Skip to main content
SpringerLink
Log in

Depression and suicidal ideation among Black individuals in Canada: mediating role of traumatic life events and moderating role of racial microaggressions and internalized racism

  • Research
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Although suicidal ideation (SI) is a serious concern in Canada, its prevalence and related factors among Black individuals are poorly documented. Using data from the Mental Health of Black Communities in Canada project (BeCoMHeal), this study aimed to assess the prevalence of SI in Black individuals aged 15–40 years old in Canada, the mediating role of traumatic life events in the association between depression and SI, and the moderating role of racial microaggressions and internalized racism.

Methods

Eight hundred and sixty participants aged between 15 and 40 years (Mage =24.96, SD = 6.29) completed the online questionnaire assessing sociodemographic data, depression symptoms, traumatic life events, racial microaggressions, internalized racism, and SI.

Results

Findings showed that 25.7% of the participants reported having experienced SI (26.5% women, 22.7% men, 𝛘2 = 1.08, p = .299). The moderated-mediation model revealed that traumatic life events fully mediated the association between depression and SI (B = 0.12, p = .004; 95% CI, [0.04, 0.20]) and that racial microaggressions (B = − 0.03, p = .042; 95% CI [-0.07, − 0.00]) and internalized racism (B = 0.06, p = .006; 95% CI [0.02, 0.10]) moderated this relationship.

Conclusion

These findings underscore the importance of addressing racial microaggressions and internalized racism in therapy contexts among Black individuals to mitigate the potential negative impacts on their mental health. They also emphasize the need to develop effective, culturally sensitive, and racially adapted suicide prevention and intervention programs for Black communities in Canada.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data supporting the findings of this study are available upon request from the corresponding author. The data are not publicly available due to privacy and ethical restrictions.

References

  1. Statistics Canada (2020) The Daily — Canadian Community Health Survey, 2019. https://www150.statcan.gc.ca/n1/daily-quotidien/200806/dq200806a-eng.htm

  2. Chiu M, Amartey A, Wang X, Kurdyak P (2018) Ethnic Differences in Mental Health Status and Service utilization: a Population-based study in Ontario, Canada. Can J Psychiatry 63:481–491. https://doi.org/10.1177/0706743717741061

    Article  PubMed  PubMed Central  Google Scholar 

  3. O’Keefe VM, Wingate LR, Cole AB et al (2015) Seemingly harmless racial communications are not so harmless: racial microaggressions lead to suicidal ideation by way of Depression symptoms. Suicide Life Threat Behav 45:567–576. https://doi.org/10.1111/SLTB.12150

    Article  PubMed  Google Scholar 

  4. Goodwill JR, Taylor RJ, Watkins DC (2021) Everyday discrimination, depressive symptoms, and suicide ideation among African American men. Arch Suicide Res 25:74–93. https://doi.org/10.1080/13811118.2019.1660287

    Article  PubMed  Google Scholar 

  5. Brooks JR, Madubata IJ, Jewell RD et al (2021) Depression and suicide ideation: the role of Self-Acceptance for Black Young adults. https://doi.org/101177/00957984211037440

  6. Assari S, Lankarani MM, Caldwell CH Discrimination increases suicidal ideation in Black adolescents regardless of ethnicity and gender. https://doi.org/10.3390/bs7040075

  7. Okoye HU, Saewyc E (2021) Fifteen-year trends in self-reported racism and link with health and well-being of African Canadian adolescents: a secondary data analysis. Int J Equity Health 20:1–13. https://doi.org/10.1186/S12939-021-01446-X/TABLES/7

    Article  Google Scholar 

  8. Slopen N, Shonkoff JP, Albert MA et al (2016) Interactions with Family Immigration History and Income. Am J Prev Med 50:47–56. https://doi.org/10.1016/j.amepre.2015.06.013

    Article  PubMed  Google Scholar 

  9. Zimmerman GM, Messner SF (2013) Individual, family background, and contextual explanations of racial and ethnic disparities in youths’ exposure to violence. Public Health 103:435–442. https://doi.org/10.2105/AJPH.2012.300931

    Article  Google Scholar 

  10. Williams MT, Khanna Roy A, MacIntyre M-P, Faber S (2022) The Traumatizing Impact of Racism in canadians of Colour. Curr Trauma Rep 8:17–34. https://doi.org/10.1007/s40719-022-00225-5

