"Dual Pandemics": Intersecting Influences of Anti-Black Racism and the COVID-19 Pandemic on the Mental Health of Black Youth.

BACKGROUND: The intersection of the COVID-19 pandemic with systemic anti-Black racism in the form of police violence and the subsequent Black Lives Matter movement has created an especially critical juncture to examine the mental health of Black youth. PURPOSE: The purpose of this study was to understand the intersecting impacts of anti-Black racism and the COVID-19 pandemic on the mental health of Black youth. METHODS: A youth-engaged research approach and intersectionality framework were utilized. Semi-structured interviews with Black youth across Canada (ages 16 to 30, n = 48) were conducted online via Zoom and analyzed using thematic analysis. Fourteen Black youth were hired to form a Black youth advisory committee, who guided the research process. RESULTS: The "dual pandemics" of the COVID-19 pandemic alongside highly publicized incidents of racism and the subsequent Black Lives Matter movement negatively impacted participants' mental health. Four main themes emerged: (1) ongoing exposure to acts of anti-Black racism (2) compounding effect of racism on mental health; (3) high stress levels and fear; and (4) anger and emotional fatigue from lack of shared, long-term solutions. CONCLUSION: The simultaneous occurrence of the COVID-19 pandemic and instances of systemic anti-Black racism in the form of police violence presented "dual pandemics" for the Black community, profoundly impacting the mental health of Black youth and adding urgency and impetus to its prioritization. Results of this study indicate that it is critical to explore each event individually as well as the combined impact on the mental health of Black youth, particularly from a racial perspective.

The relationship between perceived family support and subclinical positive symptoms of psychosis among Black college students.

AIM: Black individuals in the Unites States endure compounded and unique experiences of discrimination and structural racism that may not be as overtly evident in other countries. These distinctive forms of discrimination and racism can impact the mental health of Black individuals in the Unites States, in this case, their risk for psychosis. Adolescence and early adulthood are vulnerable periods in life where mental illness typically begins to manifest. Understanding the factors contributing to an increased likelihood of specific mental illnesses, such as psychosis, among youth in these vulnerable periods can inform intervention development. This is particularly important for those from minoritized backgrounds Unites States; this group is especially important to study given that Black American youth tend to experience higher psychosis rates and different symptom presentations than non-Black groups. METHODS: This study examined the associations between perceived family support, a critical environmental factor known to be associated with full-psychosis, and attenuated positive symptoms and distress levels in a sample of 155 Black students from a Historically Black College and University (HBCU). Participants completed the Prodromal Questionnaire-Brief that assessed psychosis risk and the Family Environment Scale that assessed three dimensions of family support (family cohesion, expressiveness, and conflict). RESULTS AND CONCLUSION: Positive symptom intensity (r = .30, p < .001) and distress (r = .34, p < .001) were significantly associated with higher family conflict for Black individuals in the Unites States. The findings inform novel intervention targets for psychoeducation and family therapy that have potential to reduce psychosis risk.

Police killings of unarmed Black persons and suicides among Black youth in the US: A national time-series analysis.

INTRODUCTION: Suicide deaths among Black youth in the US have increased rapidly over the past decade. Direct or vicarious racial trauma experienced through exposure to police brutality may underlie these concerning trends. METHODS: We obtained nationally aggregated monthly counts of suicides for non-Hispanic Black and White youth (age ≤ 24 years) and adults (age > 24 years) from the National Mortality Vital Statistics restricted-use data files provided by the Centers for Disease Control and Prevention, from 2013 to 2019. Monthly counts of Black youth suicides constituted our main outcome. We defined our exposure as the monthly counts of police killings of unarmed Black persons over 84 months (2013 to 2019), retrieved from the Mapping Police Violence database. We used ARIMA (AutoRegressive Integrated Moving Average) time-series analyses to examine whether Black youth suicides increased within 0 to 3 months following police killings of unarmed Black persons, controlling for autocorrelation and corresponding series of White youth suicides. RESULTS: Suicides among Black youth increase by ∼1 count three months following an increase in police killings of unarmed Black persons (exposure lag 0 coefficient = 0.16, p > 0.05; exposure lag 1 coefficient = -0.70, p > 0.05; exposure lag 2 coefficient = -0.54, p > 0.05; exposure lag 3 coefficient = 0.95, p < 0.05). The observed increase in suicides concentrates among Black male youth (exposure lag 3 coefficient = 0.88, p < 0.05).

