Mental Health Equity and Suicide Prevention: Supporting Marginalized Communities and Special Populations

DEI Prof-spectives Events
  • Patricia Fortunato
  • 19 September 2023

Rowan University DEI Suicide Prevention Month 2023 Health Promotion

Image Alternative Text: The health promotion image reads, at the top, "It's okay not to be okay all the time" and "Prioritize your mental health," and depicts a diverse circle of hands with bright-colored sleeves and accessories, and an icon depicting conversation/support and a "heart" symbol. One hand has the word "Love" depicted on it. The background of the image is light-colored purple. The Substance Abuse and Mental Health Services Administration (SAMHSA) created the 988 Suicide and Crisis Lifeline logo.

Click here to download the health promotion handout for sharing with all Rowan University students, faculty, and staff across all Rowan colleges and schools, and the general public.

 

Written by:

Patricia Fortunato, Content and Program Manager, Clinical Research and Grants, NeuroMusculoskeletal Institute (NMI); and Mental Health and Suicide Prevention Training and Content Developer, Department of Psychiatry, Rowan–Virtua School of Osteopathic Medicine (Rowan–Virtua SOM) (fortun83@rowan.edu)

with input from

Division of Diversity, Equity, and Inclusion (DEI) at Rowan University

Thank you to medical, clinical, and administrative colleagues at the Rowan University Wellness Center, Rowan University Academic Affairs, Rowan–Virtua School of Osteopathic Medicine (Rowan–Virtua SOM), and Cooper Medical School of Rowan University (CMSRU) for collaborating and helping to provide input and resources at go.rowan.edu/bethe1to.

Together with all Rowan colleges and schools, we are committed to supporting our campuses and communities and helping one another in prioritizing mental health and preventing suicide.

 

Warning: This content discusses suicide. If you or someone you know is in crisis, call or text the 988 Suicide and Crisis Lifeline at "988." Additionally, all Rowan University students from all Rowan colleges and schools including the Rowan–Virtua School of Osteopathic Medicine (Rowan–Virtua SOM) and Cooper Medical School of Rowan University (CMSRU) can call Rowan Public Safety at 856.256.4911. If these resources do not meet your needs and you or someone you know is still at risk for harm from yourself or others, please call 911. If you are supporting someone in need, do not leave the person alone until emergency medical services arrive.

 

Across the United States, suicide is the leading cause of death among young adults ages 15 to 34.1 With the Centers for Disease Control and Prevention (CDC) release of the latest provisional estimates for suicide deaths in the U.S. in 2022,2 it is clear that mental health is still stigmatized in society and that access to and continued care must increase. After declining in 2020, suicide deaths increased approximately 5% in 2021, and then 2.6% for an estimated 49,449 suicide deaths in 2022.2 Additional data indicates the following statistics, outlined below, surrounding marginalized communities and special populations who are experiencing mental health issues. All of these data illustrate the need for more advocacy and work across all levels of government to help destigmatize and normalize mental health care and substance use disorder (SUD)/addictions treatment, supporting provision of increased access to longitudinal integrated, trauma-informed, and culturally responsive care.

 

Learn more about stigma, SUD/addictions treatment, and related terms at go.rowan.edu/recovery. More educational information and supportive resources focused on suicide prevention are provided at go.rowan.edu/bethe1to.


Find specific information and resources for marginalized communities and special populations below.

 

U Good F.A.M.? Fall 2023 Rowan University Student Dialogues

U Good F.A.M.? is a network of faculty, staff, and mental health and educational professionals that fosters and advances the mental health and emotional well-being among self-identified students of color at Rowan University. Through this network, students will have the opportunity to engage in monthly U Good F.A.M.? dialogues that address psychological presentations including but not limited to: depression, anxiety, adjustment concerns, trauma, race-based stress, grief and loss, acculturation, and suicide awareness.

