Differences in Suicide Risk Reduction for Underrepresented Minority Youth in a Community Based Psychoeducation Program

Background:

This research seeks to explore differences in risk at baseline and differences in risk reduction for underrepresented gender, sexual, and racial minorities. An adapted version of the evidence-based Love Notes, a manualized relationship education curriculum designed for youth and young adults with an addition of a suicide-based module, was implemented. These efforts were also informed by Wyman’s (2014) commentary that addressing suicide in childhood or adolescence may prevent the later onset of suicide risk and that larger changes in suicide risk—a less frequent yet high-risk condition—could be possible through targeting more common but lower risk conditions. To address a connection between adverse childhood experiences (ACES) and suicidal behavior, the team developed a suicide-related module—in addition to modules on human trafficking and consent in sexual behavior—to add to Love Notes. The suicide prevention module instructed youth about the prevalence of suicidal ideation, how to know if they need to ask for help, and what to do if they or a peer is thinking about suicide. The module ended with a discussion-based activity about applying these concepts to youth suicide risk and a demonstration of crisis resources commonly available. Previous research has identified that overall, youth who participated in Love Notes experienced a reduction in suicide risk.

Methods:

This was a convenience sample of youth affiliated with residential and community-based organizations serving at-risk youth. Youth ages 14 to 24 completed this 16-session adaptation of Love Notes. Data were collected at two points, baseline and immediate post-intervention, in the setting participants received the intervention. Sample of youth (N=181) were between the ages of 14 and 24. Of these participants, 36.46% were white, 63.54% were Black or other races, 51.93% identified as female, 44.75% identified as male, and 3.31% identified as transgender. Participants identified their sexuality as 80.66% heterosexual and 19.34% LGBTQ. Suicidal thoughts and behaviors were measured by using a modified version of the Columbia Suicide Severity Rating Scale (Posner et al., 2008). Youth were asked about their desire to die, ideation, planning, intent, and attempt in the past month and ever in their life. Chi-square analyses and logistic analyses were run to examine differences from baseline to post-intervention.

Results: The analysis reveals differences in suicidal ideation, intent, plan, and attempt in the past month by sexual orientation. Additionally, the analysis shows differences in suicidal ideation, intent, plan, and attempt in the past year by sexual orientation, gender identity, and race.

Implications: The findings suggest that additional research should be conducted to determine the impact of the intervention across other geographical areas. Findings cannot be compared to a control group and cannot be generalized across populations. Additionally, suicide was assessed based on dichotomous reports of whether someone had experienced five differentiating levels of suicidal thoughts or behaviors in their lifetime and within the past month. Additional suicide assessments could elucidate more specific variations of a suicidal experience, such as specific thoughts related to suicide and how those might impact the connection to help-seeking.