Young Latina Suicide
Teenage Latina girls show increasing rates of suicide attempts in the city.
by Alaïs Diop
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At one o’clock in the morning on a Friday last year, just a few days before their annual beach trip for the 4th of July, the Parapis discovered the body of one of their teenaged daughters, hanging in the basement of their East Elmhurst home. In the days that followed, family members were at a loss to understand why 14-year-old Alejandra had taken her own life.
The family attributed her suicide to the trauma she felt at the age of six when she made the clandestine journey from Ecuador to New York. Her parents had left her behind with her grandmother while they made the transcontinental move northward and hired strangers to help her emigrate to the United States. Upon arrival in New York City, the young girl did not even recognize her parents.
Walther Sinche, president of the International Ecuadorian Alliance, retold the child’s story to a group of reporters, explaining the difficult choice Alejandra’s parents faced once her grandmother could no longer look after their child. “It was their only choice to bring the family back together,” he said. The Parapis had two more daughters in the next eight years and “in time” Sinche said, “Alejandra seemed to adapt. Everything looked normal.”
Reports of the child’s death appeared in the Latino media, including publications like Voices of New York, Latin Trends, El Diario NY, as well as a brief story in the the New York Daily News. The reporting around the tragedy reflected a larger issue for New York within the city’s Latino community: the increase each year in the number of suicide attempts by Latina girls, often associated with the difficulties both first and second generation immigrants have with assimilating into the local culture.
This emerging crisis underscores the complexities of being held to the expectations of both one’s native and one’s adopted culture. Such issues need attention from more than just the Latino community.
Although too few, a number of local organizations have undertaken initiatives aimed at addressing the issue of teen suicide in the Latino community in the city. Medical research teams are studying the problem to understand the underlying reasons more fully and to start a wider discussion. Experts are also developing preventative techniques. A few suicide prevention centers for Latinas have emerged, along with other general programs that promote self-confidence in girls as they recover from suicide attempts or traumatic experiences that influence their vulnerability.
The statistics explain the issue’s urgency. Figures compiled by the Centers for Disease Control and Prevention show that in the general population, there is one death by suicide in the United States every 13 minutes. In a 2012 report, the CDC reported that suicide was the third leading cause of death for Americans between the ages of 15 and 24. While the number of fatalities is higher for Native American and Alaskan Native youth, the CDC explained that suicide attempts are particularly high for Latinos between the 9th and 12th grades.
Nationwide, deaths from attempted male suicides of any ethnicity are four times more frequent than those of females. Yet, women are three times more likely to try to put an end to their lives. For Latinos, 36.7 percent reported feeling sad or hopeless.
In the case of Latina girls, that figure was astounding: more than 47 percent, compared to 37 percent white and 35 percent black according to the 2013 CDC Youth Risk Behavior Survey. Unfortunately, reports have not been made since.
In the case of Latina girls, that figure was astounding: more than 47 percent, compared to 37 percent white and 35 percent black according to the 2013 CDC Youth Risk Behavior Survey.
A CDC Morbidity and Mortality Weekly report from 2011 said that “Latino teenagers have the highest rates of having made a suicide plan,” which means that “one out of every 25 Latina teens made a suicide attempt that resulted in an injury, poisoning or overdose that had to be treated by a doctor or a nurse.” This phenomenon mainly concerns Latina girls born in the US, rather than those born elsewhere.
In 2010, more than 33 percent of Latina girls in NY between the ages of 12 and 18 admitted to feeling depressed for two or more weeks, the CDC reported, while more than 14 percent prepared a death plan.
United States Centers for Disease Control and Prevention Data , 2012.
These girls, depending on the intensity of their dejection, will usually ingest household substances as lethal as detergents and pumice stones. Depending on accessibility, they might even take prescription medications or over-the-counter pills. Some will decide to cut themselves with razor blades, knives, or math compasses, and those with the unwavering intention of dying will suffocate themselves or jump off buildings.
In 2013, the rate of Latina girls who contemplated suicide in the country was higher than that of their white counterparts – 26 percent compared to approximately 21 percent for whites and 18 percent for African Americans. But, New York’s rates are even scarier and increasing annually, especially in the outer boroughs of Manhattan. In Queens, the number of attempts has almost doubled since 2011. In Staten Island and Brooklyn, almost a quarter of the Latina youth population contemplated suicide, a five percent increase from the year before.
United States Centers for Disease Control and Prevention Data , 2012.
Various studies have tried to assess the reasons behind these suicidal behaviors, by characterizing the Hispanics demographic as a group. Dr. Yovanska Duarté-Vélez and Dr. Guillermo Bernal explain that there are more than 30 Hispanic subgroups in a report published in 2007. Their analysis reveals why it is valid to consider the Hispanic community as a whole: “Hispanics share a common language and for many, the experience of migration from their country of origin, acculturation process, racism, and discrimination.”
