Black Teens, Especially Girls, at High Risk for Suicide Attempts

Black American teens, especially females, may be at high risk for attempting suicide even if they have never been diagnosed with a mental disorder, according to researchers funded in part by NIMH. Their findings, based on responses from adolescent participants in the National Survey of American Life (NSAL), provide the first national estimates of suicidal thoughts and behaviors (ideation) and suicide attempts in 13-to 17-year-old black youth in the United States. The study was published in the March 2009 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Background: Suicide is the third leading cause of death in all teens in the United States, according to the National Center for Health Statistics. Historically, black teens and young adults have lower suicide rates than white teens, but in recent decades, the suicide rate for black youth has increased dramatically.

The NSAL is a nationally representative household survey of African Americans and blacks of Caribbean descent. From the NSAL households, 810 African American and 360 Caribbean black teens, ages 13-17, were randomly selected to complete the NSAL-Adolescent (NSAL-A) survey.

Findings from this Study: Sean Joe, PhD, LMSW, University of Michigan, and colleagues evaluated NSAL-A teens’ responses to questions about suicidal ideation and nonfatal suicide attempts. According to the researchers, such attempts may occur up to 10-40 times more often than completed suicides and are important risk factors for future suicide.

According to the study, in a given year, African American teen girls are most likely to attempt suicide, followed by Caribbean teen girls, African American teen boys, and Caribbean teen boys.

However, Caribbean females in the study reported the highest rates for suicidal ideation, while Caribbean teen males reported the lowest rates for ideation and suicide attempts. This is in contrast to a previous NSAL report, which found that Caribbean adult males had the highest rates of suicide attempts among black Americans.

Also, in contrast to previous studies, the researchers noted that youth from lower income households ($18,000-$31,999 annually) were least likely to report attempting suicide, while youth living in homes of modest means ($32,000-$54,999) were most likely.

Having a mental disorder was closely linked to attempted suicide among study participants. Teens with anxiety disorders were a highest risk. Despite this relationship, roughly half of teens who attempted suicide did not have or were never diagnosed with a mental disorder.

As in previous studies, teens living in the U.S. South and West appeared to be less at risk for attempted suicide than those living in the Northeast.

Overall, the researchers estimated that at some point before they reach 17 years of age, 4 percent of black teens, and more than 7 percent of black teen females, will attempt suicide.

Significance: Suicide prevention efforts require a better understanding of population-specific risk factors. This study provides the first national estimates for rates of suicidal ideation and attempts among black youth in the United States, including important information on ethnic differences.

What’s Next: According to the researchers, their findings show the need for further studies on risk factors for suicide in this population, especially on ethnicity-specific risks and non-psychiatric risks. Because only half of suicide attempters had ever been diagnosed with a psychiatric disorder, Joe and colleagues suggest that suicide prevention efforts should include screening for suicidal behaviors in clinical and non-clinical settings (schools, community centers, etc.) when working with black teens, especially females.

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