During the fall 2023 semester, student dialogues will take place on September 27, October 25, November 15, and November 29 from 7:30pm to 9:30pm at 302 Victoria Street in Glassboro. U Good F.A.M.? was created by Kha' Sadler, Psy.D., Mental Health Clinician and Associate Provost at Rowan University. Student dialogues will be facilitated by Dr. Sadler. For more information about the network and to register for an event, visit the Rowan Campus Labs website, or email Dr. Sadler at ugoodfam@rowan.edu.

 

Black Mental Health

Suicide deaths are increasing among Black adolescents and young adults (AYA),3 and overall, the suicide death rate among Black AYA is increasing more than other racial/ethnic groups.4 With just one in three Black individuals who need mental health care receiving this support,5 addressing disparities and increasing access to inclusive and culturally competent care for Black/African American communities is a public health priority.

The Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within the United States Department of Health and Human Services (HHS), leads public health efforts to advance behavioral health across the U.S. and improve the lives of people living with mental health and substance use disorder (SUD), along with their loved ones/families. The Office of Behavioral Health Equity (OBHE) at SAMHSA facilitates efforts to reduce disparities among marginalized and special populations. Learn more about research and grants to support Black/African American communities on the SAMHSA website. The OBHE also facilitates the African American Behavioral Health Center of Excellence (AABH–COE), with the goal of disseminating technical assistance (TA) and educational content to support health care professionals to eliminate disparities within the diverse population across the U.S. Educational content focused on suicide prevention in Black/African American communities is also available on the SAMHSA-funded Suicide Prevention Resource Center (SPRC) website.

More information about Black mental health care and resources to support are available on the 988 Suicide and Crisis Lifeline website. Additional resources include the following:

  • The Steve Fund: The Steve Fund is the U.S.' leading organization focused on supporting the mental health and wellbeing of young people of color. If you are a young person of color and feeling stressed, depressed, and/or anxious, text "STEVE" to 741741 to connect with a trained crisis counselor. Learn more about services and additional resources on the Steve Fund website.
  • Therapy for Black Girls: Founded by licensed psychologist Dr. Joy Harden Bradford, Therapy for Black Girls is "an online space dedicated to encouraging the mental wellness of Black women and girls." The website offers a database for finding a licensed therapist located near you or to schedule telehealth, a podcast on mental health and personal development, and additional wellness resources. Learn more about these resources on the Therapy for Black Girls website.
  • Therapy for Black Men: The online space was "born from the idea that Black men and boys face unique challenges and stigmatization, and therefore need a dedicated space for seeking and finding mental health support. We've made it our mission to strip away that stigmatization and ease the process of finding help. By providing targeted resources and a database filled with professionals equipped to support men of color, our users can now obtain the help they need and deserve." Learn more about these resources on the Therapy for Black Men website.
  • Inclusive Therapists: Inclusive Therapists is a social justice movement founded by licensed marriage and family therapist Melody Li to destigmatize and expand mental health care to people with marginalized identities. You can search on the Inclusive Therapists website for a local licensed therapist, or licensed therapists available by telehealth, by insurance, specialties, and identity.

Native American, Indian, Indigenous, and Alaska Native Mental Health

Among non-Hispanic/non-Latine Indigenous American Indian and Alaska Native (AI/AN) people, suicide deaths currently are higher than those of any other racial or ethnic group.1 Complex factors contribute to the crisis, including historical trauma that community members have experienced.6

The Office of Tribal Affairs and Policy (OTAP) at SAMHSA is the primary point of contact for tribal governments and agencies, federal departments and agencies, and other governments and agencies on behavioral health and SUD issues among AI/AN communities in the U.S. The OTAP is committed to continuing and enhancing collaboration with American Indian tribes through consultation, outreach, engagement, and education. Learn more about research and grants to support AI/AN communities on the SAMHSA website. The OTAP also facilitates the Tribal Training and Technical Assistance (TTA) Center, with the goal of supporting AI/AN communities and organizations with educational content on mental health, SUD, and suicide prevention. Additional educational content focused on suicide prevention in AI/AN communities is available on the SPRC website.