    Article  PubMed  PubMed Central  Google Scholar 

  11. Abdillahi I, Shaw A (2020) Social determinants and inequities in health for black canadians. a snapshot

  12. Sanchez YM, Lambert SF, Ialongo NS (2011) Adverse life events and depressive symptoms in African American Youth: the role of control-related beliefs. Depress Res Treat 2011:13. https://doi.org/10.1155/2011/871843

    Article  Google Scholar 

  13. Franko DL, Striegel-Moore RH, Brown KM et al (2004) Expanding our understanding of the relationship between negative life events and depressive symptoms in black and white adolescent girls. Psychol Med 34:1319–1330. https://doi.org/10.1017/S0033291704003186

    Article  PubMed  Google Scholar 

  14. Opara I, Assan MA, Pierre K et al (2020) Suicide among Black children: an Integrated Model of the interpersonal-psychological theory of suicide and intersectionality theory for researchers and clinicians: https://doi.org/101177/0021934720935641. 51:611–631. https://doi.org/10.1177/0021934720935641

  15. Lewis JA, Mendenhall R, Ojiemwen A et al (2021) Racial microaggressions and sense of belonging at a historically White University. Am Behav Sci 65:1049–1071. https://doi.org/10.1177/0002764219859613

    Article  Google Scholar 

  16. Hollingsworth DW, Cole AB, O’Keefe VM et al (2017) Experiencing racial microaggressions influences suicide ideation through perceived burdensomeness in African americans. J Couns Psychol 64:104–111. https://doi.org/10.1037/COU0000177

    Article  PubMed  Google Scholar 

  17. Joiner T (2005) Why People Die by Suicide

  18. Christensen H, Batterham PJ, Mackinnon AJ et al (2014) Predictors of the risk factors for suicide identified by the interpersonal-psychological theory of suicidal behaviour. Psychiatry Res 219:290–297. https://doi.org/10.1016/J.PSYCHRES.2014.05.029

    Article  PubMed  Google Scholar 

  19. Walker RL, Salami TK, Carter SE, Flowers K (2014) Perceived racism and suicide ideation: Mediating Role of Depression but Moderating Role of Religiosity among African American adults. Suicide Life Threat Behav 44:548–559. https://doi.org/10.1111/SLTB.12089

    Article  PubMed  Google Scholar 

  20. Van Orden KA, Witte TK, Cukrowicz KC et al (2010) The interpersonal theory of suicide. Psychol Rev 117:575. https://doi.org/10.1037/A0018697

    Article  PubMed  PubMed Central  Google Scholar 

  21. Cole AB, Wingate LRR, Slish ML et al (2013) Burdensomeness, depression, and suicide in a sample of american-indian college students. Ethn Inequal Health Soc Care 6:77–86. https://doi.org/10.1108/EIHSC-10-2013-0026

    Article  Google Scholar 

  22. Caro-Cañizares I, Vila MM, Durán Pacheco JI, Carballo JJ (2023) Interpersonal theory of suicide and stressful life events in a clinical sample of adolescents in Spain. Early Interv Psychiatry. https://doi.org/10.1111/eip.13438

    Article  PubMed  Google Scholar 

  23. Cénat JM, Farahi SMMM, Dalexis RD (2023) Prevalence and determinants of depression, anxiety, and stress symptoms among black individuals in Canada in the context of the COVID-19 pandemic. Psychiatry Res 326. https://doi.org/10.1016/j.psychres.2023.115341

  24. Cénat JM, Kogan C, Noorishad PG et al (2021) Prevalence and correlates of depression among black individuals in Canada: the major role of everyday racial discrimination. Depress Anxiety 38:886–895. https://doi.org/10.1002/da.23158

    Article  PubMed  Google Scholar 

  25. Cénat JM, Hajizadeh S, Dalexis RDRD et al (2022) Prevalence and effects of daily and major experiences of racial discrimination and microaggressions among black individuals in Canada. J Interpers Violence 37:NP16750–NP16778. https://doi.org/10.1177/08862605211023493