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For Dr. Robert Luis Zayas, the Dean of the School of Social Work at the University of Texas in Austin, thinks there needs to be more “within-group studies . . . and particularly with Latino-a older adolescents.” Zayas is a specialist on Latina suicide behaviors and has been trying to find ways to prevent suicide attempts for more than 30 years. His essay, “Why Do So Many Latina Teens Attempt Suicide? A Conceptual Model for Research,” explains that historically, at least since 1961 when the Puerto Rican community was the largest of the Hispanic groups, no particular Latino subgroup has shown considerably bigger risk of attempted suicide than another. Since then, Dominicans, Mexicans, Ecuadorians and other ethnicities have settled in the country and have now come to represent large segments of the population in general. CUNY’s Center for Latin American, Caribbean and Latino Studies reported that in New York City this year, for the first time in history, the Dominican community has outgrown the Mexican and Puerto Rican subgroups. Similarly, Dominicans are the group with the highest birth rate, with more than 33,000 children born between 2010 and 2012.
CUNY’s Graduate Center Study Finds that Dominicans Have Likely Surpassed Puerto Ricans to Become New York City.
Dr. Zayas first became conscious of the number of young Latinas who were being brought to emergency rooms while he was working as a social worker in New York in the 1970s. Since then, he has written extensively on the subject and has conducted the most detailed analyses available in the field.
Some of his reports explain that the history of migration and the families’ respective experience migrating are both decisive agents in these girls’ difficulty adapting to a multicultural environment. Each girl carries her own emotional baggage and a different story. While some are first-generation immigrants who arrive at a later stage of their adolescence, others are born in the city. In both cases, they feel more isolated than other teenagers of the same age, and find it harder to assimilate to American life.
The history of migration and the families’ respective experience migrating are both decisive agents in these girls’ difficulty adapting to a multicultural environment.
However, while every suicide attempt is unique, medical and psychological studies still show that clear commonalities still impact these girls and lead them to suffer from similar depressive conditions.
In the case of foreign-born immigrants like the young Parapis daughter, it can be harder to adapt to a new status and family structure, as one of Zayas’ studies shows. The family’s living situation causes girls to feel isolated, neglected or even hopeless. In 2008, the Census Bureau reported that despite the growing number of Hispanics in the United States, their living conditions are still particularly disadvantaged, marked by low-income households, low levels of employment and minimal access to health insurance.
Cultural surroundings may play their part in the rise of depressive thoughts, but the values and traditions imposed upon the girls by their families are also a factor. Duarté-Vélez & Bernal use the term familismo (familism) to describe Latino community values, an environment and system based on heritage, cultural traditions, and a strong sense of community and sharing. Parents try to inculcate these core values in their children while their teenage children are influenced by a more liberal, independent and autonomous way of thinking.
In the words of CUNY professor Jillian Báez, “They have to be two different persons at once.”
Báez teaches in CUNY’s department of Latino media. She grew up in the Bronx with her Puerto Rican family, and has witnessed some of these dynamics directly. She is especially sensitive to the connections girls must make between their parents and the other authorities in their lives, such as teachers or school counselors. “These girls have to be translators,” Báez said, “mediators for their parents.”
Undoubtedly, verbal communication creates a particular problem for girls whose parents only speak Spanish as they try to fit into the American educational system, especially for first and 1.5 generation immigrants, that is, those who migrated to the United States as teenagers. Language gets in the way of the support they need at home as well as the advocacy the young girls might need from teachers, administrators, therapists and doctors. A child’s ability to assimilate relates directly to her ability to learn English, and they often times have to tutor themselves at home.
“Within a family setting,” Báez explained, “if parents are not actually seeing what’s going on with their daughters, and seeing it as [a situation where] they would need to intervene, then she is by herself.” And as if to compound the problem, traditional Latino families tend to be secretive about physical and mental health issues. Attempted suicide is a completely taboo.
Báez maintains that with their lack of diversity, schools are of little help to Latinos, who have a 23 percent high school dropout rate, more than double the 11 percent for African Americans and nearly four times higher than for whites, according to a 2007 CDC Survey.
The diversity issue is just as pronounced at the college level, Báez said. At CUNY, “we don’t have faculty and staff that look like our students,” she said. “People complain about it all the time.”
“Ee don’t have faculty and staff that look like our students,” she said. “People complain about it all the time.”
She explained she has seen many Latina girls drop out of college after freshman or sophomore year, either because of financial strain, the familial pressure for quick employment, peer pressure or a sense that what they are studying does not seem relevant enough. To encourage more Latino success at the college level and perhaps beyond, Mayor Bill de Blasio has introduced a bill to increase diversity in the city’s specialized high schools, where 70 percent of students are black and Latino, but, according to The Epoch Times, only 11 percent are in the elite public schools,.
Statistics confirm Báez’s impressions. An article from 2014 that appeared on the site of Teachers of English to Speakers of Other Languages indicated that only around 14 percent of Latino students have a bachelor’s degree by the time they turn 25.