More information about AI/AN mental health care and resources to support are on the 988 Suicide and Crisis Lifeline website. Additional resources include the following:

  • The Steve Fund: The Steve Fund is the U.S.' leading organization focused on supporting the mental health and wellbeing of young people of color. If you are a young person of color and feeling stressed, depressed, and/or anxious, text "STEVE" to 741741 to connect with a trained crisis counselor. Learn more about services and additional resources on the Steve Fund website.
  • StrongHearts Native Helpline: This helpline is a 24/7 confidential, anonymous, and culturally-sensitive domestic and sexual violence support resource. Call 844.762.8483 to access the following services, cost-free: crisis intervention; support finding a local crisis center or clinical practice trained in caring for survivors of sexual assault and forensic exams; domestic and sexual violence education; safety planning; and more. Learn more about these services on the StrongHearts Native Helpline website.
  • Inclusive Therapists: Inclusive Therapists is a social justice movement founded by licensed marriage and family therapist Melody Li to destigmatize and expand mental health care to people with marginalized identities. You can search on the Inclusive Therapists website for a local licensed therapist, or licensed therapists available by telehealth, by insurance, specialties, and identity.

Asian American, Native Hawaiian, and Pacific Islander Mental Health

Suicide is the leading cause of death among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) adolescents and young adults (AYA) ages 10 to 19, and the second leading cause of death among AANHPI AYA ages 20 to 34.7 Further, adults who identify as AANHPI are the racial group who are least likely to seek and utilize mental health care.8 AANHPI barriers to mental health care include cultural stigma,9 high rates of underinsurance and uninsurance,10 immigration status,11 and lack of cultural competency among health care professionals.12–14

The Asian American, Native Hawaiian, and Pacific Islander Behavioral Health Center of Excellence (AANHPI–COE), funded by SAMHSA, is facilitated by the Hawai'i State Department of Health in partnership with California State University and San José State University, with the goal of advancing behavioral health equity of AANHPI communities; creating and disseminating evidence-based and culturally-informed educational content; and providing TA focused on addressing and overcoming disparities in AANHPI communities across the U.S. Further educational content focused on suicide prevention in AANHPI communities is available on the SPRC website.

The Asian Mental Health Project (AMHP) provides educational content, cost-free peer-led wellness groups, and grants that help make mental health care more accessible. Through September 29, 2023, individuals can apply for the Mental Health Assistance Grant. During this application period, 30 individuals will be randomly selected from the applicant pool to each receive a $500 grant to support their mental health journeys.

More information about AANHPI mental health care and resources to support are on the AANHPI–COE website. Additional resources include the following:

  • The Steve Fund: The Steve Fund is the U.S.' leading organization focused on supporting the mental health and wellbeing of young people of color. If you are a young person of color and feeling stressed, depressed, and/or anxious, text "STEVE" to 741741 to connect with a trained crisis counselor. Learn more about services and additional resources on the Steve Fund website.
  • The Asian Mental Health Collective (AMHC): The AMHC raises awareness about mental health care within Asian communities, and offers online directories of licensed mental health professionals who identify as Asian in the U.S. and Canada. You can search on the AMHC website for a licensed therapist by insurance, specialties, and identity.
  • Inclusive Therapists: Inclusive Therapists is a social justice movement founded by licensed marriage and family therapist Melody Li to destigmatize and expand mental health care to people with marginalized identities. You can search on the Inclusive Therapists website for a local licensed therapist, or licensed therapists available by telehealth, by insurance, specialties, and identity.

