Suicide continues to remain a global crisis, claiming over 700,000 lives annually (WHO, 2021). In the United States alone, more than 49,000 people died by suicide in 2022, marking it one of the leading causes of death in the nation (CDC, 2023). Behind these sobering statistics lies an often-overlooked reality. Marginalized communities face unique challenges that significantly elevate their risk of suicide. From systemic inequalities to cultural stigma, the barriers to mental health care in these communities are vast and multifaceted. Addressing these issues requires more than conventional strategies, such as increasing mental health awareness campaigns or expanding general access to healthcare. While these efforts are important, they often fail to account for the unique social, economic, and cultural dynamics that marginalized communities face.
Marginalized Communities
Marginalized communities are groups of people who face systemic barriers and social exclusion due to their race, ethnicity, gender, sexual orientation, socioeconomic status, immigration status, or other aspects of their identity. These communities often experience disparities in access to resources, opportunities, and rights, leaving them vulnerable to various forms of discrimination and disadvantage. Racial and ethnic minorities often encounter systemic racism that affects their education, employment opportunities, and healthcare access. Similarly, LGBTQ+ individuals face stigma and rejection in various facets of life, from their families to the workplace. Immigrants, particularly those who are undocumented, frequently navigate a world of uncertainty, facing language barriers, xenophobia, and limited access to services.
Marginalization doesn’t just mean being excluded from mainstream systems; it means carrying the burden of societal inequities. These inequities manifest in tangible ways, such as higher poverty rates, limited healthcare access, and reduced educational opportunities, all of which have a profound impact on mental health. Marginalized individuals often live at the intersection of multiple disadvantages, a concept known as intersectionality. For instance, a Black transgender woman may face the combined effects of racism, transphobia, and gender discrimination, amplifying the challenges she experiences.
Understanding the Challenges
What makes the plight of marginalized communities particularly urgent is that the consequences of exclusion are not just economic or social, but they are deeply psychological. Persistent feelings of being alienated or devalued can lead to chronic stress, anxiety, and depression, increasing the risk of mental health crises, including suicide.
Among immigrants, the stressors begin long before arrival. Pre-migration trauma, including violence, persecution, or displacement, leaves many immigrants grappling with Post-Traumatic Stress Disorder. A meta-analysis revealed that the prevalence of suicidal ideation among refugees alone is 20.5% (BMC Public Health, 2022). Once in their host countries, immigrants face acculturation stress, a byproduct of adapting to a new culture, learning a language, and navigating unfamiliar societal norms. Latino immigrants in the United States have reported high levels of acculturation stress, which are strongly associated with depression and suicidal ideation (Fortuna et al., 2008). This adjustment often creates identity conflicts, especially for younger immigrants who straddle the values of their heritage and those of their new environment.
Another often marginalized population is the growing LGBTQ+ community, which continues to face unique and pervasive challenges. At the core of these struggles is societal stigma, which manifests as judgment, prejudice, and outright rejection. For many LGBTQ+ individuals, being part of a minority group often means navigating a world where acceptance is not guaranteed, and support can be hard to find. According to The Trevor Project (2023), nearly 45% of LGBTQ+ youth reported experiencing discrimination based on their sexual orientation or gender identity in the past year alone. These experiences can lead to feelings of shame, fear, and alienation, which are major risk factors for depression and suicidal ideation. Accessing mental health care is often a daunting journey for LGBTQ+ individuals, marked by systemic obstacles and emotional hurdles that can make seeking help feel overwhelming. Imagine finally gathering the courage to share deeply personal struggles, only to face a provider who doesn’t understand, or worse, dismisses, your experiences. Unfortunately, this is a reality for many within the LGBTQ+ community.
Intersectionality: When Disadvantages Overlap
Marginalized individuals often face not just one but multiple layers of disadvantage that compound their struggles. This concept, known as intersectionality, refers to the overlapping forms of discrimination based on race, gender, sexual orientation, socioeconomic status, and other identities. These intersections create unique challenges that cannot be understood in isolation. Each layer of marginalization amplifies the others, creating barriers that affect every aspect of her life, from accessing healthcare to feeling safe in public spaces. Research shows that individuals with intersecting marginalized identities are at a higher risk for mental health challenges, including depression and suicidal ideation (Meyer, 2015). This overlap complicates solutions. A program designed to address racial disparities in healthcare might not consider the unique needs of LGBTQ+ individuals within that racial group. Similarly, mental health services that cater to LGBTQ+ populations may overlook the specific barriers faced by immigrants or people with disabilities.
Culturally Responsive Approaches
Addressing suicide in marginalized communities requires strategies that reflect the unique cultural and social realities of these groups. Standard approaches often fall short, failing to consider the diverse challenges these populations face. Instead, culturally responsive interventions focus on building trust and delivering care that resonates with individuals’ lived experiences. One key strategy is community engagement. Partnering with trusted figures, like faith leaders or community organizers, helps break down stigma and create safe spaces for discussing mental health. For example, African American church programs have successfully increased awareness and access to care by leveraging the influence of faith-based institutions (Hankerson & Weissman, 2022). Another essential element is cultural competence training for providers. Mental health professionals must understand how cultural backgrounds shape expressions of distress and healing. Offering services in multiple languages or training providers in cultural humility can make a significant difference for immigrants and other marginalized groups (Hinton et al., 2012).
Finally, incorporating traditional healing practices, such as storytelling or community circles, bridges gaps in trust and complements evidence-based therapies. These culturally rooted practices not only address mental health but also foster a sense of belonging and identity. Culturally responsive care isn’t just about improving access; it’s about meeting people where they are and affirming their unique experiences. By prioritizing this approach, we can create more inclusive and effective pathways to mental wellness.
Oyindamola Williams, LMSW, is a Child and Family Therapist at Southwest Community Health Center. For more information and resources, please contact oyinwilliams01@gmail.com.
References
BMC Public Health. (2022). The prevalence of suicidal ideation and behavior among refugees: A systematic review and meta-analysis. BMC Public Health, 22(13029). Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13029-8
Centers for Disease Control and Prevention. (2023). Suicide data and statistics. Retrieved from https://www.cdc.gov/suicide/facts/data.html
Fortuna, L. R., Porche, M. V., & Alegría, M. (2008). Political violence, psychosocial trauma, and the context of mental health services use among immigrant Latinos in the United States. Ethnicity & Health, 13(5), 435–463. https://doi.org/10.1080/13557850701837286
Hankerson, S. H., & Weissman, M. M. (2022). Church-based programs to reduce stigma and increase access to care for mental illness: A review. Psychiatric Services, 73(6), 711-717. https://doi.org/10.1176/appi.ps.201100216
Hinton, D. E., Pich, V., Hofmann, S. G., & Otto, M. W. (2012). Cultural adaptations of cognitive-behavioral therapy: Current findings and directions for future research. Behavior Therapy, 43(3), 431-447. https://doi.org/10.1016/j.psc.2017.08.006
Meyer, I. H. (2015). Resilience in the study of minority stress and health of sexual and gender minorities. Psychology of Sexual Orientation and Gender Diversity, 2(3), 209-213. https://doi.org/10.1037/sgd0000132
The Trevor Project. (2023). 2023 National Survey on LGBTQ Youth Mental Health. Retrieved from https://www.thetrevorproject.org
World Health Organization. (2021). Suicide worldwide in 2019: global health estimates.