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At the very end of a tunnel-like corridor of Columbia Presbyterian in Washington Heights is a tiny office where a group of young researchers are trying to understand the reasons behind youth suicide. The way there involves several flights of stairs that seem to go in opposite directions as well as badging in and out of a series of glass doors. Behind other heavy doors appear a series of cubicles lit up with the same white hospital lamps that burn the eyes.
Ana Ortin Peralta, the study’s project coordinator conducted a study there that consisted of three years of recruiting. It involved 68 teenagers treated in the hospital’s emergency room after their suicide attempts, who lived in the area. Most were between 12 and 19 years old. Only five were boys and of the 63 girls in the group, 50 were Latina.
Ortin works as a research assistant under the direction of Christiane Duarte, a professor of psychiatry at Columbia University Medical Center. For up to four months, the group of researchers followed these young Latinos after they got out of the hospital. The teenagers completed questionnaires that asked about what they felt and experienced before their suicidal behavior. Their parents also took part in the discussion. “We looked at the emotional, behavioral and cognitive sides to the events during the 24 hours before they tried to kill themselves, or thought about it,” Ortin explained. “We didn’t ask about the reasons.”
The questions explored the teenagers’ ruminations, the life events that might have precipitated their actions, and how anxious, depressed or hopeless they had felt. The researchers asked the group of teenagers to walk them through that day, from the moment they woke up to the moment they took the decision to end their lives. What the psychologists learned, Ortin said, is that the day prior to the event is usually the crucial one. The abrupt aspect of self-injury can come from sensation-seeking, which is very frequent in teenagers.
Some of these girls did not show signs of suicide ideation, she explained, nor did their peers or family members suspect their intentions. Some of their actions were even described as “impulsive,” in other words, taken without fully considering the consequences of their acts.
Specifically, the young patients were asked a set of four questions: Do you think about death? Do you think about people dying in a passive way? In the past year, have you thought about suicide seriously? If yes, did you have a plan in mind?
The team concluded that high sensation-seekers were 1.7 times more likely to have suicidal thoughts and two times more likely to have attempted to kill themselves at some point in their lifetime. Ortin explained that adolescents gain cognitive control of their emotions at the end of adolescence, at around 18 years of age. “You are not only trying to find who you are,” she said when referring to the girls’ specific cases, “but you don’t have role models you want to follow.”
Mother-daughter relationships are often key factors in these young girls’ difficulties. In most cases, fathers are absent, therefore exacerbating tensions between mothers and daughters. The female roles and power dynamics within the household subsequently begin to slowly sink into interchangeability. The likelihood that the girls have become sexually active complicating the dynamic further. In the CDC’s 2007 study, Latina girls were reported to have the highest teen birth rate at 83 per every 1,000 girls.
The female roles and power dynamics within the household subsequently begin to slowly sink into interchangeability.
In any number of clinical interviews, teenagers who have attempted suicide cite instances of domestic violence or physical or sexual abuse in their homes, often at the hand of extended family members. This makes it harder for the teenagers to tell anyone else close to them what has happened. Every study concludes that hostile and disturbing environments can deeply affect the girls’ states of mind, their self-esteem and their behavior.
The following table, representing data from 2013, indicates that Hispanic teens are engaged in more physically or sexually abusive relationships that white or black teenagers in the country.
Youth Risk Behavior Surveillance — United States, 2013. Centers for Disease Control and Prevention.
These mother-daughter dynamics take lots of turns, and can involve many phases, including strong rejection and intergenerational conflicts. Dr. Beth Silverman-Yam has met with many women who have suffered from domestic violence, primarily in the United States but also in South Africa, Asia, and other parts of the world. She worked for 20 years before her retirement as the Director of Clinical Programs at Sanctuary for Families at Columbia University, where more than 70 percent of her patients were immigrants, the majority coming from Latin-America and West Africa.
“How do you engage people in a conversation where they have to question the sensitivity to their own culture?” Silverman-Yam asked. Many of the women she cited have not received education after high school, and were more often than not involved in abusive relationships with their husbands, boyfriends, or family members. From her own experience as a social worker, one who would testify regularly at hearings to help some of her clients, she soon realized that many of these women were pressured to be “a good woman,” one who suffers in order to keep her family intact. Religion often played a major role in these women’s discourses, she said, especially when it came to their obligations as wives and mothers. And the more religious their environment was, the more silent they stayed.
Religion often played a major role in these women’s discourses, she said, especially when it came to their obligations as wives and mothers. And the more religious their environment was, the more silent they stayed.
In most cases, she immediately saw the impact this mentality had on their daughters. “They are caught in crossfires culturally,” Silverman-Yam explained. “Adolescents are exposed to so much more, and they are vulnerable to having the same kind of abusive relationships in the future.”
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In 2006, New York University was greatly shaken by the suicides of six of its students, mostly inside Bobst, the university’s main library. Even though none of them was Latino, the episode speaks to the copycat dimension of suicide. The university tried to create an academic response to the horrifying events, and asked Dr. Jess Shatkin to develop a minor in Child and Adolescent Mental Health Studies Program within the Child and Adolescent Psychiatry department. First, he and his team developed a series of classes and workshops under the names, “How to succeed in college?,” “”Success in college: Thriving at NYU,” or “Transition to College and Young Adulthood.” But while these opportunities did attract students, the team still felt the need for a more clinical response to the tragedies.
