Perceptions of suicide among African American youth: Investigating suicide risks and barriers to help-seeking

Few studies have examined suicide perceptions among urban African American adolescents. Because suicide attempts among District of Columbia (DC) youth exceed the national average and increased between 1997-2007, the DC Department of Mental Health sought to better understand youth perceptions of suicide and the factors associated with suicide and depression risk. Five focus groups were conducted with African American youth ages 14-21 (11 males; 20 females) attending a DC Summer Youth Employment Program. Transcripts were analyzed using QSR NVivo software and a grounded theory-based coding approach. Although most youth understood the meaning of suicide, few viewed suicide as a problem compared to homicide. Most knew someone who made suicidal threats/gestures, but these behaviors were not always taken seriously (e.g., it's a figure of speech, attention getting, a sign of weakness). Emotional consequences (e.g., feeling alienated, unloved, hopeless, ashamed) of negative interpersonal relationships, including neglect, abuse, bullying, and problems with intimate partners, family, and peers, were frequently mentioned as reasons why youth might think about suicide. Reasons for potentially suicidal self-destructive behaviors included to fit in/be accepted, show off/look better, avoid being seen as weak, prove you're not afraid to die, and kill yourself before others hurt/kill you. Help seeking barriers included distrust, stigma, and confidentiality concerns. The unique issues identified through the focus groups contributed to the development of community-based interventions and a social marketing campaign entitled “I Am The Difference,” which is designed to reduce youth suicide by promoting positive coping strategies and increasing awareness of mental health resources.