You Only Live ONCE: bREAK THE SILENCE theoretical fRAMEWORK

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There has been a lack of attention on how ethnicity and environmental stress promotes suicidal behavior. As suicide in the Black community increases, the development of culturally sensitive screening, prevention and intervention are either slowly in progress or not being considered at all. The presenting problem we face is suicide in the Black community is misunderstood due to inadequate data, and culturally insensitive evaluations and assessments (Walker, Wingate, Obasi & Joiner, 2008). These assessments and evaluations have been misleading in two ways: (1) the accuracy of suicides recorded is subject to underreporting, and (2) the definition of suicide is restricted to one, which is, taking one's own life (Chu et al., 2010). Instead, suicidal behavior should be defined along a continuum, like schizophrenia. Suicide defined as a continuum gives practitioners the opportunity to utilize early effective screening, prevention and intervention strategies (Kaslow, Jacob, Young & Cook, 2006).

Another problem mental health practitioners face is the cultural differences manifested as suicidal behavior. Theses differences make it challenging, well impossible for practitioners to utilize most existing assessments that is in a sociocultural context for White Americans (Klibert et al., 2011). It is important to consider different factors that indicate suicide in different cultural contexts. It is important practitioners educate themselves on the challenges Blacks face in the United States. There are many existing challenges Blacks face while trying to obtain or maintain cultural congruity (Gloria, Hird & Navarro, 2001). Daily environmental stressors, such as, marginalization and acculturation difficulties are common in the Black community. If these stressors are experienced for a prolonged period of time, it can negatively affect their mental wellness which results in suicidal behavior (Walker, 2007). Therefore, we need to construct more culturally sensitive assessments and evaluations to better serve the Black community.

Popular belief in the United States, Blacks rarely engage in suicidal behavior nor commit suicide (Davis, 1978). Davis' (1978) research findings indicated suicide is more common among Black males aged 25-29, and among Black females aged 15-19 than their White counterparts. Suicide is the 12th leading cause of death for Blacks ages 18-64 (Davis, 1978). It is the 15th leading cause of death among Black women (Davis, 1978). Due to the increase suicides in the Black community, it has deprived youthful presence and manpower, financial stability within the black community is difficult to maintain, and a host of contributions from our youth that would make a difference in society (Davis, 1978). It is important that we focus on our youths and become more active in what is occurring in their lives because they need our support to cope being a minority in the United States.

According to the Status Integration Theory, there has been an increase in Black men and women gaining career, social and economic mobility which has been associated with acculturative stress (Davis, 1978). This stress is attributed to false sense of freedom and security that has shifted them from collectivism to individualism which separates or loosen their communal family ties that has been considered a protective factor against suicide (Davis, 1978). Davis (1978) indicated young, upward mobile Blacks are vulnerable to suicide due to isolation from families, communities, and social institutions. Therefore, relationships that cultivate and encourage racial identity and values and communal family ties are vital protective factors against suicide.

An important factor to consider is the likelihood of an individual committing suicide. If an individual has previous history of suicide attempts, there is a likelihood they will repeat attempt (Kaslow, Jacobs, Young & Cook, 2006). There are some distinctions between first-attempters and repeat-attempters. Repeat-attempters display more severe and persistent psychopathology and suicidality (Kaslow, Jacobs, Young & Cook, 2006). They are more accepting of their attempts and express a greater desire to repeat suicidal behavior (Kaslow, Jacobs, Young & Cook, 2006). Interestingly, Black female repeat-attempters self-report child maltreatment, family history of mental illness and/or suicide (Foreman et al., 2004). Evidence shows that child maltreatment (e.g. child abuse and neglect) is associated with high likelihood that the individual will display self-harm and/or suicidal behavior (Thompson, Kaslow, Bradshaw et al., 2000). It has been suggested child maltreatment is a precursor for severe suicidal behavior. For future consideration, suicidal assessments should incorporate questions of the consumers' history of child maltreatment in their evaluation. Kaslow, Jacobs, Young & Cook (2006) indicated repeat-attempters were overdetermined, conditioned, and have maladaptive responses to stress that is easily triggered. It is important that practitioners and support systems highlight on finding healthy alternatives that is less injurious to cope with stress. From professional experience, it is challenging to engage Blacks in follow-up treatment because they have developed distrust towards mental health practitioners. We must develop culturally sensitive interventions. Here are ways to consider as culturally sensitive interventions:

1. Address and acknowledge culture-specificissues that affect the therapeutic process.

2. Utilize examples and materials that are culturally relevant.

3. Facilitate empowerment.

4. Adopt a strength-base approach to apply towards Black females Black males and their community.

If you are experiencing any thoughts of killing yourself, you have access to the means of killing yourself, please seek services immediately. If you have anyone that you can trust please reach out to them, so they can help you. If you know anyone may be displaying suicidal behavior, please reach out to them and help them seek professional help. IT IS NOT ABOUT SAVING FACE, IT IS ABOUT SAVING A LIFE.

National Suicidal Prevention Lifeline (800) 273-8255. They will connect you to your local crisis centers.

References:

Chu, J.p., Goldblum, P., Floyd, R., & Bongar, B. (2010). The cultural theory and model of suicide. Applied and preventive psychology, 14, 25-40.

Davis, R. (1978). “Black suicide and the relational system: Theoretical and empirical implications of communal and familial ties,” Institute for research on poverty discussion paper, 481-78.

Forman, E.M., Berk, M.S., Henriques, G.R., Brown, G.K. & Beck, A.T. (2004). History of multiple suicide attempts as a behavioral marker of severe psychopathology. American journal of psychiatry, 161, 437-443.

Heron, R.L., Twomey, H.B., Jacobs, D.P., & Kaslow, N.J. (1997). Culturally competent interventions for abused and suicidal African American women. Psychotherapy: Theory, research, practice, training, 34, 410-424.

Kaslow, N.J., Jacobs, C.H., Young, S.L. & Cook, S. (2006). Suicidal behavior among low-income African American women: A comparison of first-time and repeat suicide attempters. Journal of black psychology, 32(3), August 2006, 349-365, doi: 10.1177/0095798406290459.

Thompson, M.P., Kaslow, N.J., Kingree, J.B., Rashid, A., Puett, R. Jacobs, D. et al. (2000). Partner violence, social support, and distress among inner-city African American women. American journal of community psychology, 28, 127-143.

Walker, R.L. (2007). Acculturation and acculturative stress as indicators for suicide risk among African Americans. American journal of orthopsychiatry, 77, 386-391. Doi:10.1037/0002-9432.77.3.386

Walker, R.L., Wingate, L.R., Obasi, E.M., & Joiner, T.R. (2008). An empirical investigation of acculturative stress and ethnicity identity as moderators for depression and suicidal ideation in college students. Cultural diversity and ethnic minority psychology, 14, 75-82. Doi: 10.1037/1099-9809.14.1.75

Klibert, J., Langhinrichsen-Rohling, J., Luna, A., & Robichaux, M. (2011). Suicide proneness in college students: Relationships with gender, procrastination, and achievement motivation, Death studies, 35, 625-645.