Hispanic/Latine Mental Health

Suicide is the third leading cause of death among Hispanic adolescents and young adults (AYA) ages 10 to 34.1 Hispanic/Latine barriers to mental health care include high rates of underinsurance and uninsurance,15 immigration status,16 lack of culturally competent health care professionals,17 and/or limited options.18

The National Hispanic and Latino Mental Health Technology Transfer Center (MHTTC), funded by SAMHSA, is facilitated by Universidad Central del Caribe in Puerto Rico and provides TA to help improve the behavioral health workforce serving Hispanic/Latine communities in prevention, treatment, and recovery across the U.S. and its territories. Educational content focused on suicide prevention in Hispanic/Latine communities is available on the SPRC website.

More information about Hispanic/Latine mental health care and resources to support are on the SAMHSA website. Additional resources include the following:

  • The Steve Fund: The Steve Fund is the U.S.' leading organization focused on supporting the mental health and wellbeing of young people of color. If you are a young person of color and feeling stressed, depressed, and/or anxious, text "STEVE" to 741741 to connect with a trained crisis counselor. Learn more about services and additional resources on the Steve Fund website.
  • Therapy for LatinX: Therapy for LatinX is an online database of licensed therapists who either identify as Latine or who have worked closely with Latine communities and have worked to understand their needs. You can search on the Therapy for LatinX website for a local licensed therapist, or licensed therapists available by telehealth, by insurance, specialties, and identity.
  • Inclusive Therapists: Inclusive Therapists is a social justice movement founded by licensed marriage and family therapist Melody Li to destigmatize and expand mental health care to people with marginalized identities. You can search on the Inclusive Therapists website for a local licensed therapist, or licensed therapists available by telehealth, by insurance, specialties, and identity.

 

Maternal Mental Health

Pregnant people can experience maternal mental health issues, caused by physiological/biological, psychological, and/or socio-structural stress factors. These stressors can include an overall lack of familial support, prior experience with symptoms, and/or family medical history. Perinatal mood and anxiety disorders (PMAD) are common childbirth complications and impact up to one in five people.19–20

A recent study examined data on psychiatric-related deaths, suicide, and overdose from Maternal Mortality Review Committees (MMRC) in each state; of the 14 reports meeting study inclusion criteria, 1929 cumulative maternal deaths were reviewed and of these deaths, 31.3% were due to accidental overdose and 5.7% were due to suicide.21 These study findings illustrate the need for increased mental health and SUD screening and care during the perinatal periods; and supporting the perinatal SUD patient population with stigma-free, compassionate, and evidence-based treatment options and mental health care.

More information about maternal mental health care needs and resources to support are on the 988 Suicide and Crisis Lifeline website. Additional resources include the following:

  • Postpartum Support International (PSI) HelpLine: If you are pregnant or postnatal and struggling with non-emergency mental health issues, call 1.800.944.4773 or text "HELP" to 1.800.944.4773. HelpLine hours are Sunday to Saturday, 8am to 11pm. Visit the PSI website for additional resources.
  • Health Resources and Services Administration (HRSA) National Maternal Mental Health Hotline: This 24/7 hotline provides free, confidential support for mental health before, during, and after pregnancy. Call or text 833.TLC.MAMA (833.852.6262). TTY callers can use a preferred relay service, or dial 711 and then 833.852.6262. Visit the HRSA Maternal and Child Health Bureau (MCHB) website for additional resources.

Veterans Mental Health

Veterans overall are impacted by opioid-related morbidity and mortality,22 and overdose mortality among veterans increased more than 50% from 2010 to 2019.23–26 Suicide is a critical issue among veterans especially those who served in the wars in Afganistan and Iraq.27–28 Further, with a high frequency of military-related injuries leading to long-term prescription opioid use,29 increased opioid prescription use associated with overdose and suicide among veterans,30–34 and veterans at increased risk of suicide within the first six months of opioid therapy discontinuation,35 there is a need for increased mental health and SUD screenings and longitudinal integrated, trauma-informed care to support veterans.

