The Pursuit of Radical Hope: Suicidal Help-Seeking Behaviors Among Black Adolescents and Caregivers.

OBJECTIVE: While suicidal behaviors among adolescents declined from 1991 to 2017, suicides among Black youth increased. There is limited research on suicidal help-seeking behaviors among Black adolescents, which is essential for effective suicide prevention and intervention. This study examined suicidal help-seeking behaviors and treatment preferences among Black youth and caregivers, using the Psychological Framework of Radical Hope to explore strategies for fostering hope and healing. METHODS: This qualitative study included Black youth (ages 14-19), caregivers, health and mental health providers, and community members (N = 55). Participants were predominantly Black (96%) and female (53%), with ages ranging from 14 to 68 years. Semi-structured interviews, conducted in 60-90-min virtual focus groups, explored experiences with suicidal help-seeking, service needs, and support preferences. Constant comparative methodology was employed to organize and categorize data into themes. RESULTS: Youth balanced ideas of faith and agency toward help-seeking behaviors. In contrast, caregivers, providers, and community members were less optimistic about the service needs of Black youth being met largely due to historical and current experiences with systemic barriers. Participant groups discussed how collective memory informs their experiences and inspires them to have hope for positive change. DISCUSSION: Suicide-specific interventions should integrate strategies for fostering hope, faith, and agency individually and collectively with diverse groups to support Black youth suicidal help-seeking behaviors. Clinical strategies are provided to support the design of interventions to effectively address suicidal help-seeking behaviors for Black youth and their caregivers.