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Suicide and Self-Injury

A Qualitative Study of Risk Pathways for Suicide Ideation and Behavior among Black Youth Presenting to an Emergency Department

(PS2-D81) A Qualitative Study of Risk Pathways for Suicide Ideation and Behavior Among Black Youth Presenting to an Emergency Department

Friday, November 18, 2022

10:30 AM – 11:30 AM EST

Location: Westside Ballroom, 5th Floor

Author(s)

ER

Erica Rodriguez, B.A.

Project Coordinator
Hunter College, City University of New York
Brooklyn, New York

Co-Author(s)

AH

Alexis R. Hopkins, M.P.H.

Visiting Researcher Appointment CUNY Hunter College
CUNY Hunter College
Greenville, South Carolina
LG

Lauren E. Gulbas, Ph.D.

Associate Professor
Steve Hicks School of Social Work
Austin, Texas
CH

Carolina Hausmann-Stabile, Ph.D.

Assistant Professor
Bryn Mawr College
Bryn Mawr, Pennsylvania
CK

Colleen C. Katz, Ph.D., LCSW

Assistant Professor
Hunter College, City University of New York
New York, New York
AO

Ana Ortin-Peralta, Ph.D.

Assistant Professor
Ferkauf Graduate School of Psychology, Yeshiva University
New York, New York
RM

Regina Miranda, Ph.D.

Professor of Psychology
Hunter College and The Graduate Center, City University of New York
New York, New York

Suicide attempts increased significantly among Black adolescents in the United States between 1991 and 2017 (Lindsey et al., 2019), yet Black adolescents remain underrepresented in research on adolescent suicidal thoughts and behavior. There is a pressing need to understand the risk pathways that lead Black youth to suicide ideation and attempts to inform the development of culturally sensitive assessments and treatments for suicide risk among Black youth. There have been recent calls for researchers to take a “ground zero” approach to suicide prevention among Black youth that does not rely on quantitative methods, alone, and instead, incorporates qualitative research methods to gain a “baseline” understanding of suicidal behavior among Black youth (Sheftall & Miller, 2021). In response, this qualitative study examined factors indicative of imminent risk of suicidal behavior among Black youth receiving services at a New York City hospital for suicide ideation or suicide attempts. Participants included 11 self-identified Black adolescents (8 female, 3 male), ages 12-19, who presented to a hospital with suicide ideation (n=7) and/or a suicide attempt (n=4). Interviews were conducted by clinically trained researchers within about a week of the youths’ suicide ideation or attempt. Interviews were part of a larger study on the development of a semi-structured Adolescent Suicide Ideation Interview (Miranda et al., 2021) that inquired about the circumstances leading up to their suicide ideation or attempts. Interviews were audio recorded, transcribed, and coded in Dedoose. Data were analyzed using a thematic framework that combined deductive and inductive coding for qualitative analysis (Arcury & Quandt, 1998). We deductively developed eight broad themes related to our research question. These broad codes were then systematically applied to interviews with participants to identify themes that were salient to their risk pathways for suicidal thoughts and behavior. A second inductive coding pass was performed on the transcripts to identify emerging sub-themes, themes, and codes. The findings suggest two distinct risk trajectories for suicide ideation and attempts among Back youth: episodic and chronic. Teens with episodic risk trajectories described imminent stressors (e.g., family conflict, peer victimization) leading to their suicide ideation or behaviors. Their suicidal thoughts and behaviors were part of the teens’ acute stress response to these situational stressors. Black youth with chronic risk trajectories often did not disclose identifiable stressors for their suicidal thoughts and behaviors; instead, their clinical complaints were related to persistent negative mood states. Clinicians serving Black suicidal teens should focus on mapping their suicide risk trajectories, as they have implications for assessment and treatment planning. Black youth with episodic risk trajectories would benefit from clinical interventions to improve their coping skills, while those presenting with chronic risk trajectories require multiple levels of care.