Suicide Prevention Takes a Nation: Collaborative Approaches to Universalize Suicide Prevention.

Suicide is a complex public health issue impacting many children and adolescents-and their families-each year, and it requires a complex public health solution. Local, state, and national collaboratives that leverage evidence-based strategies, foster community engagement, and prioritize equity are necessary to holistically address this issue. Here, the authors discuss the necessary steps for fostering inclusive community partnerships and outline the rationale for partnering with schools, youth groups, faith organizations, parent-teacher organizations, clinical settings, and professional organizations, as well as collaborating with the juvenile justice and child welfare systems and working together to foster suicide prevention policy.

Developing the Blueprint for Youth Suicide Prevention.

Suicide and suicidal behavior among youth and young adults are a major public health crisis, exacerbated by the COVID-19 pandemic and demonstrated by increases in suicidal ideation and attempts among youth. Supports are needed to identify youth at risk and intervene in safe and effective ways. To address this need, the American Academy of Pediatrics and the American Foundation for Suicide Prevention, in collaboration with experts from the National Institute of Mental Health, developed the Blueprint for Youth Suicide Prevention ( Blueprint ) to translate research into strategies that are feasible, pragmatic, and actionable across all contexts in which youth live, learn, work, and play. In this piece, we describe the process of developing and disseminating the Blueprint. Through a summit and focus meetings, cross-sectoral partners convened to discuss the context of suicide risk among youth; explore the landscape of science, practice, and policy; build partnerships; and identify strategies for clinics, communities, and schools-all with a focus on health disparities and equity. These meetings resulted in 5 major takeaways: (1) suicide is often preventable; (2) health equity is critical to suicide prevention; (3) individual and systems changes are needed; (4) resilience should be a key focus; and (5) cross-sectoral partnerships are critical. These meetings and takeaways then informed the content of the Blueprint , which discusses the epidemiology of youth and young adult suicide and suicide risk, including health disparities; the importance of a public health framework; risk factors, protective factors, and warning signs; strategies for clinical settings, strategies for community and school settings; and policy priorities. Following the process description, lessons learned are also discussed, followed by a call to action for the public health community and all who serve and support youth. Finally, key steps to establishing and sustaining partnerships and implications for policy and practice are discussed.

Structural indicators of suicide: an exploration of state-level risk factors among Black and White people in the United States, 2015-2019.

Purpose ­: Death by suicide among Black people in the USA have increased by 35.6% within the past decade. Among youth under the age of 24 years old, death by suicide among Black youth have risen substantially. Researchers have found that structural inequities (e.g. educational attainment) and state-specific variables (e.g. minimum wage, incarceration rates) may increase risk for suicide among Black people compared to White people in the USA. Given the limited understanding of how such factors systematically affect Black and White communities differently, this paper aims to examine these relationships across US states using publicly available data from 2015 to 2019. Design/methodology/approach ­: Data were aggregated from various national sources including the National Center for Education Statistics, the Department of Labor, the FBI's Crime in the US Reports and the Census Bureau. Four generalized estimating equations (GEE) models were used to examine the impact of state-level variables on suicide rates: Black adults suicide rate, Black youth (24 years and younger) suicide rate, White adult suicide rate and White youth suicide rate. Each model includes state-level hate group rates, minimum wage, violent crime rates, gross vacancy rates, and race-specific state-level poverty rates, incarceration rates and graduation rates. Findings ­: Across all GEE models, suicide rates rose between 2015-2019 (ß = 1.11 - 2.78; ß = 0.91 - 1.82; ß = 0.52 - 3.09; ß = 0.16 - 1.53). For the Black adult suicide rate, state rates increased as the proportion of Black incarceration rose (ß = 1.14) but fell as the gross housing vacancy rates increased (ß = -1.52). Among Black youth, state suicide rates rose as Black incarcerations increased (ß = 0.93). For the adult White suicide rate, state rates increased as White incarceration (ß = 1.05) and percent uninsured increased (ß = 1.83), but fell as White graduation rates increased (ß = -2.36). Finally, among White youth, state suicide rates increased as the White incarceration rate rose (ß = 0.55) and as the violent crime rate rose (ß = 0.55) but decreased as state minimum wages (ß = -0.61), White poverty rates (ß = -0.40) and graduation rates increased (ß = -0.97). Originality/value ­: This work underscores how structural factors are associated with suicide rates, and how such factors differentially impact White and Black communities.

Expanding our paradigms: Intersectional and socioecological approaches to suicide prevention.

Despite increasing research on suicide, we continue to see rising rates, particularly among youth. In answering recent calls for critical suicidology and transdisciplinary approaches to research, I discuss expanding beyond the paradigmatic confines of suicidology by proposing two related approaches to improve our science: intersectionality theory and socioecological theory. Following a discussion of social identity and its relation to suicide risk, I review the literature on these topics and highlight importance of paying attention to the unique experiences of youth through the study of intersectionality and using socioecological models in our research moving forward.

Intersectionality, social support, and youth suicidality: A socioecological approach to prevention.

OBJECTIVE: This study examined the relationship between social support and suicidality among youth from a public health perspective by using (1) a socioecological framework and (2) an intersectional approach to social identity. METHODS: Secondary analysis of cross-sectional survey data (N = 5058) involved means comparisons and a series of standard and hierarchical regression analyses. RESULTS: Youth with intersecting marginalized identities (i.e., females and racial and sexual minority youth) were significantly more likely to report higher suicidality scores. Social support at the family, school, and community levels was significantly associated with lower suicidality scores, and the combination of family and school support was associated with the lowest suicidality scores. Finally, family support significantly reduced the relationship between intersecting marginalized identities and suicidality. CONCLUSIONS: Findings highlight the importance of protective factors in every context in which youth live, learn, and play. Measuring and reporting social identities as well as their intersections add to our understanding of both risk and prevention.