Black, Male Youth at Increased Risk of Attempting Suicide Without Suicide Thoughts and Plans

stressed black man
stressed black man
As nearly one-third of suicide deaths among youth occur without warning, investigators conducted a study to assess factors contributing to these types of suicide attempts.

Black and male youth were found to be at increased risk for suicide attempts without reported thoughts or plans of suicide, according to research published in Prevention Science.

“To our knowledge, limited research exists for this specific group of youth,” the researchers said. “Recent postmortem analyses have shown up to 30% of suicide deaths among youth occur seemingly without warning (e.g., no history or expression of suicidal ideation; Rodway et al., 2020). It is imperative to better understand who is in this group and what factors are associated with these types of suicide attempts.”

The researchers evaluated data from students who had reported in the 2015, 2017, and 2019 editions of the CDC’s National Youth Risk Behavior Survey that they had suicidal thoughts, a plan, or an attempt within the past year (n=7491).

Youth were divided into 4 groups based on their suicidal behavior patterns: suicidal thoughts only (pattern 1), suicidal thoughts and suicide plans without an attempt (pattern 2), suicide attempt with ideation (pattern 3), and suicide attempt without ideation (pattern 4). The researchers examined which psychosocial factors (bullied at school, bullied online, feeling sad/hopeless, and lifetime history of sexual violence), substance use factors (current use of alcohol, cannabis, electronic cigarettes, and cigarettes; ever illicit substance use; ever prescription opiate misuse), and demographic factors (age, race/ethnicity, and sex) were linked to these patterns.

Most students in the study sample were female, White, and aged 15 or 16 years; there were significantly more girls than boys in patterns 1, 2, and 3.

Each factor was found to be linked with greater odds of suicide attempts with thoughts or plans (pattern 3) than suicide thoughts only (pattern 1) or suicide thoughts and plans (pattern 2).

More boys (63.8%) than girls reported suicide attempt without ideation. Boys were 3.5-times more likely than girls to attempt suicide without ideation and less likely (adjusted odds ratio (AOR), 0.77) to attempt suicide with ideation.

Black youth (10.6% of the total sample) were more likely than White youth (52.4% of the sample) to report they attempted suicide without having suicidal thoughts or suicide plans (Black [n=81] 26.4%; White [n=82] 38.5%). Black youth were 4.3-times more likely than White youth to attempt suicide without ideation.

White youth were less likely than youth of Black (AOR, 1.6), Hispanic/Latinx (AOR, 1.57), or other races (AOR, 1.67) to report suicide attempt with ideation.

Youth with a history of sexual violence were more than twice as likely (AOR, 2.26) to report they had attempted suicide without ideation than to report they solely had suicide thoughts or suicide thoughts and plans.

When they analyzed all factors simultaneously, the researchers discovered that youth who reported feeling sad/hopeless had lower odds for attempted suicide without ideation. They also found that use of cigarette and cannabis was linked to greater odds of attempted suicide, with and without ideation, while illicit substances and prescription opiates were linked to attempted suicide with ideation.


Romanelli M, Sheftall AH, Irsheid SB, Lindsey MA, Grogan TM. Factors associated with distinct patterns of suicidal thoughts, suicide plans, and suicide attempts among US adolescents. Prev Sci. Published online September 4, 2021. doi:10.1007/s11121-021-01295-8