Recommendation 1: Center youth voice by prioritizing their leadership and input in developing youth suicide prevention programs.

CBOs should include youth voices in their suicide prevention programming to ensure that programmatic efforts are relevant for their intended audiences. In many communities, youth have a strong interest in learning to help their friends and families. For example, in suicide prevention programs, youth report wanting to learn skills to help a loved one who has had thoughts of self-harm and provide them with general information about mental health. Such an approach would contrast with programs and interventions that are created by individuals who are not part of the group an intervention is intended to benefit. Youth at higher risk for suicide may find more value in programs that allow young people to serve as assets for their families and friends, relative to programs that focus exclusively on helping youth recognize their own distress and acquire skills for coping with stress and accessing care.

Youth are assets to their communities, not problems to be solved. Young people can help CBOs shift toward approaches that will resonate better with youth in their communities. This outlook is especially important for partnering with Asian, Black, Indigenous, Hispanic, and LGBTQ+ youth to prevent suicide. For example, in some communities, Black youth may be less comfortable with suicide prevention programs held in certain institutions, such as school, religious, or clinical mental health settings. LGBTQ+ youth may feel more comfortable in familiar institutions like schools and health care settings when those settings affirm their sexual orientation and gender identity and foster a greater sense of belonging—both of which are prominent protective factors against suicide risk. Community organizations can play a unique role in creating safe spaces for youth to engage in relevant and respectful suicide prevention interventions and in helping them advocate for changes to the ways in which familiar institutions implement suicide prevention efforts in their communities.

Recommendation 2: Identify youth suicide risk factors and promote protective factors that capitalize on a population’s strengths.

CBOs must identify salient risk factors for the population they serve to properly address the root causes of youth suicide. Risk factors, or factors that are associated with increasing the likelihood of youth suicidal behaviors, are complex and may vary by specific populations. Asian, Black, Indigenous, Hispanic, and LGBTQ+ youth may exhibit risk factors that are overlooked in general youth suicide prevention and promotion-focused efforts. For example, recent research has shown that racial discrimination increases the risk of suicidal ideation for African American youth, while navigating acculturation may act as a risk factor for Asian American youth. Inupiat youth note that loss of culture may have implications for the youth suicide rates of Indigenous youth while, on a more interpersonal level, familial conflict serves as a particularly salient risk factor of youth suicide to Mexican-origin youth. Exposure to bullying and a negative school experience, in addition to family rejection, are risk factors of youth suicide for LGBTQ+ youth. While these examples are not exhaustive, they highlight the need to recognize that the same risk factors may have varying degrees of salience for different groups of youth.

Conversely, protective factors are attributes associated with enhancing well-being in the face of adversity. While CBOs must be aware of communities’ most salient risk factors, their work should lead with a strengths-based approach, meaning they should integrate protective factors and cultural strengths/assets when promoting targeted suicide prevention efforts. For example, in some Hispanic communities, promoting familism (i.e., a tendency to strongly value the family unit) may be effective, whereas promoting cultural and spiritual beliefs may be a vital component for Yup’ik Alaska Native youth. Emphasizing these cultural protective factors can help buffer the effects of risk factors to prevent youth suicide behaviors. Notably, risk and protective factors within racial/ethnic and LGBTQ+ groups may present differently based on lived experiences, especially regarding the circumstances of those with multiple marginalized identities. To avoid generalizations and simplistic approaches, ask youth to help identify risk and protective factors across singular and intersecting identities.

Recommendation 3: Partner with other organizations in youth’s communities to coordinate efforts and leverage each group’s unique strengths.

CBOs should collaborate with local partners to maximize their efforts to reduce youth suicide risk and promote protective factors. Community partnerships are essential when implementing suicide prevention efforts at the community level. Asian, Black, Indigenous, Hispanic, and LGBTQ+ youth are impacted by community-level risk and protective factors that require interventions with contributions from many groups across a community. Many communities may have untapped resources or benefit from better-coordinated efforts.

Relative to interventions that are implemented in isolation, collaboration requires relationship building, communication of shared interest, and commitment from all involved parties to result in larger-scale change. For example, in the Somerville Cares About Prevention community coalition, the mayor of Somerville, Massachusetts was able to help a community coalition effectively respond to the youth suicide crisis by leveraging existing resources from community partners, community activists, and a research organization. This partnership ultimately reduced youth suicide and overdose rates in Somerville.

Footnotes

[1] There is a clear distinction between reporting on suicide deaths for racial and ethnic groups and reporting on suicide attempts for LGBTQ+ youth. National data on suicide rates for LGBTQ+ youth are nonexistent due to the lack of sexual orientation and gender identity questions on national surveys and their exclusion from reporting criteria on death certificates.

[2] In the survey, students were asked which of the following terms best describes them: “heterosexual (straight),” “gay or lesbian,” “bisexual,” “questioning,” or “I describe my sexual identity in some other way.” Students were not asked questions pertaining to gender identity.