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HeartMind e-News: Teach, Learn, Lead

A monthly publication dedicated to trauma-informed, compassionate school practices that help educators, students, and families move toward a sense of wholeness and well-being


Cultural Sensitivity and Teen Suicide Prevention

Sophia Coco, CEI Intern

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Suicidality in Marginalized/Underserved Teens

In a public health advisory in December of 2021, the U.S. Surgeon General issued a rare warning on the youth mental health crisis, calling the crisis “devastating.” Suicide is the second leading cause of death for young people. Although suicide can affect all, certain groups have been impacted more than others, including American Indians and Alaska Natives, LGBTQ individuals, and those in the child welfare system. Research has shown that LGBTQ youth are four times more likely to seriously consider suicide, to make a plan for suicide, and to attempt suicide than their peers. Additionally, a 2019 study found that suicide attempts have steadily increased among Black high school students in the last 25 years. 

A variety of risk factors increase an individual’s potential to develop suicidal ideation and engage in suicidal behaviors. Discrimination, prejudice, limited culturally-appropriate mental health service access, and historical trauma all contribute to an increased risk of suicide for youth. A student with depression, who may confront bullying in the classroom due to their skin color or background, and then encounters prejudices and biases from a psychiatrist, is experiencing a variety of risk factors that are likely to further hurt their mental health.

On the other hand, protective factors can make suicidal ideation and behaviors less likely, provide sources of support and promote beneficial connections. These include supportive social interactions and safe community environments. According to the Trevor Project, an organization that advocates for LGBTQ+ youth, “It is hypothesized that increased support from others can serve as a protective factor, decreasing the risk for negative mental health outcomes among LGBTQ youth… LGBTQ youth who report having at last one accepting adult were 40% less likely to report a suicide attempt in the past year”. 

According to the 2012 National Strategy for Suicide Prevention, suicide is less likely to occur when risk factors are minimized and protective factors are maximized. Teens can feel more supported in their social interactions when their peers act and speak in a more culturally conscious manner. Community environments are more safe when schools make the effort to use inclusive language and understand the various backgrounds of their students.

Increasing Cultural Sensitivity in Teens and Schools

Operating your teen suicide prevention program with a commitment to cultural consciousness helps to create a more inclusive environment and better serve your student population. With this in mind, we’ve detailed some of the activities that you could incorporate to increase the cultural sensitivity of your program.  

The implementation of cultural sensitivity is necessary for schools, parents, and peers to maximize safe, supportive environments and thus promote mental health protective factors. A person may experience various stages of cultural sensitivity, as Milton Bennett illustrates including: 

  • Denial: “We are all the same and I don’t understand why we have to learn about the different countries that my students’ families are from. Why don’t they just learn how we do things in America? ”
  • Defense: “With students from Latin America you can’t just get to the point and get homework done. They want to tell you their life story. I don’t understand why they can’t just learn to be more direct and save everyone time.”
  • Minimization: “In the end, we all want to be liked,” or, “We are all people.”
  • Acceptance: “What would your family do in a situation like this?”
  • Adaptation: Seamlessly interacting with students from different cultures by following the norms of that culture
  • Integration: Genuine comfort in multiple cultures

Starting Conversations to Enhance Connections and Support

Your group can work towards the stages of acceptance, adaptation, and even integration through exercises that increase empathy and understanding. The Cultural Competence Learning Institute suggests a safe and interesting group dialogue entitled Cultural Connection Conversation Starters. You can begin the questions in pairs and then offer opportunities to share with a larger group or go around in a circle and ask each person to share their experiences. Ask: 

  • What were some birthday traditions in your family growing up? What was important to you as a child about birthdays? Do you still keep up those traditions?
  • How and when does your family celebrate the new year?
  • What was a food served in your family growing up that you really didn’t like?
  • If you wanted to serve a visitor a meal that would help them to understand your cultural heritage, what meal would you serve?
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Using inclusive language is a key aspect of supportive social interactions and safe community environments. You may have noticed that people are sharing their pronouns in introductions, on name tags, and at the beginning of group conversations. This gives everyone in the room the opportunity to self identify instead of assuming someone’s identity or which pronouns they use. Including pronouns is a first step toward respecting people’s identity and creating a more welcoming space for people of all genders. This preferred pronoun chart from the Training Peer Mentors Facilitation guide offers some common pronouns that people use. They suggest having a discussion with your group around using pronouns to ensure that everyone’s identities are respected and giving your group members the opportunity to share their pronouns if they are comfortable. 

These exercises can help increase understanding and empathy in your community and group, leading to better suicide prevention efforts. Building up protective factors is a key aspect of improving the mental health outcomes of teens.

References and Related Sources

Centers for Disease Control and Prevention. (2021, December 2). WISQARS (Web-based Injury Statistics Query and Reporting System). Injury Prevention & Control.

Cultural Competence Learning Institute. (n.d.). Cultural connections conversation starters—Welcome to CCLI.

Hochhauser, S., Rao, S., England-Kennedy, E., & Roy, S. (2020). Why social justice matters: A context for suicide prevention efforts. International Journal for Equity in Health, 19(1), 76.

Dally, J. (2013, September 28). Bennett’s Developmental Model of Intercultural Sensitivity (DMIS).

Kyte, A., & Pereira, J. (2018). Peer support toolkit for people living with HIV and/or hepatitis C: Part 2 training peer mentors: facilitation guide. Canadian Mental Health Association Kelowna & District Branch.

Lindsey, M. A., Sheftall, A. H., Xiao, Y., & Joe, S. (2019). Trends of suicidal behaviors among high school students in the United States: 1991-2017. Pediatrics, 144(5).

GLSEN (n.d.). Pronouns: A guide from GLSEN.

Johns, M.M., Lowry, R., Haderxhanaj, L.T., et al. (2020). Trends in violence victimization and suicide risk by sexual identity among high school students — youth risk behavior survey, United States, 2015–2019. MMWR Suppl;69(Suppl-1):19–27.

Office of the Surgeon General (US); National Action Alliance for Suicide Prevention (US). (2021, September) 2012 national strategy for suicide prevention: Goals and objectives for action: A report of the U.S. surgeon general and of the national action alliance for suicide prevention. Washington (DC): US Department of Health & Human Services (US); Strategic Direction 2: Clinical and Community Preventive Services.