The program was the first such college minor in the country and versions of it have been started at Stanford University, Georgetown University, and The University of Vermont. The 40 classes available in NYU’s program range from the brain’s developmental process, the impact of literature in teens, to love, sex, parents’ divorce, eating disorders, and mental illnesses.
The closest subject to the theme of suicide falls under the “adolescent risky behavior and healthy decision-making” section, where one course is entitled “Risk & Resilience in Urban Teens: Mental Health Promotion and Practicum.” This two-semester course involves training students to be peer mentors and counselors in a public high school during the spring semester. First, they are taught the principles and theories behind mental disease prevention methods. They then apply these directly in a pre-designed curriculum aimed at a group of 9th graders who they advise and talk to openly about risks.
“We realized that the program benefited the college students more,” Shatkin pointed out after explaining that they stopped offering the course. A semester- long training was not enough, and they did not see a particular response from any of the middle school students. The department has thought about focusing on a class about suicide, about what Shatkin calls “big cutters,” but it would evolve into a group therapy class which would not be academic enough for a university curriculum.
One of Shatkin’s colleagues, Lori Evans, is a clinical assistant professor at the Department of Child and Adolescent Psychiatry at NYU. She assists teenagers as they go through their adolescence, counseling them on everything from standardized testing to depression. For Evans, it is clear that not every community gets the same access to help. Studies show that there are clear disparities between minority groups and their access to mental services, especially prior to a suicide attempt. From her own experience, Evans said, white populations are also more attuned to seek help immediately, while Latino patients seemed more reticent, and were quite often looking for non-medical methods of healing often through religious sources.
But Evans argues that there is an even more important layer to the issue. The uneven availability of mental health services reflects the patients’ race and income. “The problem is the treatment’s cost,” Evans argued. “So much of it is not covered by insurance.” The 2014 CDC Health Insurance Coverage showed Latinos to be the most uninsured racial and ethnic group with 27 percent uninsured versus 11 percent of whites, and 15 percent of blacks. One in three Latino children has no regular source of medical care and 33 percent experienced problems getting specialty care. And on the occasion that families decide to talk to a mental health professional, Evans explained, they might even be assigned to a therapist who is either not professionally trained or who does not speak Spanish.
The problem is the treatment’s cost,” Evans argued. “So much of it is not covered by insurance.”
In a New York Daily News in the summer of 2014, U.S. Sen. Kirsten Gillibrand (D-NY) called on Congress to “help strengthen the safety net for youth in crisis.” “With the growth of the nation’s Hispanic community, the number of girls at-risk for mental illness and suicide rises daily,” she wrote “All of us must work together to end this epidemic.”
Gillibrand introduced the Garrett Lee Smith Memorial Act Reauthorization which passed the Senate and House of Representatives last year. This is a prevention and intervention program started in 2004 by the American Foundation for Suicide Prevention, which gives money to 35 states, including New York. It offers funding to educational institutions through a campus suicide prevention program. With a renewal of $7 million dollars, this reauthorization plans on offering more assistance by employing more trained personnel, and increasing treatment services, information on the subject and awareness campaigns.
Evans argues that talking more openly about suicide in order to prevent it, even though it can be of great help for some, can also have ambiguous results for others. For Latina girls, the problem is especially acute. Many scientists and doctors do not want to take risks by conducting research that will negatively impact the patients they are questioning, especially if they are young and vulnerable. The New York Community Trust indicated that Latina girls submitting to mental health care programs does not mean they will fully recover. “Although more Hispanic girls are hospitalized for depression than girls of other ethnicities, for many, mental health care isn’t enough; 60 percent of Latinas who have received mental health care attempt suicide again.”
“We have to be careful when we educate,” Evans said. There is a clear necessity to create hope for those who keep negative thoughts to themselves. Even though it is hard to hear a cry for help when it stays silent, suicide attempts can be predicted if the community knows how to pay closer attention to signs of a problem brewing.
Even though it is hard to hear a cry for help when it stays silent, suicide attempts can be predicted if the community knows how to pay closer attention to signs of a problem brewing.
In terms of available treatments such as antidepressant medications for children and adolescents, some have been proven to lead a small number of patients to suicidal behaviors. The Food and Drug Administration issued a “black box” public warning in 2004 towards specific medications for patients with “major depressive disorder” that caused suicidal behaviors and endangered youth up to age 25. Evans said it is difficult to find the right treatments and solutions for the right people as they experience depression.
She also cited another recent approach, via the Columbia-Suicide Severity Rating Scale, as the most recent and effective suicide rating scale to date. Created by Kelly Posner, the director of the Center for Suicide Risk Assessment at Columbia University, the rating scale was adopted by the CDC and is used nationwide to assess suicide ideation. It deploys a questionnaire similar to the one Ortin used for the Presbyterian study. It is now being used in high schools and universities, in the military, in fire departments, in the justice system and in scientific research. It has has been translated into 103 languages.