    Article  PubMed  Google Scholar 

  26. Cénat JM, Hajizadeh S, Dalexis RD et al (2022) Prevalence and effects of Daily and Major experiences of racial discrimination and microaggressions among black individuals in Canada. J Interpers Violence 37:NP16750–NP16778. https://doi.org/10.1177/08862605211023493

    Article  PubMed  Google Scholar 

  27. Cénat JM, Dalexis RD, Darius WP et al (2023) Prevalence of current PTSD symptoms among a sample of black individuals aged 15 to 40 in Canada: the major role of everyday racial discrimination, racial microaggresions, and internalized racism. Can J Psychiatry 68:178–186. https://doi.org/10.1177/07067437221128462

    Article  PubMed  Google Scholar 

  28. Kogan CS, Noorishad P-G, Ndengeyingoma A et al (2022) Prevalence and correlates of anxiety symptoms among black people in Canada: a significant role for everyday racial discrimination and racial microaggressions. J Affect Disord 308:545–553. https://doi.org/10.1016/J.JAD.2022.04.110

    Article  PubMed  Google Scholar 

  29. Radloff LS (1977) The CES-D scale: a self-report Depression Scale for Research in the General Population. Appl Psychol Meas 1:385–401. https://doi.org/10.1177/014662167700100306

    Article  Google Scholar 

  30. Andresen EM, Malmgren JA, Carter WB, Patrick DL (1994) Screening for depression in well older adults: evaluation of a short form of the CES-D. Am J Prev Med 10:77–84. https://doi.org/10.1016/s0749-3797(18)30622-6

    Article  CAS  PubMed  Google Scholar 

  31. Chae DH, Powell WA, Nuru-Jeter AM et al (2017) The role of racial identity and implicit racial Bias in Self-reported racial discrimination: implications for Depression among African American men. J Black Psychol 43:789–812. https://doi.org/10.1177/0095798417690055

    Article  PubMed  PubMed Central  Google Scholar 

  32. Mohebbi M, Nguyen V, McNeil JJ et al (2018) Psychometric properties of a short form of the Center for epidemiologic studies Depression (CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults. Gen Hosp Psychiatry 51:118–125. https://doi.org/10.1016/j.genhosppsych.2017.08.002

    Article  PubMed  Google Scholar 

  33. James C, Powell M, Seixas A et al (2020) Exploring the psychometric properties of the CES-D-10 and its practicality in detecting depressive symptomatology in 27 low- and middle-income countries. Int J Psychol 55:435–445. https://doi.org/10.1002/ijop.12613

    Article  PubMed  Google Scholar 

  34. Zhang W, O’Brien N, Forrest JI et al (2012) Validating a shortened depression scale (10 item CES-D) among HIV-Positive people in British Columbia, Canada. PLoS ONE 7. https://doi.org/10.1371/journal.pone.0040793

  35. Dohrenwend BP (2006) Inventorying stressful life events as risk factors for psychopathology: toward resolution of the problem of intracategory variability. Psychol Bull 132:477–495. https://doi.org/10.1037/0033-2909.132.3.477

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kubany ES, Leisen MB, Kaplan AS et al (2000) Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: the traumatic life events Questionnaire. Psychol Assess 12:210–224. https://doi.org/10.1037//1040-3590.12.2.210

    Article  CAS  PubMed  Google Scholar 

  37. Molina KM, James D (2016) Discrimination, internalized racism, and depression: a comparative study of African American and afro-caribbean adults in the US. Group Processes Intergroup Relations 19:439–461. https://doi.org/10.1177/1368430216641304

    Article  PubMed  Google Scholar 

  38. Mercer SH, Zeigler-Hill V, Wallace M, Hayes DMM (2011) Development and initial validation of the inventory of microaggressions against black individuals. J Couns Psychol 58:457–469. https://doi.org/10.1037/A0024937

    Article  PubMed  Google Scholar 

  39. Cénat JM, Smith K, Hébert M, Derivois D (2019) Cybervictimization and suicidality among French undergraduate students: a mediation model. J Affect Disord 249:90–95. https://doi.org/10.1016/j.jad.2019.02.026

    Article  PubMed  Google Scholar 

  40. Cénat JM, Blais M, Hébert M et al (2015) Correlates of bullying in Quebec high school students: the vulnerability of sexual-minority youth. J Affect Disord 183:315–321. https://doi.org/10.1016/J.JAD.2015.05.011

