A Nuanced Perspective on Suicide Awareness

By: Niah Singletary

LCMHCA| CRC| MA|

As we begin to close out suicide awareness month it is important that we continue the conversation of suicide awareness and prevention well beyond the month of September. Throughout the month of September appropriate discussions on suicide preventions, warnings signs to look out for regarding suicide ideation, and resources surrounding those struggling with suicide ideation are had. However, there is rarely a discussion surrounding how suicide ideation and death as result of suicide can vary across cultures and communities. As we continue to have important discussion on how to assist in suicide prevention it is pertinent, we also review this from a nuanced a culturally competent perspective.

According to the Center for Disease Control (CDC) 45, 979 people died by suicide in 2020. The CDC also reported that as staggering 12.2 million adults seriously thought about suicide and 1.2 million attempted suicides in 2020. Within certain racial ethnic groups there are disproportionately high rates of suicide. In 2020, non-Hispanic American Indigenous peoples and Alaskan Native peoples had the highest suicide rates among ethnic groups. The suicide rate among males in 2020 was four times higher than the rate of females. Males make-up 49% of the population but nearly 80% of suicides (CDC, 2022) According the American Psychological Association (APA, 2017) the rate of suicide attempts is four times greater for lesbian, gay, and bisexual youth and two times greater for questioning youth than that of heterosexual youth.

So, how do we begin culturally examining suicidal awareness and prevention so that provide the

most ethically appropriate assistance? One way to begin is to acknowledge that understanding racial and intergenerational trauma is critical when recognizing the somatization of Black, Indigenous, People of Color (BIPOC). BIPOC are more likely to express psychological distress

through bodily symptoms for two primary reasons: As compared to European Americans, there is a higher level of stigma associated with mental illness and, therefore, physical symptoms are more socially acceptable. There is typically a more holistic conceptualization of the person, and therefore, less of a distinction between mind and body among BIPOC (USDHHS, 2001 via Chapman et al., 2014). Many cultural traditions recognize the spirit as an integral part of the person, inseparable from mind and body (Parham, 2002 via Chapman et al., 2014). When clinicians do not consider this perspective, it can reduce the salience of treatment in racially diverse clients.

When participating in suicide prevention and intervention with BIPOC clients it is important to have a cultural curiosity (an openness to learn further learn and understand a client’s cultural perspectives and influence) when delivering services and this should include services around suicide. For example, passive suicide, may look different across cultures, genders, religions, and ages. Passive suicide is defined by the APA as ambiguous behavior that tends to be self-destructive, but

not actively so, and is sometimes thought to reflect suicidal intentions. Examples of this behavior include failing to feed oneself or to engage in rudimentary self- care. Understanding a client’s learned and normalized sociocultural behaviors can help clinicians better identify suicidal ideations or other behaviors. As we continue to have nuance discussions on how best to approach suicide intervention and prevention it is important to remember that cultural awareness and competency should be a nuanced element to discussed in best practices.

Niah Singletary | LMCHA, CRC, MA

Sources:

American Psychological Association. (n.d.). Apa Dictionary of Psychology. American Psychological

Association. Retrieved September 29, 2022, from https://dictionary.apa.org/passive-suicide

Centers for Disease Control and Prevention. (2022, June 28). Suicide data and statistics. Centers for Disease Control and Prevention. Retrieved September 29, 2022, from

https://www.cdc.gov/suicide/suicide-data-statistics.html

Chapman, L. K., Delapp, R. C. T., & Williams, M. T. (2014). Impact of Race, Ethnicity, and Culture on the Expression and Assessment of Psychopathology. In Adult Psychopathology and Diagnosis (pp. 131–154). essay, John Wiley & Sons, Inc The Division of Diversity and Health Equity. (2017). Mental health disparities: LGBTQ - american psychiatric association. Psychiatry,org . Retrieved September 29, 2022, from

https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-

Disparities/Mental-Health-Facts-for-LGBTQ.pdf