Clinical Intern The Ohio State University Wexner Medical Center Columbus, Ohio, United States
Body of Abstract: Although suicide is a leading cause of death for People of Color (PoC) (CDC, 2019), most suicide researchers focus on predominantly White populations (Cha et al., 2018) contributing to a knowledge gap in understanding suicide risk for PoC. Further, PoC are the least likely to receive mental health treatment even when experiencing suicidal thoughts and behaviors (Kuramoto-Crawford et al., 2017; Tang et al., 2022). Efficacious suicide prevention treatments such as Brief Cognitive-Behavioral Therapy for Suicide Prevention (BCBT) exist, but these studies are completed with predominantly White samples (Rudd et al. 2015). Thus, limited numbers of PoC in intervention research are often a barrier to demonstrating that treatments are equally effective for PoC (Meza & Bath, 2020). Notably, researchers often do not focus on potential mechanisms for reductions in suicidal thoughts and behaviors for PoC, which further contributes to the ethnoracial inequity in suicide prevention efforts.
Extant research supports that both oppressive social processes (e.g., structural and interpersonal racism) and cultural factors (e.g., acculturative stress) can increase suicidal thoughts through increases in PB (and sometimes TB) for PoC (Keum, 2023; Kwan et al., 2023; Oakey-Frost et al., 2021). Further, there is some evidence that increased PB is associated with less willingness to seek mental health treatment in PoC (Tang & Masicampo, 2018). Thus, it is important to understand how initial levels of PB and TB and any changes influences treatment outcomes. The current study aims to address one small piece of this gap by examining whether BCBT reduces suicide attempts for PoC. Further, we will examine whether two established risk factors for suicidal thoughts, perceived burdensomeness (PB) and thwarted belongingness (TB), matter in reducing suicidal thoughts for PoC. The current study aims to address one small piece of this gap by examining whether BCBT reduces suicide attempts for PoC. Further, we examined whether two established risk factors for suicidal thoughts, perceived burdensomeness (PB) and thwarted belongingness (TB), matter in reducing suicidal thoughts for PoC.
Participants included 65 PoC (Asian, Black, Pacific Islander, Multiethnoracial, Native American, Non-White Hispanic) active-duty Army soldiers with either a suicide attempt within the past month or suicidal thoughts with intent within the past week. They were randomized to complete either BCBT or treatment as usual, and were followed from baseline to 24-month follow-up assessment. Preliminary analyses indicate no significant association between treatment condition and suicide attempts at 90 days post baseline, which is the earliest a participant could finish treatment (X2 (1) = 3.43, p = .064). However, the difference in suicide attempts between the two treatment conditions was statistically significant at 180 days (X2 (1) = 4.36, p = .037), 365 days, (X2 (1) = 6.32, p = .012), and 730 days following baseline (X2 (1) = 7.84, p = .005). At 180 days, five people in the control condition attempted suicide; zero people in the BCBT condition attempted suicide. At 365 days, seven people in the control condition attempted suicide; zero people in the BCBT condition attempted suicide. At 730 days, 11 people in the control condition attempted suicide and one person in the BCBT condition attempted suicide. Analyses examining the association of PB and TB with thoughts of suicide across a 12-month period for PoC are ongoing.
Initial results indicate that BCBT is effective in reducing suicide attempts for PoC and these reductions remain two years after starting treatment, which is consistent with the original randomized clinical trial for BCBT. Whether PB and TB matter in reducing suicide risk for PoC receiving BCBT is yet to be determined.
Learning Objectives:
Upon completion, participants will be able to identify whether BCBT is effective in reducing suicide attempts for PoC.
Upon completion, participants will be able to describe the current ethnoracial inequities in suicide prevention efforts.
Upon completion, participants will be able to explain whether initial levels and changes in perceived burdensomness and thwarted belongingness are associated with thoughts of suicide.