However, Evans said, “Even though it deeply increased awareness, it is still too imprecise.”
At Gibney Dance Company, movement, dance and therapy come hand in hand when it comes to preventing traumatic experiences. For that matter, Gibney Dance is much more than two sunny spacious studios in downtown Manhattan. Its website describes its Community Action initiative as “the first program to unite dancers with survivors of domestic violence.” At Gibey, dancers use movement to help victims of domestic abuse prevent the perpetuation of these patterns for future generations and themselves. Its mission is to find ways to help such victims heal both mentally and physically. The organization serves women (and some men) from many ethnic communities including Latinos.
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Now that Silverman-Yam has retired from Sanctuary, she has joined the company as its full-time counselor. For the past 15 years, she has helped out on the side. “I believe that healing through the arts — any kind of art — is one of the best non-stigmatizing ways to change yourself,” Silverman-Yam said.
“I believe that healing through the arts — any kind of art — is one of the best non-stigmatizing ways to change yourself.”
The center offers 500 free annual workshops to domestic violence survivors, as well as counseling and dance workshops that are therapeutic in nature. Through these various programs, trained professionals engage participants in debates over what well-being really means, and how to stay mentally and physically healthy. So far, the actions taken at Gibney Dance have helped 40,000 women change their lifestyles. The program served to open 5,000 shelter workshops, some of which got extended to other countries, including South Africa and Amsterdam. In February, the team organized the Hands Are For Holding campaign for Teen Dating Violence Awareness Month, which served to educate high school and middle school students about some of the wrong and dangerous movements that can delineate an abusive relationship.
“We teach women and girls to claim their space,” Silverman-Yam concluded. “We need a cri du coeur from schools, community centers, organizations, the arts, media. This is everybody’s problem.”
This is one of the goals set by the suicide prevention program La Vida Es Preciosa — Life Is Precious in English. It was co-founded in 2009 by Dr. Rosa Gil, founder of the organization Comunilife, and Beatriz Coronel, the director of the center. They offer a wide variety of projects, activities and plans to girls from ages 12 to 17 who have attempted suicide. And they invite strong Latina voices to meet with the girls, share their experiences, and discuss their lives and careers.
Sarita Tabarez would be a model speaker at Life Is Precious. She is the director of business development for the five-star hotel group Faena, located in Buenos Aires and Miami. It’s a job she has held for more than a decade. Even though she was never suicidal, her future did not always seem promising growing up. “There was no consistency in my life,” Tabarez recalled as she sat at her immense dining table, in the middle of art deco lamps and photography books. A blizzard was making violent noises outside the large windows that surround her living-room near the New York Stock Exchange building just a few feet away.
This apartment was far away in more than time from the homes of her childhood. She remembers moving around a lot with her single mother and little sister, always ending up in poor neighborhoods with no real access to extra-curricular activities. But she remembers well the laborious days spent trying to get better grades, handwashing her two pairs of pants, and waiting for her Dominican mother to come home from one of her three jobs to cook dinner for Tabarez and her sister.
“I always tried to be studious, but nobody tutored me English,” she recalled. “I would do everything by myself.” Every summer, the girls would be sent to visit their aunts in the Dominican Republic, while their mother kept at her job.
Tabarez remembers seeing other girls getting pregnant in high school, and gangs being formed early. Of the suicide attempt rates today, she affirmed calmly: “That doesn’t surprise me at all.”
She is well aware of her success at prevailing over difficult circumstances. When she was nine, she found a non-profit dance studio that offered classes every Saturdays from 9 a.m. to 3 p.m. She was the only young girl in her circle who left the neighborhood on weekends to go dance. The commute easily became a habit, which soon evolved into a reason enjoyable enough to not be in the streets with her friends. By eighth grade, she had the opportunity to enter a private high school. “I had some nice teachers that cared,” she said, “I started coming into my own.” She became class president and graduated at the top of her class.
“I had some nice teachers that cared,” she said, “I started coming into my own.”
From high school, she went to SUNY Oneonta to study communications and political science. “Not having a premier education has set me back,” Tabarez explained. However, she recognizes that she was lucky to find the right teachers, and had opportunities to meet significant people and organizations that all helped her along the way.
“I don’t have any friends left from high school or college,” she later confessed. After graduating, Tabarez worked as a waitress when her boss told her she was a really good sales person. Two years later, they opened a restaurant together. She was 26 at the time. Even though the adventure didn’t last long, she was able to take online business classes at Hunter College and met a businessman and real estate investor with whom she developed projects, including the Soho Grand Hotel and Tribeca Grand Hotel. She later joined the Faena group where she is today with her good friend Alan Faena, founder and owner of the upscale company.