    Article  PubMed  PubMed Central  Google Scholar 

  41. Igartua JJ, Hayes AF (2021) Mediation, moderation, and conditional process analysis: concepts, computations, and some common confusions. Span J Psychol 24. https://doi.org/10.1017/SJP.2021.46

  42. Hayes AF (2018) Partial, conditional, and moderated moderated mediation: quantification, inference, and interpretation. Commun Monogr 85:4–40. https://doi.org/10.1080/03637751.2017.1352100

    Article  Google Scholar 

  43. Hayes AF (2019) Appendix A - Introduction to Mediation, Moderation, and Conditional Process Analysis. 2507:1–9

  44. Ivey-Stephenson AZ, Demissie Z, Crosby AE et al (2020) Suicidal ideation and behaviors among High School Students — Youth Risk Behavior Survey, United States, 2019. MMWR Suppl 69:47–55. https://doi.org/10.15585/MMWR.SU6901A6

    Article  PubMed  PubMed Central  Google Scholar 

  45. Lindsey MA, Sheftall AH, Xiao Y, Joe S (2019) Trends of Suicidal Behaviors Among High School Students in the United States: 1991–2017. Pediatrics 144:. https://doi.org/10.1542/PEDS.2019-1187

  46. Statistics Canada (2021) Chap. 1: Health of youth in Canada. In: Portrait of Youth in Canada: Data Report. https://www150.statcan.gc.ca/n1/pub/42-28-0001/2021001/article/00001-eng.htm

  47. Assari S (2021) Perceived discrimination and suicidal thoughts and behaviors among American African American and White Children. Hosp Pract Res 6:148–156. https://doi.org/10.34172/HPR.2021.28

    Article  Google Scholar 

  48. Assari S, Lankarani MM, Caldwell CH (2017) Discrimination Increases Suicidal Ideation in Black Adolescents Regardless of Ethnicity and Gender. Behavioral Sciences 2017, Vol 7, Page 75 7:75. https://doi.org/10.3390/BS7040075

  49. Husbands W, Lawson DO, Etowa EB et al (2022) Black canadians’ exposure to Everyday Racism: Implications for Health System Access and Health Promotion among Urban Black Communities. J Urb Health 99:829–841. https://doi.org/10.1007/s11524-022-00676-w

    Article  Google Scholar 

  50. Statistics Canada (2020) Mental health characteristics and suicidal thoughts - Tables 13-10-0098-01

  51. Statistics Canada (2019) Diversity of the black population in Canada : an overview. https://www150.statcan.gc.ca/n1/pub/89-657-x/89-657-x2019002-eng.htm. Accessed 11 Apr 2022

  52. Castle K, Conner K, Kaukeinen K, Tu X (2011) Perceived racism, discrimination, and acculturation in suicidal ideation and suicide attempts among black young adults. Suicide Life Threat Behav 41:342–351. https://doi.org/10.1111/j.1943-278X.2011.00033.x

    Article  PubMed  PubMed Central  Google Scholar 

  53. Borges G, Orozco R, Rafful C et al (2012) Suicidality, ethnicity and immigration in the United States. Psychol Med 42:1175. https://doi.org/10.1017/S0033291711002340

    Article  CAS  PubMed  Google Scholar 

  54. Liu RT, Miller I (2014) Life events and suicidal ideation and behavior: a systematic review. Clin Psychol Rev 34:181–192. https://doi.org/10.1016/J.CPR.2014.01.006

    Article  PubMed  Google Scholar 

  55. Serafini G, Muzio C, Piccinini G et al (2015) Life adversities and suicidal behavior in young individuals: a systematic review. Eur Child Adolesc Psychiatry 24:1423–1446. https://doi.org/10.1007/S00787-015-0760-Y/METRICS

    Article  PubMed  Google Scholar 

  56. Howarth EJ, O’Connor DB, Panagioti M et al (2020) Are stressful life events prospectively associated with increased suicidal ideation and behaviour? A systematic review and meta-analysis. J Affect Disord 266:731–742. https://doi.org/10.1016/J.JAD.2020.01.171