More information about veterans' mental health care needs and resources to support are on the 988 Suicide and Crisis Lifeline website. Additional resources include the following:

  • Veterans Crisis Line: For mental health and suicide prevention crisis support, for veterans who are struggling and their loved ones/families, call or text "988" and then press "1" to reach responders from the United States Department of Veterans Affairs (VA)—many of whom are veterans themselves—or visit the website at veteranscrisisline.net
  • NJ Vet2Vet Peer Support Line: The NJ Vet2Vet Peer Support Line provides 24/7 support to New Jersey National Guard members, active military personnel, veterans, and families/caregivers of active military personnel and veterans. Trained prior military team members provide peer support and case management and connect callers to clinical providers where needed. Call 866.838.7654 for 24/7 support, or utilize the online chat function for live chat Mondays to Thursdays, 8am to 8pm, or Fridays from 8am to 4:30pm. You can also email the team for a reply within 24 hours. Visit the NJ Vet2Vet Peer Support Line website for additional resources.

 

Neurodivergent Mental Health

Recent research indicates high rates of suicide in autistic adolescents and young adults (AYA), with rates among AYA girls and women increased compared to AYA boys and men, and for autistic people diagnosed with mental health disorders.36–37 These findings emphasize the need for more research into screening of and suicide prevention counseling for autistic people, and a better understanding for health care professionals of the negative effects of camouflaging, a paradigm that stresses autistic people camouflage/mask their autistic traits to conform to society. Research indicates that camouflaging is associated with exhaustion, poor mental health, and suicidal ideation.38–41 Societal expectations can contribute to autistic people experiencing stigmatization and rejection at school, work, and in social situations.42

Acceptance of neurodiversity—a movement based on the philosophy that "different ways of thinking and behaving should be embraced, and are natural variations of being human"43—has the potential to benefit everyone in society, may lead to decreased suicidal thoughts in autistic people, and can help support acceptance of all neurodivergent people.

The Center for Neurodiversity at Rowan University facilitates resources, educational events, and support services for the Rowan community. The center's shared tenets of neurodiversity culture are:

  • valuing neurological differences as diversity and as one of many aspects of identity
  • recognizing that a variety of minds benefits society
  • viewing neurodivergence from a strengths perspective
  • understanding that neurodiversity and disability co-exist

More information about neurodivergent mental health care and resources to support are on the 988 Suicide and Crisis Lifeline website.

 

LGBTQIA+ Mental Health

The Trevor Project, an organization dedicated to ending suicide among lesbian, gay, bisexual, transgender, and queer or questioning adolescents and young adults (AYA) in the U.S. and worldwide, recently conducted the 2023 U.S. National Survey on the Mental Health of LGBTQ Young People,44 expressing the experiences of more than 28,000 LGBTQ AYA ages 13 to 24. The survey's findings indicated:

  • 41% of LGBTQ AYA seriously considered suicide within the past year, with AYA who are transgender, nonbinary, and/or people of color reporting higher rates than peers who do not identify within the marginalized groups.
  • 56% of LGBTQ AYA who wanted mental health support within the past year were unable to obtain this support.
  • Transgender and nonbinary AYA who reported that their loved ones/family members/roommates/all those they live with respect their gender identity and pronouns reported lower rates of suicide attempts.
  • Less than 40% of LGBTQ AYA reported their homes to be LGBTQ-affirming.
  • Approximately half of transgender and nonbinary AYA reported their schools to be gender-affirming. Those who reported their schools to be gender-affirming also reported lower rates of suicide attempts.
  • The majority of LGBTQ AYA survey participants reported experiencing verbal harassment at school because people perceived them to be LGBTQ.
  • Approximately one in three LGBTQ AYA reported poor mental health majority of the time because of anti-LGBTQ legislation.
  • Approximately two in three LGBTQ AYA reported that becoming aware of potential local or state legislation banning discussion of LGBTQ people while in school settings negatively affected their mental health.

All of these data underscore that sexism, racism, and anti-LGBTQIA+ victimization are serious issues in the U.S. This research also underscores types of support that can positively impact marginalized communities, including developing and supporting safe spaces and respecting everyone's pronouns, as well as advocating for increased and inclusive mental health care for all.