Surely, she attributes some of her progress to her own confidence, which still emanates from her strong dark eyes and deep velvety voice. “It takes a lot of strength to grow up in a poor household,” Tabarez said. “You find yourself in very unfortunate circumstances, yet you have so many values.” Proudly, she recalls her dedication to help her mother, who taught her how to “clean, cook, and be a lady,” or that time she finally got her hands on a pair of $1.99 Converse Factory Rejects. The family also attended church every Saturday and Sunday, without fail. All of these memories were nourished by the sweet taste of home cooked plantains in the evening.
Her mother is surely the most valuable example she has of courage and hard work. She lived with her until a few months ago when her mother decided to retire to Florida.
Life Is Precious is the first suicide prevention center that offers medical and mental health services to individuals in need. The center welcomes pre-teens and teenagers who have attempted suicide at least once. It took two years for Comunilife and the Puerto Rican Family Institute to raise the $225,000 they needed to get the center started. A new location opened recently in Long Island City, making it the third such center. The other two are in Brooklyn and the Bronx.
These centers give the girls access to a wide range of activities, from support groups to drawing classes and or creative writing workshops, all available in Spanish and English, all aimed at healing and recovery. Specific workshops for mothers are also available, where they can share their own struggles and learn how to address certain issues with their daughters. Once a week, they can reunite in tertulias, or social gatherings similar to the more ancient version of salons, where they discuss recent news, share poems or stories they wrote. Similarly, fathers can join a dominoes club and hang out together.
Open on Mondays and Wednesdays for a few hours in the afternoon, and on Saturdays from 10 a.m. to 2 p.m., the center is usually full of life, with more than 150 girls enrolled. Every event or activity is free of cost; it requires self-will and some free time from parents to show their support and be involved with their daughters’ recovery.
“My desire is that more Latinos go into the field of psychiatry so that when they approach the issues these girls have, they can do it from a cultural perspective, from a standpoint that promotes cultural sensitivity,” said Raquel Cepeda, a friend of the director who works as a filmmaker. Cepeda went to the Brooklyn center to discuss identity and self-esteem with the group of teenagers, before going back to meet with the group living in the Bronx. “Life is Precious is such a powerhouse,” Cepeda said. Every trained female who works at the center is closely linked to the Latino culture and heritage, and can therefore offer perspectives for the girls.
“My desire is that more Latinos go into the field of psychiatry so that when they approach the issues these girls have, they can do it from a cultural perspective, from a standpoint that promotes cultural sensitivity,”
Cepeda immediately felt a strong bond with the group and decided to follow seven teens at the Bronx location, which evolved into her yet-to-be released documentary, entitled “Some Girls.” The film was shot over the course of three consecutive years, and is centered in New York, especially the Bronx, Santo Domingo, and the Dominican Republic.
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Cepeda believes there is a strong need for more such centers, not only in New York but nationwide. “I’m not white enough and I’m not black American enough,” was the kind of comment she heard while she was shooting the film five years ago. With the girls’ permission, she accompanied them and interacted with their families in weekly group meetings. Most came from single mother households living in low-income housing. Some had been abused or abandoned by their fathers. Twenty years after her own childhood memories, the stories the girls told sounded achingly similar to her own path as a Dominican girl growing up in Washington Heights.
The film serves in one sense as a sequel to Cepeda’s autobiography, Bird of Paradise: How I Became Latina, in which she recalls growing up with her step-mother and abusive father. However, the film leaves her personal story behind to focus on the group of girls she met at Life is Precious. “Teenagers really tell you how they feel,” Cepeda said. “They are not polite.” She emphasized that the girls that the center welcomes are usually “left in a very dangerous environment where they are often times sexually assaulted, molested or attacked in other ways by the men in their lives.”
“Teenagers really tell you how they feel,” Cepeda said. “They are not polite.”
The center is still struggling to find funding, but its objectives are clear. There is a wish to expand in other parts of the country, build bigger facilities, raise awareness in national conferences about health and add more therapists to the staff. The New York Community Trust showcased Life Is Precious in its newsletter to show some of the results of giving grants to such organizations. Between 2007 and 2009, the center received $225,000 to create a location in the Bronx.
The process is definitely taking longer than expected, but early results are encouraging. The Comunilife website reports that all of the participants in the Life is Precious program have continued their education (“where once 50 percent were held back or dropped out of school”) and none has attempted to end her life since getting involved with the center.
Comunilife also created the Latino Youth Suicide Prevention Training Center in the Bronx, which is coordinated by Miriam Steinberg. Thanks to the New York State Office of Mental Health, the organization received a $70,000 grant that lasted five years. Steinberg and her team were able to hold intervention workshops on the themes of “How to connect people to the right resources” and “What to do if someone tells you they want to kill themselves.”
“We were taking some time with people through their personal history,” Steinberg explained. “The response was immediate.” Word-of-mouth proved especially successful in getting people to join the trainings, even those who had never been affected by these issues before but were interested enough to take part in the discussion. “Most [suicidal] people would not approach a social worker, but a friend instead,” she said. This emphasizes the need for parents and school communities to be trained as effectively as counselors or therapists. Participants at the trainings were 15 years old and up. The workshops lasted between a few hours, two days or a month.
