a national emergency in children’s mental health in 2021, citing the toll of the COVID-19 pandemic and the ongoing struggle for racial justice on youth of color. In our research using statewide population-based data we found wide variability in suicidal thoughts and behaviors (STBs) across Black youth sub-populations, with lowest STB rates among Somali youth compared to rates among Black and Black Latine adolescents almost three times as high. This and other prior work demonstrate that aggregated pan-ethnic Black youth STB rates obscure differences between Black subpopulations. We hypothesize that each group may be characterized by unique risk/protective factor profiles. Knowledge about group-specific experiences would inform tailored strategies to reduce STBs among diverse Black youth. Possible reasons for variation in Black STB rates include varying exposures to adverse childhood experiences, low-resourced neighborhoods and schools, mass incarceration, violence, and discrimination, as well as potential protective factors, for example, religious or cultural values.  We propose a qualitative interview study among Black adolescents (n=65) aged 13-18 years who identify as (a) non-Hispanic Black, (b) Black with Latin heritage, and (c) Somali to Identify and characterize the role of sociocultural and environmental risk and protective factors for suicide risk among diverse Black youth. Participants will complete one-time interviews which we will transcribe and analyze using a systematic phenomenological thematic coding approach. A youth advisory board (two participants aged 19-24 years from each of the three study populations) will aid with recruitment, provide feedback on the interview guide, and help interpret findings. We will recruit study participants through organizations with which we have existing relationships, such as public health and faith-based organizations (e.g., Minnesota Department of Health, Masjid Da’wah). Participant eligibility criteria include a history of mental health concerns including, but not limited to, depression, anxiety disorders, ADD/ADHD, and past suicidal ideation and/or suicide attempt. Our interdisciplinary study team has previously worked together and combines expertise in adolescent mental health and development, youth suicide risk, public health disparities, youth violence prevention, and data analysis.

The study design, thematic analytic methods, and interpretation of the data will be guided by an integrative child development theory combining the Integrative Model for the Study of Developmental Competencies in Minority Children with the Interpersonal Psychological Theory of Suicide. This composite conceptual framework will contextualize individual-level risk and protective factors within environmental and structural factors to capture unique experiences of Black children. At the end of the study, we will have identified risk and protective factors relevant for STBs in three diverse Black youth subpopulations. These findings will be immediately relevant for our subsequent work going forward to design and test suicide prevention strategies that are tailored to the unique circumstances of specific Black youth populations. Further, we will have deepened our connections with diverse Black communities that will be instrumental in reaching youth we are trying to serve as we move this work forward.