Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems

Álvarez, Kiara; Polanco-Roman, Lillian; Breslow, Aaron S.; Molock, Sherry Davis

doi:10.1176/appi.ajp.21101001

Cited by 57 publications

(45 citation statements)

References 115 publications

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“…Complex trauma, prolonged stress, and other adversities can increase the risk of a variety of undesirable outcomes including poor academic achievement, mental health disorders, suicidality, and substance use across the lifespan and affect disproportionally socially and economically marginalized A-YA (Alvarez et al, 2022 ; Chartier et al, 2010 ; Edwards et al, 2003 ; Polanco-Roman et al, 2016 ). For example, Copeland and colleagues ( 2018 ) found that cumulative childhood trauma was associated with higher rates of later onset psychiatric disorders during the transition to adulthood and poorer functional outcomes (e.g., unemployment, social isolation).…”

Section: Adolescent and Young Adult Mental Healthmentioning

confidence: 99%

“…Despite this growing problem, many A-YA do not access mental health services, and those that do access care often disengage prematurely and experience challenges with continuity (Substance Abuse and Mental Health Services Administration [SAMHSA], 2020 ). Rates of disengagement are higher among minoritized groups (Moore, 2018 ) many of whom are involved with public systems (Alvarez et al, 2022 ; NeMoyer et al, 2020 ) and experience environmental stressors. These concerns are multi-faceted and so must be our strategies to address them.…”

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confidence: 99%

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A Systematic Review of Music-Based Interventions to Improve Treatment Engagement and Mental Health Outcomes for Adolescents and Young Adults

Rodwin

Shimizu

Travis

et al. 2022

Child Adolesc Soc Work J

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Mental health disorders and suicidality are rising among adolescents and young adults (A-YA) while rates of treatment engagement remain notoriously low. Emerging research supports the potential of music-based interventions to improve mental health, but their efficacy remains unclear for A-YA. This systematic review evaluates the evidence on music-based psychosocial interventions to improve engagement in treatment and/or mental health outcomes among A-YA. This review was prospectively registered with PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-six studies were extracted. There was heterogeneity of designs, populations, measures, and outcomes. A typology of music-based interventions emerged, which is characterized by combinations of three broad categories: 1) Somatosensory, 2) Social-Emotional, and 3) Cognitive-Reflective. Most interventions are Socio-Cognitive and Holistically Integrated (combines all three) followed by Socio-Somatic . All interventions involved Social-Emotional processes. Results indicate that most studies report significant effects for mental health outcomes related to social and emotional improvements and reductions of internalizing symptoms for adolescents. Few studies targeted young adults and effects on engagement were rarely measured. There is a need for more studies that use rigorous methods. This review illuminated a need for interventions that are developmentally and culturally tailored to subgroups. Finally, the field is ripe from more studies that apply experimental therapeutics to conceptualize, operationalize, and test mechanisms of change to improve the understanding of how and for whom music-based interventions work. Recommendations for embedding these innovative strategies into research and practice for A-YA are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s10560-022-00893-x.

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Section: Adolescent and Young Adult Mental Healthmentioning

confidence: 99%

mentioning

confidence: 99%

A Systematic Review of Music-Based Interventions to Improve Treatment Engagement and Mental Health Outcomes for Adolescents and Young Adults

Rodwin

Shimizu

Travis

et al. 2022

Child Adolesc Soc Work J

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“…We illustrate disparities/inequities and opportunities for equitable suicide prevention across the SIM for youth impacted by the JLS (see Figure 1 ) using a Structural Racism and Suicide Prevention Systems Framework ( 9 ), which posits that youth are embedded across multiple ecological systems that illustrate how individual, interpersonal, community, and societal factors intercept and influence each other over time and have an impact on suicide risk. Additionally, given that childhood trauma is a significant risk factor for suicide attempts ( 10 ) and that ethnoracially minoritized youth are more likely to experience potentially traumatic events ( 11 , 12 ), we will pay particular attention to efforts disrupting the pathway from trauma to suicidal risk.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, given that childhood trauma is a significant risk factor for suicide attempts ( 10 ) and that ethnoracially minoritized youth are more likely to experience potentially traumatic events ( 11 , 12 ), we will pay particular attention to efforts disrupting the pathway from trauma to suicidal risk. Within these frameworks, we contend that inequities are compounded across the SIM, and to truly address inequities through culturally and trauma responsive care, we must evolve from individual to structural targets in suicide prevention efforts ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Equitable suicide prevention for youth impacted by the juvenile legal system

Meza

Snyder²,

Shanholtz³

2022

Front. Psychiatry

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Suicide is the second leading cause of death for adolescents in the United States. Despite the already alarmingly high rates of suicide attempts among adolescents, youth involved in the juvenile legal system (JLS) are up to three times more likely to have suicide attempts than their peers not impacted by the JLS. This public health crisis is also a matter of health equity, knowing that ethnoracially minoritized youth, mainly Black and Latinx youth, have disproportionate contact with the JLS. In order to disrupt the current elevated rates of suicide among Black and Latinx youth involved in the JLS, there needs to be more concerted efforts to improve assessment and suicide prevention efforts in the JLS. There are various potential touch points of care for suicide prevention and the Sequential Intercept Model (SIM), which outlines community-based responses to the involvement of people with mental and substance use disorders in the criminal justice system, can be used as a strategic planning tool to outline possible equitable interventions across these various touch points. Our purpose is to provide a comprehensive picture of gaps and equitable opportunities for suicide prevention across each intercept of the SIM. We provide recommendations of priorities to promote health equity in suicide prevention for ethnoracially minoritized youth impacted by the JLS.

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“…It is now more widely acknowledged within the current fields of clinical psychology and psychiatry that suicide in the United States is more than a mental health problem (Barnhorst et al, 2021, p. 299), that social determinants of health are key drivers of increasing suicide death rates (Dev & Kim, 2021), and that for ethnoracially minoritized youth, structural racism constitutes a key social determinant (Alvarez et al, 2022). In response, the Surgeon General's office has released a Call to Action (U.S.…”

mentioning

confidence: 99%

Setting a course to protect indigenous cultures and communities in our national suicide prevention agenda.

Rasmus¹,

Wexler²,

Allen³

2022

Clinical Psychology: Science and Practice

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It is now more widely acknowledged within the current fields of clinical psychology and psychiatry that suicide in the United States is more than a mental health problem (Barnhorst et al., 2021, p. 299), that social determinants of health are key drivers of increasing suicide death rates (Dev & Kim, 2021), and that for ethnoracially minoritized youth, structural racism constitutes a key social determinant (Alvarez et al.

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Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems

Cited by 57 publications

References 115 publications

A Systematic Review of Music-Based Interventions to Improve Treatment Engagement and Mental Health Outcomes for Adolescents and Young Adults

A Systematic Review of Music-Based Interventions to Improve Treatment Engagement and Mental Health Outcomes for Adolescents and Young Adults

Equitable suicide prevention for youth impacted by the juvenile legal system

Setting a course to protect indigenous cultures and communities in our national suicide prevention agenda.

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