Through programs such as CONNECT: Postvention is Prevention, professionals instructed participants in how to be prepared to handle the kind of distress that follows a suicide within a community. For Steinberg, training should start directly with parents, close relatives and friends, and the school staff. She brought up suicide clusters as another issue. Clusters emphasize the alluring aspect of suicide.
“We don’t want to romanticize suicide,” Steinberg pointed out. “Planting a tree [in memoriam] is not recommended, because it’s too permanent. Instead, we encourage walks, community service opportunities, writing notes in paper to put in a school counselor’s office.” These are methods of remembrance that are less likely to influence others to imitate the deathly action..
Cepeda recalled her own experience being taunted by white and African-American girls at her school, who called her “Mexican” and “illegal,” neither of which she was. Her response at the time was to fight back, but that nearly landed her in jail. The girls in her documentary also suffer from racial stereotypes attributed to them by others.
Now 41 and a mother of two, Cepeda remains deeply moved by the stories she collected. As a journalist, author, mother and filmmaker, she considers it her duty to raise awareness about these issues. “It shocked me how similar the mother and daughter stories were to my own,” she said about her first encounters with the teenagers. As a volunteer, Cepeda got to directly witness the complicated relationships they have with their mothers. They rapidly identified with her story and did not mind her presence as they were slowly regaining confidence.
As part of her project, Cepeda decided to explore the girls’ identity through an ancestral DNA test that she conducted on a trip with them to the Dominican Republic. They learned about their family roots which led them to feel more powerful and proud of their culture of origin. It was an important step in making them understand their heritage in order to be confident enough and embrace both cultures. “Finding out my roots – what I was before becoming Dominican, was fascinating and empowering and life affirming,” she recalled. “I wanted to share that experience with them.”
“Finding out my roots – what I was before becoming Dominican, was fascinating and empowering and life affirming.”
She asked for their permission as well as their mother’s to conduct a mitochondrial DNA test, which uses the mother’s DNA to discover the teenagers’ maternal ancestors, or their own “Eve,” as she puts it. “Your DNA is a history book and you’re going to be burning this book if you do something to yourself. This is what I try to instill in them instead of trying to not feel like it doesn’t matter if they die or if they live.
The reactions following the test results were mixed. Most of the girls realized they came from indigenous people brought to the continent from West Africa during colonial trading. “One of the girls was upset that she came out to be West African,” Cepeda said. “She wanted to be Japanese, she said, or white.” Everyday, these young women are bombarded with messages and faces that are hard to connect with, with physical appearances that are distant from their own, hence their own desire to look whiter, or darker, as if they needed to belong somewhere more certain and questionless. These models seem unreachable, both physically and socially.
“You’re always stuck in the middle,” Cepeda said. “There is this whole negotiating of not fitting anywhere, of living in the grey space.” She plans to return to the center as a volunteer as soon as her film project is completed. Her wish for the future is to start a program where the girls will write chronicles. “There should be more voices,” she argued. “Sometimes you find diamonds in the rough. You never know who can write. I believe that our experiences, even if they are dark and Latino, are all part of the American narrative.”
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At one o’clock in the morning on a Friday last year, just a few days before their annual beach trip for the 4th of July, the Parapis discovered the body of one of their teenaged daughters, hanging in the basement of their East Elmhurst home. In the days that followed, family members were at a loss to understand why 14-year-old Alejandra had taken her own life.
The family attributed her suicide to the trauma she felt at the age of six when she made the clandestine journey from Ecuador to New York. Her parents had left her behind with her grandmother while they made the transcontinental move northward and hired strangers to help her emigrate to the United States. Upon arrival in New York City, the young girl did not even recognize her parents.
Walther Sinche, president of the International Ecuadorian Alliance, retold the child’s story to a group of reporters, explaining the difficult choice Alejandra’s parents faced once her grandmother could no longer look after their child. “It was their only choice to bring the family back together,” he said. The Parapis had two more daughters in the next eight years and “in time” Sinche said, “Alejandra seemed to adapt. Everything looked normal.”
Reports of the child’s death appeared in the Latino media, including publications like Voices of New York, Latin Trends, El Diario NY, as well as a brief story in the the New York Daily News. The reporting around the tragedy reflected a larger issue for New York within the city’s Latino community: the increase each year in the number of suicide attempts by Latina girls, often associated with the difficulties both first and second generation immigrants have with assimilating into the local culture.
This emerging crisis underscores the complexities of being held to the expectations of both one’s native and one’s adopted culture. Such issues need attention from more than just the Latino community.
Although too few, a number of local organizations have undertaken initiatives aimed at addressing the issue of teen suicide in the Latino community in the city. Medical research teams are studying the problem to understand the underlying reasons more fully and to start a wider discussion. Experts are also developing preventative techniques. A few suicide prevention centers for Latinas have emerged, along with other general programs that promote self-confidence in girls as they recover from suicide attempts or traumatic experiences that influence their vulnerability.
