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Qualitative Study of Suicidality and Help-Seeking Behaviors in African American Adolescents

  • Original Paper
  • Published:
American Journal of Community Psychology

Abstract

This qualitative study explores adolescents’ perceptions of help-seeking behaviors in the context of a hypothetical suicide crisis. Cauce and colleague’s (2002, Journal of Consulting and Clinical Psychology, 70, 44–55) model was used to examine help-seeking behaviors in 3 domains: problem recognition, decision to seek help, and selection of helpers. Forty-two church-going African American adolescents participated in 1 of 6 focus groups that discussed ways to help a hypothetically suicidal student in a vignette. Findings suggest that although the majority of youth had been exposed to a suicidal peer (76%), they were unsure of the seriousness of suicide as a problem in the African American community. The findings suggest that youth were less comfortable with formal interventions in school, religious institutions or traditional mental health settings. However, youth were open to community-based programs that could be located in school, church or community settings if helpers were: young adults, empathic listeners, non-judgmental, maintained confidentiality, and viewed as “natural helpers”. Implications for developing church-based suicide interventions are discussed.

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References

  • Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Balamani, M. D. (2001). Dancing on our graves: Healing the hearts and souls of women. Clinton, MD: DOOG Publishers.

    Google Scholar 

  • Becker, M. H. (1974). The health belief model and personal health behavior. Health Education Monographs, 2, 324–508.

    Google Scholar 

  • Becker, P. E. (1999). Congregations in conflict: Cultural models of local religious life. New York: Cambridge University Press.

    Google Scholar 

  • Birkel, R. C., & Repucci, N. D. (1983). Social networks, information-seeking, and utilization of services. American Journal of Community Psychology, 11, 185–205.

    Article  PubMed  Google Scholar 

  • Blum, R. W., Beuhring, T., Shew, M. L., Bearinger, L. H., Sieving, R. E., & Resnick, M. D. (2000). The effects of race/ethnicity, income, and family structure on adolescent risk behaviors. American Journal of Public Health, 90(12), 1879–1884.

    PubMed  Google Scholar 

  • Burns, B., Angold, A., & Costello, E. (1992). Measuring child, adolescent and family service use. In L. Bickman, & D. J. Roger (Eds.), Evaluating mental health services for children (pp. 42–65). San Francisco: Jossey-Bass.

    Google Scholar 

  • Cameron, L., Leventhal, E. A., Leventhal, H., & Shaffer, P. (1993). Symptom representations and affects as determinants of care-seeking. Health Psychology, 12, 171–199.

    Article  PubMed  Google Scholar 

  • Cauce, A. M., Domenech-Rodriguez, M., Paradise, M., Cochran, B., Shea, J. M., Srebnik, D., & Baydar, N. (2002). Cultural and contextual influences in mental health help seeking: A focus on ethnic minority youth. Journal of Consulting and Clinical Psychology, 70, 44–55.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2002). Surveillance Summaries, MMWR 2002: 50(No. SS-).

  • Centers for Disease Control and Prevention. Surveillance Summaries, May 21, 2004 MMWR 2004:53(No. SS-2).

  • Cialdini, R. B., Reno, R. R., & Kallgren, C. A. (1990). A focus theory of normative conduct recycling the concept of norms to reduce littering in public places. Journal of Personality and Social Psychology, 58, 1015–1026.

    Article  Google Scholar 

  • Early, K. E., & Akers, R. L. (1993). “It’s a white thing”. An exploration of beliefs about suicide in the African American community. Deviant Behavior, 14, 277–296.

    Article  Google Scholar 

  • Eggert, L. L., Thompson, E. A., Herting, J. R., & Nicholas, L. J. (1995). Reducing suicide potential among high-risk youth: Tests of a school-based prevention program. Suicide and Life Threatening Behavior, 25, 276–296.

    PubMed  Google Scholar 

  • Forbes, C. A., Molock, S. D., Anastacio, B. A., Khoury, F., Bui, T., Scott, T., & Folstein, S. (1999, April). Cultural factors in teen suicidal behavior. Paper presented at the American Association of Suicidology Convention. Houston, Texas.

  • Gallup, G. H., & Bezilla, R. (1992). The religious life of young Americans. Princeton, NJ: The George H. Gallup International Institute.

    Google Scholar 

  • Gould, M. S., Greenberg, T., Velting, D., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: a review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 386–405.

    PubMed  Google Scholar 

  • Harris, T. L., & Molock, S. D. (2000). Cultural orientation, family cohesion and family support in suicide ideation and depression among African American college students. Suicide & Life-Threatening Behavior, 30, 341–353.

    Google Scholar 

  • Hines-Martin, V., Malone, M., Kim, S., & Brown-Piper, A. (2003). Barriers to mental health care access in an African American population. Issues in Mental Health Nursing, 24(3), 237–256.

    Article  PubMed  Google Scholar 

  • Joe, S. (personal communication, November 23, 2005).

  • Joe, S., & Marcus, S. (2003). Datapoints: Trends by race and gender in suicide attempts among U. S. adolescents, 1991–2001. Psychiatric Services, 54, 454.