Factors Associated With Suicide Risk Behavior Outcomes Among Black Middle School Adolescents.

OBJECTIVE: Early adolescent self-identifying Black youth present with high rates of suicidality. This study assesses associations among 7 explanatory variables (sex, weapon carrying, weight perceptions, grades, grade level, bullying at school, and cyberbullying) and suicide ideation, planning, and attempts, and identifies associations with suicidality as a composite measure among a sample of Black middle school adolescents (BMSA) in the United States. METHOD: Data were extracted from the 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 among 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 that approximately 28% reported suicidality. Prevalence rates were found of about 1 in 4 BMSA for suicidal ideation, 1 in 6 for suicidal planning, and 1 in 10 for attempting suicide. Female BMSA, victims of cyberbullying, and BMSA carrying a weapon experienced significantly higher odds of all suicidality outcome measures. CONCLUSION: Practical implications for identifying and screening suicidality among BMSA to guide suicide prevention efforts are necessary. Findings validate the need for informed cultural approaches to suicide screening and prevention efforts to reduce suicide risk outcomes, especially when identifiable environmental factors are strongly associated with those outcomes. DIVERSITY AND INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Sleep Problems Among Black Youth Exposed to Police Violence on Digital Media.

Findings from a recent survey of a community-based sample of Black youth ages 12 through 21 in Baltimore City, Maryland (n = 345) reveal that viewing fatal police violence videos is associated with significant increases in the odds of youth sleep disturbances, and about 30% of this association is attributable to emotional distress after viewing the videos.

Engaging Black youth in depression and suicide prevention treatment within urban schools: study protocol for a randomized controlled pilot.

BACKGROUND: Depression continues to be an ongoing threat to adolescent well-being with Black adolescents being particularly vulnerable to greater burdens of depression as well as lower mental health service utilization. Black adolescents are likely to have untreated depression due to social network influences, varied perceptions of services and providers, or self-stigma associated with experiencing depressive symptoms. Furthermore, if or when treatment is initiated, low engagement and early termination are common. To address this gap, a trial is being conducted to preliminarily test the effectiveness of an engagement intervention targeting Black adolescents with depression in school mental health services in New York City. METHODS: A total of 60 Black middle and high school adolescents displaying depressive symptoms are equally randomized (based on school site) to the treatment arms. Both trial arms deliver Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), a time-limited, evidence-based treatment for depression. Additionally, one arm pairs IPT-A with a brief, multi-level engagement intervention, the Making Connections Intervention (MCI), involving adolescents, caregivers, and clinicians. Outcomes of interest are group differences in depression and suicide ideation, adolescent and caregiver engagement, and mental health service use. DISCUSSION: This trial will serve as an efficacy assessment of the MCI among a sample of Black adolescent students with depressive symptoms. Clinical and implementation results will be used to inform future research to further test the MCI intervention in a larger sample. TRIAL REGISTRATION: Registered by ClinicalTrials.gov on May 3, 2019, identifier: NCT03940508.

Examining the integrated model of the interpersonal-psychological theory of suicide and intersectionality theory among Black male adolescents.

INTRODUCTION: Guided by Opara et al.'s (2022), Integrated Model of the Interpersonal Psychological Theory of Suicide and Intersectionality Theory, the current study examined contextual stressors experienced disparately by Black youth (racial discrimination, poverty, and community violence) as moderators of the association between individual motivating factors for suicidal thoughts and behaviors (perceived burdensomeness, thwarted belongingness, and hopelessness) and active suicidal ideation. METHOD: Participants were 457 Black adolescent boys (mean age = 15.31, SD = 1.26) who completed self-report surveys. RESULTS: As predicted, the association between perceived burdensomeness and active suicidal ideation was significantly moderated by economic stress. In addition, the association between peer belongingness and suicidal ideation was significantly moderated by racial discrimination, but there were no moderating effects for school belongingness. Finally, the association between hopelessness and suicidal ideation was significantly moderated by both racial discrimination and witnessing community violence. CONCLUSION: These findings highlight the need for research, interventions, and policy work devoted to using integrated approaches of individual and socioeconomically relevant patterns of suicidal thoughts and behaviors to support Black youth exposed to various forms of structural oppression.