    Article  PubMed  Google Scholar 

  57. Cénat JM (2022) Who is black? The urgency of accurately defining the black population when conducting health research in Canada. CMAJ 194:E948–E949. https://doi.org/10.1503/CMAJ.220274

    Article  PubMed  PubMed Central  Google Scholar 

  58. Cénat JM, Noorishad P, Bakombo SM et al (2022) A systematic review on vaccine hesitancy in black communities in Canada: critical issues and research failures. Vaccines (Basel) 10:1937. https://doi.org/10.3390/vaccines10111937

    Article  PubMed  Google Scholar 

  59. Cénat JM, Smith K, Hébert M, Derivois D (2019) Polyvictimization and cybervictimization among College Students from France: the mediation role of psychological distress and resilience. J Interpers Violence. https://doi.org/10.1177/0886260519854554

    Article  PubMed  Google Scholar 

  60. Hébert M, Cénat JM, Blais M et al (2016) Child sexual abuse, bullying, cyberbullying, and mental health problems among high schools students: a moderated mediated model. Depress Anxiety 33:623–629. https://doi.org/10.1002/da.22504

    Article  PubMed  PubMed Central  Google Scholar 

  61. Williams MT, Printz DMB, DeLapp RCT (2018) Assessing racial trauma with the trauma symptoms of discrimination scale. Psychol Violence 8:735–747. https://doi.org/10.1037/vio0000212

    Article  Google Scholar 

  62. Cénat JM (2022) Complex racial trauma: evidence, Theory, Assessment, and treatment. Perspect Psychol Sci. https://doi.org/10.1177/17456916221120428/ASSET/IMAGES/LARGE/10.1177_17456916221120428-FIG1.JPEG

  63. Rousseau C, Gomez-Carrillo A, Cénat JM (2022) Safe enough? Rethinking the concept of cultural safety in healthcare and training. Br J Psychiatry 221:587–588. https://doi.org/10.1192/bjp.2022.102

    Article  PubMed  Google Scholar 

  64. Cénat JM, Broussard C, Jacob G, Kogan C, Corace K, Ukwu G, Onesi O, Furyk SE, Bekarkhanechi FM, Williams M, Chomienne MH (2024) Antiracist training programs for mental health professionals: A scoping review. Clin Psychol Rev:102373

  65. Cénat JM (2020) How to provide anti-racist mental health care. Lancet Psychiatry 7(11):929–31. https://doi.org/10.1016/S2215-0366(20)30309-6

Download references

Funding

This article was supported by the Public Health Agency of Canada (PHAC) under the grant 1920-HQ-000053.

Author information

Authors and Affiliations

  1. School of Psychology (Clinical), University of Ottawa, 136 Jean-Jacques-Lussier, 4017, Vanier Hall, Ottawa, ON, K1N 6N5, Canada

    Wina Paul Darius, Cary S. Kogan & Jude Mary Cénat

  2. Department of Psychology, Carleton University, Ottawa, ON, Canada

    Seyed Mohammad Mahdi Moshirian Farahi

  3. Department of Nursing, Université du Québec en Outaouais, Gatineau, QC, Canada

    Assumpta Ndengeyingoma

  4. Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, ON, Canada

    Cary S. Kogan, Assumpta Ndengeyingoma & Jude Mary Cénat

  5. University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, ON, Canada

    Jude Mary Cénat

Authors
  1. Wina Paul Darius
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seyed Mohammad Mahdi Moshirian Farahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cary S. Kogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Assumpta Ndengeyingoma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jude Mary Cénat
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

WPD: Conceptualization, methodology and Writing – original draft. SMMMF: Formal analysis and Writing – original draft. CK: Writing – review & editing. AN: Writing – review & editing. JMC: Conceptualization, data interpretation, supervision, and Writing – review & editing.

Corresponding author

Correspondence to Jude Mary Cénat.

Ethics declarations

Ethical approval

The present study was approved by the Research Ethics Boards of the Université du Québec en Outaouais and the University of Ottawa.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Darius, W.P., Moshirian Farahi, S.M.M., Kogan, C. et al. Depression and suicidal ideation among Black individuals in Canada: mediating role of traumatic life events and moderating role of racial microaggressions and internalized racism. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-024-02641-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00127-024-02641-1

Keywords

Search

Navigation