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Summary: Self-reported suicide attempts rose significantly in African American teens, while they fell in teens of other ethnic backgrounds throughout an almost 20-year study. Researchers report suicide attempts increased at an accelerating rate in African American female teenagers, even as overall female suicide attempts declined.
Adding to what is known about the growing crisis of suicide among American teens, a team led by researchers at the McSilver Institute for Poverty Policy and Research at New York University have uncovered several troubling trends during the period of 1991-2017, among Black high school students in particular.
The findings were published today (Oct. 14) in the November 2019 issue of Pediatrics, the journal of the American Academy of Pediatrics:
“It is urgent that we get to the bottom of why the rate of suicide attempts among Black female adolescents is accelerating,” said the lead author of the study, Dr. Michael Lindsey, executive director of the McSilver Institute, and the Constance and Martin Silver Professor of Poverty Studies at NYU’s Silver School of Social Work. “We also need to understand why Black males are increasingly injured in suicide attempts.”
“Youth suicide is very real and must be addressed,” New York State Senator David Carlucci, chair of the NYS Senate’s Mental Health and Developmental Disabilities Committee, said about the research findings. “The numbers are staggering among Black youth, and just one life lost is one too many. We need a task force to specifically investigate the causes of Black youth suicide. I thank the McSilver Institute for their partnership and unwavering commitment to bring attention to this once silent crisis.”
“The number of Black youth who are tragically taking their own lives is rising at an alarming rate, and that is why I sponsored legislation to establish a Black Youth Suicide taskforce here in New York State,” says New York State Assemblywoman Kimberly Jean-Pierre, of the 11th Assembly District. “It’s vital for us to take action now to improve mental health and suicide prevention services to save these precious lives, and I applaud Dr. Lindsey and his research team at the McSilver Institute for shedding light on this very real issue.”
“The McSilver Institute’s findings of increased suicide attempts and self-injury among Black young adults are important and tremendously concerning, particularly for those of us who work in New York’s child welfare community where Black families are chronically, disproportionately overrepresented,” said Judge Ronald E. Richter, CEO and executive director of JCCA and former commissioner, NYC Administration for Children’s Services. “We must address Dr. Lindsey’s alarming data with urgency. Further research is critically necessary to determine best practices for our work with the young people who will shape our city’s future.”
“These findings should also push us to expand how we frame suicide prevention from mostly looking at individual-focused efforts and explanations, to societal based changes,” said Gary Belkin, former NYC deputy health commissioner and founder of the Billion Minds Institute. “Rising suicidality is the tip of an iceberg that should compel us to ask not only what are these children doing to themselves, but ask about the structural and racist violence of our society — what is society doing to them?”
“Further research must be done into why traditional precursors to suicide attempts, such as thinking about it or making plans, are decreasing while actual attempts are going up,” Lindsey said. “It’s important that we identify the signs before young people attempt to end their lives.”
According to the Centers for Disease Control and Prevention, suicide was the third-leading cause of death in 2017 among Black youth ages 15-19.
The McSilver Institute researchers conducted logistic regression analyses on data from the nationally representative school-based Youth Risk Behavior Survey (YRBS) from the years 1991 to 2017.
In addition to Lindsey, the research team included Arielle H. Sheftall of the Center for Suicide Prevention and Research, Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital and the Department of Pediatrics, College of Medicine, Ohio State University; Yunyu Xiao of the McSilver Institute and Silver School at NYU; and Sean Joe at the George Warren Brown School of Social Work, Washington University in St. Louis.
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Original Research: Open access “Trends of Suicidal Behaviors Among High School Students in the United States: 1991–2017”. Michael A. Lindsey, Arielle H. Sheftall, Yunyu Xiao, Sean Joe. Pediatrics doi:10.1542/peds.2019-1187.
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OBJECTIVES: To determine if racial and ethnic subgroups of adolescents are at high risk for engagement in suicidal behaviors.
METHODS: Using the nationally representative school-based Youth Risk Behavior Survey from the years 1991 to 2017, we conducted logistic regression analyses to examine trends by different racial and ethnic groups, with each suicide indicator serving as a dichotomous outcome. Participants included 198 540 high school students.
RESULTS: Across all sex and race and ethnic groups, there were significant linear decreases in self-reported suicidal ideation and suicide plans from 1991 to 2017. Female adolescents (odds ratio [OR], 0.98; P < .001) had significant decreases in attempts over time. Black adolescents had positive linear trends for suicide attempts among both boys (OR, 1.04; P < .001) and girls (OR, 1.02; P = .003). Black adolescent boys (OR, 1.04; P = .048) had a significant linear increase in injury by attempt.
CONCLUSIONS: The results suggest that, over time, black youth have experienced an increase in suicide attempts, which is troubling because attempts are the most prominent risk factor associated with suicide death. For black boys, a significant increase in injury by attempt occurred, which suggests that black boys may be engaging in increasingly lethal means when attempting suicide. Examining trends of suicidal thoughts and behaviors over time by sex and race and ethnicity allow us to determine where to focus prevention and intervention efforts. Future research should examine the underlying reasons for these changes observed in US high school students.
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