Discriminatory Experiences Among Black Youth: How Encounters and Expectations Explain Emotional Well-Being.

Research suggests that encounters with racism are related to depression in Black youth. However, less is known about how experienced racial discrimination can influence other aspects of well-being among Black youth including their socio-emotional development and behavior. In addition, emerging literature highlights the critical ways anticipated racial discrimination may impact the emotional well-being of Black youth. To address these gaps, the current study assessed whether experienced discrimination was associated with higher levels of internalizing problems (anxiety/depression, suicidal thoughts) and lower levels of socio-emotional development (emotion regulation, prosocial behavior). We then tested whether expected discrimination contributed to similar patterns. Lastly, this study examined how age and gender moderated this relationship. Across eight schools in three communities, 1435 Black youth (56.57% female; 56.40% 10th grade) in 10th and 12th grades responded to the Youth Experience Survey. Using a series of hierarchical linear and hierarchical binary logistic regressions, results found that those who experienced racial discrimination and expected discrimination demonstrated higher internalizing problems and lower socio-emotional development; however, expected discrimination often accounted for more variance than experienced. These findings suggest the multifaceted influence both experienced and expected racial discrimination have on the well-being of Black youth and can provide important insights to community prevention systems.

Quantifying the Representation of Black Adolescents in Suicide Intervention Research.

This systematic review aimed to quantify the representation of Black youth in U.S. suicide intervention research. Specifically, we sought to evaluate Black youth representation in terms of (a) equity of inclusion (i.e., the inclusion of Black youth in research study samples at a rate consistent with the overall national rate of Black adolescents in the US) and (b) equity of intervention efficacy (i.e., evaluating the presence of racial disparities in intervention efficacy/effect sizes). In addition, we aimed to evaluate whether an association existed between funding status of research and representation of Black youth in studies, and to provide recommendations for future research in this area. To this end, the present study extracted and analyzed demographic information of studies included in recent meta-analyses conducted by Robinson and colleagues (2018), which were not previously analyzed, in addition to new literature published between September 2017 and January 2021. Results showed that the prevalence of Black youth included in studies was representative (14.67%; ntotal = 4451, nBlack = 664), with a median inclusion rate of 13%; however, absolute sample and group sizes were so small that it precluded comparison of differential treatment outcomes for Black youth. Thus, out of 22 studies identified, only one was able to investigate treatment outcomes for suicide in Black youth specifically. This study points to the conclusion that without adequately powered studies, disparities in treatment efficacy for Black youth cannot be compared or addressed, and the existing disparity in suicidal outcomes for Black youth will grow even larger.

Violência e vulnerabilização: o cotidiano de jovens negros e negras em periferias de duas capitais brasileiras / Violence and vulnerability: the everyday life of black youth in suburbs of two Brazilian state capitals

Resumo A violência é um grave problema de saúde pública e constitui um fenômeno sócio-histórico, com causas e consequências diversas e múltiplas expressões. As principais vítimas seguem sendo as populações vulnerabilizadas e periféricas, nas quais se interseccionam dimensões como gênero, classe, raça e pertencimento social. Embora as questões étnico-raciais estejam presentes nos estudos que explicam o fenômeno da violência, estes tendem a não a considerar também fruto do racismo institucional. Este artigo pretende analisar dados de uma pesquisa quali-quanti que avaliou experiências de violência simbólica e estrutural vivenciadas por jovens negros/as de 15 a 29 anos de idade e moradores/as de bairros periféricos de duas capitais brasileiras - Recife e Fortaleza, a partir de grupos focais e entrevistas semiestruturadas. Foram enfatizados os lugares de fala que situavam a interseccionalidade, sobretudo de raça/cor da pele, pertencimento territorial e classe, na própria definição identitária. Em ambas as capitais a juventude negra trouxe à tona uma realidade comum: um horizonte limitado na definição de projetos de vida, tanto por questões econômicas quanto da demarcação concreta ou simbólica de lugares sociais para os quais seu acesso é interditado.