    Article  PubMed  Google Scholar 

  • Kuhl, J., Jarkon-Horlick, L., & Morrissey, R. F. (1997). Measuring barriers to help-seeking behavior in adolescence. Journal of Youth and Adolescence, 26, 637–650.

    Article  Google Scholar 

  • Leaf, P. J., Bruce, M. L., & Tischler, G. L. (1986). The differential effect of attitudes on the use of mental health services. Social Psychiatry, 21, 187–192.

    Article  PubMed  Google Scholar 

  • Lincoln, C. E., & Mamiya, L. H. (1990). The Black church in the African-American experience. Durham, NC: Duke University Press.

    Google Scholar 

  • Logan, D. E., & King, C. (2002). Parental identification of depression and mental health service use among depressed adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 41(3), 296–304.

    Article  Google Scholar 

  • McMiller, W. P., & Weisz, J. R. (1996). Help-seeking preceding mental health clinic intake among African-American, Latino and Caucasian youths. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1086–1094.

    Article  PubMed  Google Scholar 

  • Minke, K. M., & Anderson, K. J. (2005). Family-school collaboration and positive behavior support. Journal of Positive Behavior Intervention, 7(3), 181–185.

    Google Scholar 

  • Molock, S. D., Spann, M. N., Barksdale, C. L., Gaiber, S. L., & Plourd, A. (2004). Risk and protective factors for suicidal behaviors in African American adolescents. Paper presented at the annual American Association of Suicidology conference, Miami, FL.

  • Munsch, J., & Wampler, R. A. (1993). Ethnic differences in early adolescents’ coping with school stress. American Journal of Orthopsychiatry, 63, 633–646.

    Article  PubMed  Google Scholar 

  • National Center for Health Statistics. 2003. US Department of Health and Human Services, Hyattsville, MD.

  • Neighbors, H. W., Musick, M. A., & Williams, D. R. (1998). The African American minister as a source of help for serious personal crises: Bride or barrier to mental health care? Health Education and Behavior, 25, 759–777.

    Article  PubMed  Google Scholar 

  • Parent, R. B. (1999). Victim-precipitated homicide: Police use of deadly force. American Association of Suicidology Newslink, 25, 16–17.

    Google Scholar 

  • Pescosolido, B. A., Wright, E. R., Alegria, M., & Vera, M. (1998). Social networks and patterns of use among the poor with mental health problems in Puerto Rico. Medical Care, 36, 1057–1072.

    Article  PubMed  Google Scholar 

  • Revenson, T. A., & Pranikof, J. R. (2005). A contextual approach to treatment decision making among breast cancer survivors. Health Psychology, 24(4), S93–S98.

    Article  PubMed  Google Scholar 

  • Rogers, R. W. (1983). Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. Cacioppo, & R. Petty (Eds.), Social psychophysiology (pp. 153–176). New York: Guilford Press.

    Google Scholar 

  • Segal, S. P., Hodges, J.Q., & Hardiman, E. R. (2002). Factors in decisions to seek help from self-help and co-located community mental health agencies. American Journal of Orthopsychiatry, 72(2), 241–249.

    Article  PubMed  Google Scholar 

  • Snowden, L. R. (1999). African American service use for mental health problems. Journal of Community Psychology, 27, 303–313.

    Article  Google Scholar 

  • Srebnik, D., Cauce, A. M., & Baydar, N. (1996). Help-seeking pathways for children and adolescents. Journal of Emotional and Behavioral Disorders, 4, 210–220.

    Article  Google Scholar 

  • Summerville, M. B., Abbate, M. F., Siegel, A. M., Serravezza, J., & Kaslow, N. J. (1992). Psychopathology in urban female minority adolescents with suicide attempts. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 663–668.

    Article  PubMed  Google Scholar 

  • Swanson, M. G., & Ward, A. J. (1995). Recruiting minorities into clinical trials: Toward a participant-friendly system. Journal of the National Cancer Institute, 87, 1747–1759.

    Article  PubMed  Google Scholar 

  • Taylor, R. J., Ellison, C. G., Chatters, L. M., Levin, J. S., & Lincoln, K. D. (2000). Mental health services in faith communities: The role of clergy in black churches. Social Work, 45, 73–87.

    PubMed  Google Scholar 

  • Taylor, R. J., Neighbors, H. W., & Broman, C. L. (1989). Evaluation by Black Americans of social service encounter during a serious social problem. Social Work, 34, 205–211.

    Google Scholar 

  • Thompson, E. A., Eggert, L. L., & Herting, J. R. (2000). Mediating effects of an indicated prevention program for reducing youth depression and suicide risk behaviors. Suicide and Life Threatening Behavior, 30, 252–271.

    PubMed  Google Scholar 

  • Timlin-Scalera, R. M., Ponterotto, J. G., Blumberg, F. C., & Jackson, M. A. (2003). A grounded theory of study of help-seeking behaviors among white male high school students. Journal of Counseling Psychology, 50, 339–350.

