12-Month and Lifetime Prevalence of Suicide Attempts among Black Adolescents

Purpose:

Suicide is the third leading cause of death among all adolescents in the United States, including Black adolescents (Kochanek, Murphy, Anderson, & Scott, 2004). 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 (O'Donnell, O'Donnell, Wardlaw, & Stueve, 2004). The gap in the rates of suicide between these two groups narrowed due to a recent increase in suicide among young Black Americans (Borowsky, Ireland, & Resnick, 2001; Joe, 2008; Price, Thompson, & Dake, 2004). There is a paucity of nationally representative epidemiological research on the prevalence of attempted suicide and the suicide risk profile for Black American adolescents. Without this work little can be done to understand, intervene, or prevent suicide and suicidal behavior in this population. General population survey data are presented for the first time on the prevalence of suicide attempts for African Americans and Caribbean black adolescents in the United States.

Method:

Data on non-fatal suicidal behavior among 1170 African American and Caribbean Black adolescents aged 13-17 years are from the National Survey of American Life--Adolescent (NSAL-A), a nationally representative household survey of adults with an attached adolescent sample conducted between February 2001 and June 2003. Descriptive analyses were employed to examine patterns of non-fatal suicidal behavior. Survival analysis methods were used to derive the projected risk by age 17 of experiencing suicidal ideation and of making a suicide attempt, as well as to assess potential sociodemographic and psychiatric risk factors for these behaviors.

Results:

Nationwide black adolescents reported lifetime prevalence of 7.5% for suicide ideation and 2.7% for attempts. The 12-month prevalence of suicidal ideation and attempt were 3.2% and 1.4%, respectively. Among all respondents, 4% of Black American adolescents and 7% of females were projected to actually attempt suicide by age 17. Black teen females were almost 3 times more likely to attempt suicide than their male counterparts. African American teens were 4.5 times more likely than Caribbean teens to attempt suicide. 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. However, 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. 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.

Implications:

The study underscore that the importance of understanding ethnic differences in suicide risk among Blacks American adolescents. Black American teens, especially females, may be at high risk for attempting suicide even if they have never been diagnosed with a mental disorder. Clinicians should be trained to screen for suicidal behavior, even among those without DSM-IV disorders, when treating black adolescents.