Abstract Violence is a serious public health issue and constitutes a historical social phenomenon with diverse causes and consequences, and multiple manifestations. The main victims continue to be populations left vulnerable and marginalised, where dimensions including gender, class, race and social belonging intersect. Although studies to explain the phenomenon of violence do address ethnic and racial issues, they tend not to consider violence as stemming also from institutional racism. This paper examines data from a qualitative and quantitative study drawing on focus groups and semi-structured interviews to evaluate symbolic and structural violence experienced by young black people from 15 to 29 years old residing in peripheral neighbourhoods of two Brazilian state capitals - Recife and Fortaleza. The focus is on their standpoints that situate the intersectionality, especially among race/skin colour, territorial belonging and class, in the very definition of identity. In both capitals, the young black people revealed a common reality: life projects constrained by economic limitations and by the concrete or symbolic demarcation of social spaces to which they are denied access.

The Relationship between Religion, Substance Misuse, and Mental Health among Black Youth.

Studies suggest that religion is a protective factor for substance misuse and mental health concerns among Black/African American youth despite reported declines in their religious involvement. However, few studies have investigated the associations among religion, substance misuse, and mental health among Black youth. Informed by Critical Race Theory, we evaluated the correlations between gender, depression, substance misuse, and unprotected sex on mental health. Using multiple linear regression, we assessed self-reported measures of drug use and sex, condom use, belief in God, and religiosity on mental health among a sample of Black youth (N = 638) living in a large midwestern city. Results indicated drug use, and sex while on drugs and alcohol, were significant and positively associated with mental health symptoms. Belief in God was negatively associated with having sex while on drugs and alcohol. The study's findings suggest that despite the many structural inequalities that Black youth face, religion continues to be protective for Black youth against a myriad of prevalent problem behaviors.

Intersectionality and Social Security Age-18 Redetermination: Reducing the Stress and Trauma of Transition for Black Transition-Age Youth with Disabilities.

Greater attention is being paid to the transition to adulthood for youth with disabilities. We are also at a period of reckoning with the vestiges of slavery, Jim Crow, and a lack of constitutional protections for Black-identifying persons. The contemporary impact of inequitable access to opportunities, services, and supports that would improve the quality of life of racialized Black individuals has added consequences for Black youth with disabilities. A sub-population of youth with disabilities receives monthly support in the form of Supplemental Security Income (SSI), with a disproportionate number of Black-identifying youth qualifying for SSI. Such youth are impacted by the intersectionality of racism, disability, and poverty. The outcome of an SSI age-18 redetermination can be precarious and occurs in the backdrop of these intersectional forces, impacting the life course of racialized Black youth and their families on a scale that is concerning. The authors describe the time frames of pre age-18 redetermination, age-18 redetermination and post age-18 redetermination in the contexts of intersectionality and transition, and articulate what type of services and supports can reduce the experience of chronic stress in the lives of racialized Black youth facing an SSI age-18 redetermination, and thereby improve the outcomes of these youth as they transition to adulthood.

Virtual Implementation of a Photovoice Project With Youth in Baltimore During the COVID-19 Pandemic.

This article describes the virtual implementation of Photovoice activities conducted as part of a project that sought to gather youths' perspectives on neighborhood and housing conditions, community redevelopment, and health and well-being in Baltimore. We discuss the original in-person design and how activities were implemented virtually, in light of coronavirus disease 2019 (COVID-19) physical distancing guidelines. Challenges to virtual implementation included establishing rapport with youth and families during recruitment and data collection, encouraging active participation during discussion sessions, and varying technological skills among youth. Facilitators of virtual implementation included partnering with a community organization, piloting virtual sessions to assess participant's technology skills, and providing various ways for youth to participate during discussion sessions, engage in group activities, and receive hands-on instruction. This article showcases the ways in which virtual implementation of Photovoice activities can be successfully implemented with youth and provides recommendations for future Photovoice projects that include virtual activities.