    Article  Google Scholar 

  • United States Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity. A supplement to mental health: A report of the Surgeon General. Rockville, MD.

  • Young, J. L., Griffith, E. E. H., & Williams, D. R. (2003). The integral role of pastoral counseling by African American clergy in Community mental health. Psychiatric Services, 54(5), 688–692.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The authors would like to acknowledge the special assistance of David Kantor, Adia Plourd and Cathy Forbes for their work in serving as facilitators in the focus groups and for data transcription

Author information

Authors and Affiliations

  1. The George Washington University, Washington, DC, USA

    Sherry Davis Molock, Crystal Barksdale, Samantha Matlin, Rupa Puri, Nicole Cammack & Marisa Spann

Authors
  1. Sherry Davis Molock
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  2. Crystal Barksdale
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  3. Samantha Matlin
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  4. Rupa Puri
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  5. Nicole Cammack
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  6. Marisa Spann
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Corresponding author

Correspondence to Sherry Davis Molock.

Additional information

This study was supported by a K-01 Career Development Award from NIMH

Appendices

Appendix A

The following vignette was read to the focus groups as a primer for discussion.

James is a 17 year-old who is a junior in high school. James used to be an honor roll student, but for the last two years he has been barely passing his classes. His guidance counselor told him last week that he is about to fail the 11th grade if he doesn’t pick his grades up. James feels that going to school is a waste of time; he just sits in class and falls asleep or is completely bored and not paying attention. James doesn’t want to admit it but sometimes he skips school because he just doesn’t feel like being bothered with all the fighting and cussing and carrying on that goes on each day. He sick of having to “prove” himself to his teachers, his parents and to the kids at school. He thinks of school like a war zone: you are either the predator or the prey. He doesn’t want to be a predator, but he’s tired of being the prey. James is small for his age so a lot of dudes try to step up to him to challenge him. So far, he has managed to avoid any major fights but he’s not sure how long he’s going to be able to hold out.

James doesn’t get along with his parents either; they want him to go to college but he wants a career in the music industry. He and some of his fellas’ have competed in some local talent shows and they have developed a good reputation. His parents hate his involvement in hip-hop music; they call it “the Devil’s workshop”. They just want him to be a little “Choir Boy” but James says his days singing in the church and being a “good boy” in the church are over, who can make money-singing gospel music? The only time James feels he has any peace is when he’s with his boys rehearsing their music, kicking back smoking some weed or throwing back some ‘40’s.

One weekend at a talent contest, James and his group win the top prize. While he is walking up to get the prize money, some guy named Eddie trips James on purpose. When James tries to play it off, Eddie embarrasses James and cusses him out in front of everyone. When James goes to school on Monday, everyone is talking about what happened at the club to James. On his way home, one of his boys tells him Eddie was looking for him at school to “settle some business”. James manages to avoid Eddie for about a week but then he gets tired of ducking and hiding. Finally, James decides to go into his parents’ bedroom and get his stepfather’s gun. James doesn’t want to kill anybody, so he takes the bullets out of the gun. He knows that Eddie has a reputation for carrying a loaded gun on him but James doesn’t know what else to do. Things just never seem to work out for him. When James tells his plans to one of his boys, PJ, he looks at him and says “Man, are you crazy? You must want to die! Everybody knows that Eddie is always carrying. James sadly looks at PJ and says “I’m tired of all this ##!$ What do you want me to do? He might shoot me but at least I won’t die like a punk!”

Appendix B

The following questions were used as prompts by the group leader to facilitate focus group discussion.

  1. 1)

    What do you think is wrong with James?

  2. 2)

    Do you think James is depressed? Suicidal?

    • Why or why not?

  3. 3)

    What should PJ do?

  4. 4)

    Should PJ try to help James by himself or should he get help from someone else?

  5. 5)

    Who do you think might be helpful to James?

    • Parents, teachers, ministers, friends

  6. 6)

    Have you ever known anyone who talked about or tried to commit suicide?

  7. 7)

    Why did they want to kill themselves?

  8. 8)

    Do you think there are ever any situations where it’s OK to commit suicide?

  9. 9)

    In the story, did you notice that we gave very little background info on James?

    1. a.

      If you had to guess, what do you think James’s ethnic background is?

    2. b.

      Do you think ethnic background makes a difference in terms of how he experiences depression/suicide? How he copes with it?

  10. 10)

    Did you notice that the story said that James used to be pretty active in his church? What do you think the church’s view would be about his behavior?

  11. 11)

    Do you think spiritual or religious beliefs are helpful to people who are depressed or suicidal?

  12. 12)

    Do you think it helps to talk to a clergy person when someone feels depressed or suicidal?

  13. 13)

    Do you think attending church, synagogue, or temple is helpful if someone feels depressed or suicidal?

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Molock, S.D., Barksdale, C., Matlin, S. et al. Qualitative Study of Suicidality and Help-Seeking Behaviors in African American Adolescents. Am J Community Psychol 40, 52–63 (2007). https://doi.org/10.1007/s10464-007-9122-3

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