Identifying Risk and Protective Factors for Suicidal Ideation and Behavior among Black Women: Exploring the Potential Applicability of the Ideation-to-Action Framework

Recent trends have shown a concerning increase in suicide rates among Black women, highlighting the need for research to understand and address this issue. Additionally, little is known about factors that influence the transition from suicidal ideation to suicide attempt among Black women. To address this dearth, this study used the ideation-to-action framework as a guide to identify risk and protective factors associated with suicidal ideation, suicide planning, and suicide attempt in a nationally representative sample of Black women. This study is a secondary data analysis of cross-sectional data from the 2022 National Survey on Drug Use and Health intended to identify the risk and protective factors associated with suicidal ideation, suicide planning, and suicide attempt in a nationally representative sample of Black women (N = 3,105). To achieve parsimonious models for logistic regression, three variable selection methods were used: random forest, backward logistic regression, and forward logistic regression. About 6.9% of Black women reported suicidal ideation, 2.5% made a suicide plan, and 1.3% attempted suicide during the prior 12 months. One in three Black women who made a suicide plan made a suicide attempt. Findings from the multivariate logistic regression reveal that higher levels of hopelessness and major depressive episodes were significantly associated with suicidal ideation. Additionally, a history of a major depressive episode and higher levels of risk-taking behavior were associated with making a suicide plan, whereas being aged 26–34 decreased the odds of making a suicide plan. Finally, history of a major depressive episode and higher levels of risk-taking behaviors were associated with reporting a suicide attempt. These findings have important clinical implications, suggesting that early identification and intervention among Black women are crucial in preventing the transition from suicidal ideation to attempt. Furthermore, suicide prevention efforts should focus on strengthening protective factors, such as collaborating with faith leaders and peer support networks, which can play a vital role in promoting help-seeking behaviors and reducing the risk of suicidal behavior.