Stress Biomarkers in Black Youth: Exploring Psychological, Behavioral, and Socio-Ecological Correlates.

Exposure to chronic stress is a major public health concern. Black youth are vulnerable to chronic stress exposure given their overrepresentation in urban neighborhoods characterized by socio-ecological stressors. We contribute to this emerging body of knowledge by (1) investigating stress-induced variability in cortisol response patterns among Black youth, and (2) examining risk and protective factors associated with physiological stress responses. Salivary cortisol was collected from a community sample of 123 low-income Black youth ages 13 to 21. Latent class analysis (LCA) and logistic regression were utilized to identify discrete groups based on cortisol reactivity, and psychological, behavioral, and socio-ecological correlates of class membership. LCA supported a 2-class model of cortisol reactivity. Youth in class one were indicative of a normative stress response with mean cortisol awakening response of 0.38 µg/dL (SD = 0.19), 0.48 µg/dL (SD = 0.20) at time 2, and 0.44 µg/dL (SD = 0.20) at time 3. Youth in class two exhibited a blunted stress response with mean cortisol awakening response of 0.20 µg/dL (SD = 0.11), 0.21 µg/dL (SD = 0.09) at time 2, and 0.18 µg/dL (SD = 0.08) at time 3. Delinquent peer exposure and post-traumatic stress symptoms were negatively associated with blunted stress responses, while greater depressive symptoms were positively associated with blunted stress responses. Black youth displayed distinct physiological stress reactivity patterns. Interventions are needed to assist youth in coping with stress while transforming the upstream factors that give rise to adverse community conditions.

Perceived Neighborhood Safety and Depressive Symptoms: The Role of Perceived Neighborhood Cohesion and Perceived Control.

Few have examined mechanisms explaining the link between perceived neighborhood unsafety, neighborhood social processes, and depressive symptoms for Black adolescents. The goal of this study was to examine the role of perceived control as a mechanism linking perceptions of neighborhood unsafety and depressive symptoms, and neighborhood cohesion as a protective factor. Participants were 412 Black adolescents living in a major Mid-Atlantic urban center in the United States (49% female, Mage = 15.80, SD = 0.36). Participants reported perceptions of neighborhood unsafety at grade 10, neighborhood cohesion at grade 10, perceived control at grades 10 and 11 and depressive symptoms in grades 10 and 12. High neighborhood unsafety was associated with low perceived control and in turn high depressive symptoms only when neighborhood cohesion was high. The results highlight the role of neighborhood unsafety and perceived control in the development of depressive symptom and the possible downsides of neighborhood social factors.

Using the intervention mapping for adaption framework to adapt an evidence-based sexual health intervention for youth affected by trauma.

BACKGROUND: Children exposed to household challenges (i.e., parental substance use, incarceration, and mental illness) are among the groups most vulnerable to sexual risk-taking in adolescence. These behaviors have been associated with a range of negative outcomes later in life, including substance abuse, low educational attainment, and incarceration. Adapting an evidence-based intervention (EBI) to be suitable for this population is one strategy to address the needs of this group. METHODS: In this study, we describe the use of the Intervention Mapping for Adaption (IM-Adapt) framework to adapt an evidence-based, sexual health intervention (Focus on Youth with Informed Children and Parents). We describe the actions taken at each step of the IM-Adapt process which are to assess needs, search for EBIs, assess fit and plan adaptions, make adaptions, plan for implementation and plan for evaluation. RESULTS: Key changes of the adapted intervention include the incorporation of trauma-informed principles and gender inclusive language, standardization of the session length, and modernization of the content to be more appropriate for our priority population. CONCLUSIONS: The adapted intervention shows promise toward meeting the behavioral health needs of Black youth exposed to household challenges. Our process and approach can serve as a model for researchers and practitioners aiming to extend the reach of EBIs.

