Adapting School Suicide Prevention Programs for Students of Color
Schools can improve their suicide prevention efforts by adopting the SOAR (Self-Awareness, Outreach, Adaptation, and Repair) framework.
There is a growing need for schools to do something different for students of color who are struggling with suicide. A study by JAMA Pediatrics reported that between 2001 and 2015, Black students younger than 13 were two times as likely to die by suicide compared to White students. Between 2014 and 2019, the age-adjusted suicide rate increased by 16% for Asian or Pacific Islander individuals (from 6.1 to 7.1 per 100 000 individuals). In a 2019 national survey, Hispanic American students reported higher rates of feeling hopeless and sadness than White, Asian, and Black students.
Since we are just starting to come out of the pandemic, the impact of COVID-19 on youth mental health and suicide is just starting to be examined. Overall suicide rates in the U.S. between 2019 and 2020 seemed to drop among White Americans, while the rates for Black, Hispanic, and Asian Americans — though lower than their White peers — continued to climb in many states.
Before, during, and after the pandemic, suicide rates have been consistently high for Native Americans. The CDC reports that Black youth have the highest reported rate of suicide attempts, followed by Hispanic and White youth. They also stated that “experiences of racism among youth have been linked to poor mental health, academic performance, and lifelong health risk behaviors.” During the pandemic, the highest levels of reported racism were among Asian American youth (64%), while Black American youth and students of multiple races (both 55%) were tied for second.
Families of color are less likely to involve mental health services when their family members are suicidal. Nearly 27% of White American patients made a mental health visit in the preceding week of attempting suicide, compared to less than 20% for most other racial/ethnic groups. Of all the racial groups, Asian-Americans were the least likely to make any type of visit within a year before attempting suicide.
While suicide is a very complex issue, most schools have had a cookie cutter approach to suicide. They tend to think in terms of universal, reactive interventions rather than more adaptive and upstream approaches. In the end, youth suicide prevention for students of color needs to be built on collaboration and customization. While there is only a scarce body of research that addresses suicide for students of color, there are some common strategies to consider.
We explain these ideas using the acronym of SOAR as a framework. SOAR stands for Self-Awareness, Outreach, Adaptation and Repair.
The SOAR Framework for School Suicide Prevention
On a national level, while eight out of 10 educators in the United States are White Americans, less than one out of four students are the same. In order to understand how to address youth suicide for diverse students, educators first have to be self-aware of how they racially show up to situations, and how their lived experiences (also known as implicit bias) may come into play as they interact with different students.
Dr. Stanley Wing Sue explains that there are many reasons why people don’t talk about race, especially when it involves conversations between mixed races. He warns that when schools do not talk about race, students and faculty of color experience many subtle but painful encounters known as “microaggressions.” These subtle biases towards students of color can include assumptions about poverty, single-parenthood, motivation to achieve, citizenship, and family involvement. Studies show that students who experienced relatively more microaggressions report that they are more of a burden to others, feel more depressed, and report more behaviors associated with being suicidal.
By becoming more self-aware by looking at our assumptions and learning about the multiple perspectives of others, we will be less prone to make students of color marginalized based on our unintentionally biased actions. As a result, educators who keep these self-identified biases in check will be more centered, open to feedback, and engaged with students who look different from them at school.
Studies show that families of color initiate mental health care less often than White American families, and students of color are less likely to identify a trusting adult in their lives. For these reasons, educators need to be more forthcoming about reaching out to those who feel marginalized at school. The more inclusive connections that schools make with students and families of color, the more encouraged they will be to accept help at school when problems occur.
Educators who make home visits can increase support for families who have circumstances that leave them home-bound due to medical concerns or transportation issues. Some schools have made therapy more accessible to families in need by partnering with community mental health centers to place therapists on campus.
We can no longer hold the belief that merely providing limited school day “drop-in” hours for students in need will be enough to connect with students of color, particularly those who are potentially suicidal. School personnel need to deliberately reach out to their families of color to promote more mental health awareness, communicate in languages and modalities that connect with them at home, and support ongoing partnerships with leaders in their community.
