Background and Objective: Suicide among adolescents has been identified as a major public health concern. Racism has also been recognized as a significant social determinant of health and has been found to increase the risk of adverse mental health outcomes, including depression, anxiety, psychological distress, and suicidal thoughts and behaviors (STBs). While cross-sectional studies have investigated the effects of perceived racial discrimination on STBs among adolescents, few studies have used longitudinal data to examine these effects, particularly among pre-adolescents. This study investigates the association between the risk of racism and STBs among pre-adolescents.

Methods: This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) study (2017-2020). The sample consisted of 10,301 pre-adolescents aged 11-12, with the risk of racism at Wave 1 as the main explanatory variable and STBs at Wave 2 as the outcome variable. Binary logistic regression was employed for the main analysis.

Results: Of the 10,301 pre-adolescents examined, 13.01% reported experiencing STBs. In terms of the risk of racism, 54.58% were classified as low risk, 42.54% as moderate risk, and 2.88% as high risk. Controlling for demographic characteristics, and risk and protective factors, pre-adolescents at high risk of racism had 3.76 times the odds of experiencing STBs [AOR=3.76, CI=2.18-6.49], and those at moderate risk had 2.36 times the odds [AOR=2.36, CI=1.52-3.66], compared to their low-risk counterparts. Accounting for the risk of racism, Black [AOR=0.44, CI=0.28, 0.70] and Latine [AOR=0.45, 95% CI=0.28, 0.71] adolescents had lower odds of STBs compared to their White counterparts. Parental acceptance and monitoring emerged as protective factors against the detrimental effects of racism on STBs.

Conclusion: The findings highlight the significant impact of racism on STBs among pre-adolescents, emphasizing the importance of addressing racial discrimination as a public health issue. Researchers should begin to rebuild trust in public health and science by directly measuring experiences of racism rather than relying on race/ethnicity as proxies. There is the need for targeted public health interventions and anti-racist policies to combat racism and promote protective familial relationships to mitigate pre-adolescent suicidality.

Introduction: Suicide is a serious and increasing public health problem, and different populations may experience suicide at different rates. Research shows that there could be a need for suicide prevention among tattooed individuals. Additionally, because tattoos chosen by clients oftentimes symbolize something meaningful to the client, such as a semicolon for suicide prevention or a date or name in memory of someone close to them who has died by suicide, this opens doors for discussion between the tattoo artist and client. The aim of this project is to determine the feasibility, acceptability, and interest among tattoo artists of providing education on suicide prevention within tattoo shops.

Methods: Tattoo artists who are working in Wisconsin were recruited via email and/or social media sites to participate in an anonymous online survey. Frequencies were tabulated to describe the study’s sample as well as responses to all survey questions. To assess the relationship between survey responses and participant attributes, we conducted unadjusted bivariate analyses using Fisher’s exact tests.

Results: A total of 79 surveys were collected. Survey results indicate that most tattoo artists have encountered at least one situation in which a client mentioned something that made them concerned about their mental health (63%). In addition, 59% of respondents (n=47) reported that a client has expressed suicidal thoughts to them at least one time. Also, 90% of respondents (n=71) indicated that they were either somewhat comfortable or very comfortable talking about issues relating to suicide and/or mental health. Unadjusted bivariate analyses reviewed significant associations (p=0.01) between an artist’s level of comfort in discussing issues related to mental health and suicide and their age.

Conclusion: To our knowledge, this is the first study assessing the attitudes of tattoo artists on the need for and the practicality and acceptability of suicide prevention within tattoo shops. Our study demonstrated that many tattoo artists encounter clients who express mental health challenges as well as suicidal ideation, underscoring the potential for tattoo artists to play an important role in early identification of individuals at risk for serious mental health issues and/or suicidal thoughts and behaviors.

Background: Promoting secure firearm storage to create time and space between an individual at risk of suicide and a loaded firearm, also known as lethal means safety (LMS), stands as a proven strategy in suicide prevention. Veterans show a preference for discussing LMS within their family circles rather than with healthcare providers. Caregivers, therefore, hold a key role in facilitating LMS discussions with Veterans, but many express a need for additional guidance and support beforehand.

Methods: To address this gap, we implemented a community-engaged approach to develop a caregiver-focused "playbook" aimed at raising awareness about LMS, equipping caregivers to initiate conversations on the topic with Veterans and providing them with relevant resources. Text of the playbook was informed by a landscape analysis of existing LMS and secure storage messaging, focus groups with caregivers of Veterans, and iterative review of drafts by scientific and clinical subject matter experts (SMEs) and caregivers. Readability was calculated at an 8th grade level.

Results: The resulting playbook includes sections on (1) importance of LMS for suicide prevention; (2) when to have LMS conversations; (3) whom to involve in LMS conversations; (4) how to have LMS conversations; (5) taking actions towards secure firearm storage; and (6) helpful VA and non-VA resources. Additionally, it addresses caregiver well-being and the role of LMS in preventing caregiver suicide.

Conclusion: The development process for this playbook highlights best practices for engaging diverse SME’s, including caregivers, in shaping the messaging of LMS. It also offers valuable perspectives on the language, content, and resources crucial for empowering caregivers to effectively engage in LMS discussion with Veterans.

Background

The World Health Organization (WHO) promotes a comprehensive multi-sectorial suicide prevention strategy; in the United States the CDC also promotes and funds a comprehensive approach to suicide prevention. Comprehensive programs in Canada, Europe, Hong Kong and Australia have shown promise, yet one can find exceedingly few peer reviewed, published studies on the subject. As such, SAVE in the US set out to conduct the first ever case controlled study of a comprehensive community based suicide prevention program.

Methods SAVE used Dakota County (USA) as an experimental county and Anoka County (USA) as the control county. Dakota was chosen due to the burden of suicide and nonfatal suicide attempts, ranking 3rd in the states in both deaths by suicide and hospital admissions for self-inflicted injury in the years immediately preceding the project’s implementation. Anoka carried a considerable burden of suicide and nonfatal suicide attempt, ranking 4th in the state in deaths by suicide and in the number of hospital admissions for self-inflicted injury in 2016-2017 in the state. Baseline data was obtained from the counties and State on suicide deaths, hospitalization, ideation and attempt data using the Youth Risk Behavior Survey, the Department of Health and hospitalization records from 2019-2022. SAVE created an Executive Committee in the experimental county, a logic model, determined high priority populations, implemented evidence based and best practice programs throughout the county and collected outcome evaluation data for analysis in change in knowledge, attitude, behavior and suicide outcomes by coordinating, implementing, and evaluating a comprehensive and integrated prevention program comprised of 14 linked strategies.

Results Over 500 individuals were trained in suicide prevention. Over 1 million public service announcements were distributed using 12 different campaign taglines developed by the executive committee. 95% of participants trained were found to have increased knowledge, a changed attitude toward suicide prevention and 85% demonstrated behavior change.

Discussion In this case control study, over 4 years outcome data was gathered. Sustainability was built into the model for the experimental county that will bring long-term benefits to the community and the replicable model for community based comprehensive suicide prevention programs.