Factors Associated with Suicide Risk Behavior Outcomes Among Black Middle School Adolescents

Background and Purpose

Suicide rates for early adolescent self-identifying Black populations, ages 10-14, have extraordinarily risen in the United States over the last two decades resulting in suicide becoming the second leading cause of death for this population. Despite the increased suicide rates for Black youth populations, less is known about the early adolescent or middle school population, necessitating an examination of this younger population. Researchers are implementing a ground-level approach to build a more encompassing understanding of suicidality for Black youth populations and to advance racial justice.

This study assesses associations between seven explanatory variables (sex, weapon carrying, weight perceptions, grades, grade level, bullying at school, cyberbullying) and suicide ideation, planning, and attempts and identifies associations with suicidality as a composite measure among a national sample of Black middle school adolescents (BMSA).

Methods

Data were extracted from the national 2019 Middle School Youth Risk Behavior Survey. Descriptive statistics were calculated, and associations between suicide ideation, planning, and attempts were explored. A network graphical representation of polychoric and tetrachoric correlations across suicidality outcomes and explanatory variables was performed. A multivariable, multinomial logistic regression model estimated associations between explanatory variables and suicide ideation (with and without planning) and planning (with and without ideation). Both suicide attempt and a composite suicidality metric were explored using independent logistic models with multiple imputation.

Results

The sample included 7,643 self-identifying BMSA. Our findings indicate approximately 28% reported suicidality. Prevalence rates were found of about one in four BMSA for suicidal ideation, one in six for suicidal planning, and one in ten for attempting suicide. These results indicate that BMSA reported higher rates of suicide ideation than the Black high school adolescent population but relatively similar rates of planning and attempts. BMSA females, victims of cyberbullying, and carrying a weapon, experienced significantly higher odds of all suicidality outcome measures. Results indicated significant associations between observable environmental, behavioral, and demographic factors and suicide risk behavior outcomes among a national sample of BMSA.

Conclusion and Implications

Our findings support a recommendation for separate sampling and examination of suicide risk factors and outcomes among Black youth. Further research on early adolescent Black youth is necessary to inform interventions to decrease suicide risk. Practical implications for identifying and screening suicidality among BMSA to guide suicide prevention efforts are necessary. Findings validate the need for informed approaches to suicide screening and prevention efforts to reduce suicide risk outcomes, especially when identifiable environmental factors are strongly associated with those outcomes. Further research is needed to explore bullying experiences and weapon carrying as these are strongly associated with suicide-risk behavior outcomes for this population, with a larger burden among female BMSAs. This research supports the ground-level approach to suicide prevention and intervention and provides additional insight into factors associated with variability in suicide risk behavior outcomes among early adolescent Black populations.