There are universal prevention efforts like PBIS, Sources of Strength, and Restorative Practices that provide effective positive behavior supports for schools, and a measure of suicide prevention for all students. But for many schools, they have limited resources of time, money, or personnel to add yet another school initiative to a very full plate. The good news is that in many cases, existing universal prevention programs, including the ones that address suicide, can be adjusted for students of color with just a few modifications.
First of all, it is important to make sure that the existing programs yield favorable results for diverse populations, including groups that are similar to the current student enrollment.
It is also important to check in with staff members or community contacts who understand the student population that you are trying to serve. Ask them the hard questions like: “Who are we not serving? How do we engage and sustain family partnerships? What are the barriers to service access and how can we remove those obstacles?” These periodic check-ins coupled with a review of key racially disaggregated data points (e.g., total suicide risk assessments and school climate surveys) to monitor your progress can help to inform and guide your prevention efforts.
Finally, embracing a trauma-informed approach to working with students of color is another way to provide schools with more equitable support within existing programs. We know that students of color who experience adverse childhood experiences (or ACE’s) like loss, abuse and/or family instability are at greater risk for later health concerns, including suicide. By increasing staff awareness of the possible presence of student or family trauma, educators will gradually shift from asking “What’s wrong with you?” to “What happened to you?” This subtle change can make a world of difference for students and families who feel marginalized.
By doing the research on your current programs, establishing feedback loops with your community, and considering the possible presence of family trauma, you can effectively adapt your efforts into a more racially conscious and culturally responsive practice.
The 2020 deaths of Ahmaud Arbery, Breonna Taylor, and George Floyd resulted in protests across the United States. Many health care organizations – including the American Medical Association, National Association of School Psychologists, and National Association of Social Workers – took a pause, reflected on their own practices, and ultimately came to the sobering conclusion that their own respective disciplines had to take responsibility for biases regarding people of color. National organizations like NASRO and NASSP also made strong public statements against systemic racism and acknowledged their need to play a central role in protecting social justice. All of these organizations put forward sweeping action plans to create concrete, equitable change.
These institutions publicly spoke to a truth that students and families of color had long believed: That there is systemic inequity regarding the care for people of color by staff and services that are supposed to support them. That glaring perceived injury has evolved into a deep mistrust by families of color in regards to seeking and accepting support at school.
As educators and campus public safety professionals who work with these students and parents on campus every day, it is our challenge to, if not remedy the injuries of the past, to at least try not to repeat them. By giving students and families of color the space and time to share their stories of struggle, and to demonstrate empathy by giving them ample time to build trust in schools over time to provide good care for their child, we hold the potential to give students and families of color, in some small way, a reparative experience.
There is great healing power for schools to invite marginalized families in to be seen, heard, and believed. As one of my school mentors from years ago once said, our first contact in school with a student may be their first experience with mental health support. It is our challenge to make that experience for students as positive as possible, and not accidentally repeat a painful experience from their family’s past.
Healthcare expert Physician and scholar Dr. Naheed Dosani recently remarked that “Equality is giving everyone a shoe. Equity is giving everyone a shoe that fits.” For suicide prevention, students of color can be given the same prevention efforts that all students at school receive, but if that proves to be ineffective, they may need something more customized. In other words, schools need to find for each student some shoes that fit.
In recent years, the growing rate of youth suicide for students of color has sounded the alarm that many schools have a desperate need to change their ways. Many young lives are in the balance. We need to be responsive to the fact that many people of color feel ignored, minimized, and mistreated by schools and other institutions of service.
Students of color may need to receive more attention and effort from school staff than other students because there is a greater chance that they have had less positive experiences when their families attempted to get the resources and the help they need. By using the SOAR approach as a guide to supplement your existing suicide prevention efforts, you will co-create with your students and families of color a greater sense of purpose and hope.
And in doing so, your students in need will learn to spread their wings and fly.
Dr. Ron Lee is a school outreach consultant for the Colorado School Safety Resource Center, a division of the Colorado Department of Public Safety.
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