More information about LGBTQIA+ mental health care and resources to support are on the 988 Suicide and Crisis Lifeline website. Additional resources include the following:

  • The Trevor Project: The Trevor Project is the world's largest suicide prevention and crisis intervention support organization for LGBTQ AYA. Call 866.488.7386 or text TREVOR to 202.304.1200, and visit the Trevor Project website for additional resources.
  • LGBT National Help Center: Through cost-free and confidential hotlines, online chat programs, email services, and an online database of resources, the LGBT National Help Center seeks to serve and uplift the community when struggling with coming-out issues, safer sex information, family and relationship issues, and mental health. Visit the LGBT National Help Center website for additional resources, and call the following hotlines for support:
    • LGBT National Hotline: 888.843.4564
    • LGBT National Coming Out Support Hotline: 888.OUT.LGBT (888.688.5428)
    • LGBT National Youth Talkline: 1.800.246.PRIDE (1.800.246.7743)
    • LGBT National Senior Hotline: 888.234.7243
  • Trans Lifeline: The Trans Lifeline is divested from law enforcement. It is the U.S.' only crisis peer support hotline, led and staffed by trans people, for people who need someone trans to talk with—even if you aren't in crisis or are unsure if you're trans. Call 877.565.8860, and learn more about services and additional resources on the Trans Lifeline website.
  • Inclusive Therapists: Inclusive Therapists is a social justice movement founded by licensed marriage and family therapist Melody Li to destigmatize and expand mental health care to people with marginalized identities. You can search on the Inclusive Therapists website for a local licensed therapist, or licensed therapists available by telehealth, by insurance, specialties, and identity.

 

Seek Help Now

If you or someone you know is at risk for harm from yourself or others, call 911 or go to your local emergency room.

 

Additional Resources

Learn about #BeThe1To at bethe1to.com, and learn more about the 988 Suicide and Crisis Lifeline at 988lifeline.org.

Learn about the physician suicide crisis, suicide prevention resources, and how to help create a culture of mental wellbeing, via the Vital Signs: The Campaign to Prevent Physician Suicide website.

Additional educational information and supportive resources focused on suicide prevention are available at go.rowan.edu/bethe1to; and educational information and supportive resources focused on stigma, substance dependence and substance use disorder (SUD)/addictions treatment, and related terms and issues are available at go.rowan.edu/recovery.

Please know that there is no shame in seeking support and treatment. You are important and your life matters.

 

Interested in contributing to the Rowan University DEI website/blog and/or social media? Please complete the following brief interest form and share with student groups and colleagues across all Rowan colleges and schools: go.rowan.edu/deicontent

 

References

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  2. Centers for Disease Control and Prevention (CDC). (2023). Suicide Data and Statistics. CDC.
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  4. Coleman, B. W. (2020). Ring the Alarm: The Crisis of Black Youth Suicide in America: A Report to Congress from the Congressional Black Caucus Emergency TaskForce on Black Youth Suicide and Mental Health.
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  33. Ilgen, M. A., Bohnert, A. S., Ganoczy, D., Bair, M. J., McCarthy, J. F., & Blow, F. C. (2016). Opioid Dose and Risk of Suicide. Pain, 157(5), 1079.
  34. Bohnert, A. S., & Ilgen, M. A. (2019). Understanding Links Among Opioid Use, Overdose, and Suicide. New England Journal of Medicine, 380(1), 71-79.
  35. United States Department of Veterans Affairs (VA). (2019). Opioid Use and Suicide Risk. VA.
  36. Newell, V., Phillips, L., Jones, C., Townsend, E., Richards, C., & Cassidy, S. (2023). A Systematic Review and Meta-Analysis of Suicidality in Autistic and Possibly Autistic People without Co-Occurring Intellectual Disability. Molecular Autism, 14(1), 1-37.
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