Do We Belong? Examining the Associations Between Adolescents' Perceptions of School Belonging, Teacher Discrimination, Peer Prejudice and Suicide.

In the USA, suicide is a leading cause of death for adolescents ages 12 to 18 (National Institute of Mental Health (NIMH), 2019). Given the urgency of this public health crisis, this paper aims to explore the impact of a sense of school belonging and teacher-based discrimination and peer-based prejudice on suicidal ideation and attempts among Black youth. This secondary analysis used a sample of Black youth (N = 4229; Mage = 16) from the National Longitudinal Study of Adolescents to Adult Health data. Independent variables included a sense of school belonging, school-based teacher discrimination, and school-based peer prejudice; the dependent variable was suicidal thoughts and behaviors. The results of multinomial regression analyses revealed that as Black adolescents' sense of school belonging decreased, they were 35% more likely to be at risk for suicidal ideation and attempts. Findings from our study support the assertion that the school microsystem plays a substantial role in modifying the risk of suicidal behavior among Black youth.

Decolonizing research with Black youths.

Black youths experience poor mental health especially due to anti-Black racism. Research related to Black youths have been conducted on Black youths with little or no participation or engagement rather than with Black youths. This paper presents information from a dialogue on decolonizing nursing research. I draw on interviews and conversation cafes with around 120 Black youths in Canada to identify strategies for decolonizing research with Black youths. First, I reflect on my relations with the Indigenous land in which the study was conducted as well as my positionality as a Black woman. In this paper, I discuss how community based participatory action research can integrate capacity building component, amplify youth's voices and capitalize on the agency of youths as fruitful actors. I also reflect on the opportunities and benefits of decolonizing nursing research.

Goal Orientation and Adolescent Social Competence: Ubuntu as a Mediator Among Black American Adolescents.

Social competence, which is the ability to demonstrate socio-emotional behavior skills, is crucial during adolescence with far-reaching implications across the lifespan. However, social competence development among youth is greatly influenced by social inequities, which places many Black American youth at a disadvantage due to the disproportionate burden on youth development in resource-constrained environments. Responsively, we sought to determine whether Afrocentric cultural norms (i.e., Ubuntu) and goal orientation contribute to the resilience of Black youth in developing social competence while controlling for social positions (i.e., social class and gender). For this study, we used the dataset of black boys and girls (average age of 14.68) from the Templeton Flourishing Children Project. Linear regression analysis followed by mediation analysis was conducted to identify the factors associated with higher degrees of social competence. Significant study findings indicate that Black youth reporting higher goal-oriented mindsets reported higher social competence scores. Goal orientation and social competence were mediated by Ubuntu, with the model explaining 63% variance in social competence in Black youth. The findings suggest prevention efforts that provide socialization centered around Afrocentric cultural norms may provide valuable means of bolstering social competence development in Black youth living in resource-constrained communities.

An emerging youth-centered model of community resilience in communities impacted by gun violence: Power through Black Community and Unity.

Studies commonly examine resilience as an outcome by way of measuring the degree to which protective factors maintain individuals' well-being despite the presence of significant risk. In this study, we developed a model of community resilience that centered the voices of Black youth. Using data collected as part of a 3-year, youth participatory action research project, we developed a model that focuses on what 11 Black youth perceive and believe contributes to community resilience through their investigation of problems and solutions related to community gun violence. Findings from a constructivist grounded theory analysis of multiple data sources (e.g., field notes, transcribed group discussions, youth photovoice activities) revealed our developing model of community resilience: Power through Black Community and Unity. Specifically, Power through Black Community and Unity was a core category that reflected the importance of care, support, and safety as strengths in the community's current response and resilience to gun violence, and future aspects the community could develop to increase community resilience to gun violence. This core category emerged in three subsequent ways: Collective Care, "Seeing Beyond the Bad," and Supportive Teen Spaces. This study illustrates potential pathways that youth service agencies and community practitioners can consider enhancing in their programming to promote resilience in their communities.