Risk and protective factors for suicidal thoughts and behaviors among Black female and male youth with depression symptoms - United States, 2004-2019

Background: From 2004 to 2019, suicide rates among Black youth increased by 122 % for females and 65 % for males. Guided by the interpersonal theory of suicide, this study explored how perceptions of social support and parental involvement may contribute to suicidal behavior among Black youth aged 12-17 years. Methods: Data are from the 2004-2019 National Survey on Drug Use and Health (NSDUH). Multivariable logistic regression with backwards elimination was conducted to determine if characteristics associated with outcomes of interest (i.e., suicidal ideation, made a suicide plan, and made a suicide attempt) differed by sex. The characteristics examined included: age, poverty level, health insurance coverage, currently receiving mental health treatment, grades for last completed semester, parental involvement, frequency of arguments or fights with parents, frequency of fights at school or work, parental attitudes, and availability of emotional support. Results: Over 400,000 Black youth with depression symptoms reported suicidal thoughts and behaviors (80 % female). Females had increased odds of suicidal ideation and making a plan if they had no one to talk to about serious problems. Males had increased odds of attempting suicide if they reported academic struggles. Limitations. This is a cross-sectional study and potential biases may affect generalizability of results. Conclusions: Risk and protective factors identified in this study aligned with the interpersonal theory of suicide. Evidence-based interventions that focus on increasing connectedness and self-esteem may be effective for Black youth struggling with suicidal ideation. Preventing suicide requires a comprehensive approach including prevention strategies for individuals, families, and communities.