The statistics explain the issue’s urgency. Figures compiled by the Centers for Disease Control and Prevention show that in the general population, there is one death by suicide in the United States every 13 minutes. In a 2012 report, the CDC reported that suicide was the third leading cause of death for Americans between the ages of 15 and 24. While the number of fatalities is higher for Native American and Alaskan Native youth, the CDC explained that suicide attempts are particularly high for Latinos between the 9th and 12th grades.
Nationwide, deaths from attempted male suicides of any ethnicity are four times more frequent than those of females. Yet, women are three times more likely to try to put an end to their lives. For Latinos, 36.7 percent reported feeling sad or hopeless.
In the case of Latina girls, that figure was astounding: more than 47 percent, compared to 37 percent white and 35 percent black according to the 2013 CDC Youth Risk Behavior Survey. Unfortunately, reports have not been made since.
In the case of Latina girls, that figure was astounding: more than 47 percent, compared to 37 percent white and 35 percent black according to the 2013 CDC Youth Risk Behavior Survey.
A CDC Morbidity and Mortality Weekly report from 2011 said that “Latino teenagers have the highest rates of having made a suicide plan,” which means that “one out of every 25 Latina teens made a suicide attempt that resulted in an injury, poisoning or overdose that had to be treated by a doctor or a nurse.” This phenomenon mainly concerns Latina girls born in the US, rather than those born elsewhere.
In 2010, more than 33 percent of Latina girls in NY between the ages of 12 and 18 admitted to feeling depressed for two or more weeks, the CDC reported, while more than 14 percent prepared a death plan.
United States Centers for Disease Control and Prevention Data , 2012.
These girls, depending on the intensity of their dejection, will usually ingest household substances as lethal as detergents and pumice stones. Depending on accessibility, they might even take prescription medications or over-the-counter pills. Some will decide to cut themselves with razor blades, knives, or math compasses, and those with the unwavering intention of dying will suffocate themselves or jump off buildings.
In 2013, the rate of Latina girls who contemplated suicide in the country was higher than that of their white counterparts – 26 percent compared to approximately 21 percent for whites and 18 percent for African Americans. But, New York’s rates are even scarier and increasing annually, especially in the outer boroughs of Manhattan. In Queens, the number of attempts has almost doubled since 2011. In Staten Island and Brooklyn, almost a quarter of the Latina youth population contemplated suicide, a five percent increase from the year before.
United States Centers for Disease Control and Prevention Data , 2012.
Various studies have tried to assess the reasons behind these suicidal behaviors, by characterizing the Hispanics demographic as a group. Dr. Yovanska Duarté-Vélez and Dr. Guillermo Bernal explain that there are more than 30 Hispanic subgroups in a report published in 2007. Their analysis reveals why it is valid to consider the Hispanic community as a whole: “Hispanics share a common language and for many, the experience of migration from their country of origin, acculturation process, racism, and discrimination.”
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For Dr. Robert Luis Zayas, the Dean of the School of Social Work at the University of Texas in Austin, thinks there needs to be more “within-group studies . . . and particularly with Latino-a older adolescents.” Zayas is a specialist on Latina suicide behaviors and has been trying to find ways to prevent suicide attempts for more than 30 years. His essay, “Why Do So Many Latina Teens Attempt Suicide? A Conceptual Model for Research,” explains that historically, at least since 1961 when the Puerto Rican community was the largest of the Hispanic groups, no particular Latino subgroup has shown considerably bigger risk of attempted suicide than another. Since then, Dominicans, Mexicans, Ecuadorians and other ethnicities have settled in the country and have now come to represent large segments of the population in general. CUNY’s Center for Latin American, Caribbean and Latino Studies reported that in New York City this year, for the first time in history, the Dominican community has outgrown the Mexican and Puerto Rican subgroups. Similarly, Dominicans are the group with the highest birth rate, with more than 33,000 children born between 2010 and 2012.
CUNY’s Graduate Center Study Finds that Dominicans Have Likely Surpassed Puerto Ricans to Become New York City.
Dr. Zayas first became conscious of the number of young Latinas who were being brought to emergency rooms while he was working as a social worker in New York in the 1970s. Since then, he has written extensively on the subject and has conducted the most detailed analyses available in the field.
Some of his reports explain that the history of migration and the families’ respective experience migrating are both decisive agents in these girls’ difficulty adapting to a multicultural environment. Each girl carries her own emotional baggage and a different story. While some are first-generation immigrants who arrive at a later stage of their adolescence, others are born in the city. In both cases, they feel more isolated than other teenagers of the same age, and find it harder to assimilate to American life.
The history of migration and the families’ respective experience migrating are both decisive agents in these girls’ difficulty adapting to a multicultural environment.
However, while every suicide attempt is unique, medical and psychological studies still show that clear commonalities still impact these girls and lead them to suffer from similar depressive conditions.
In the case of foreign-born immigrants like the young Parapis daughter, it can be harder to adapt to a new status and family structure, as one of Zayas’ studies shows. The family’s living situation causes girls to feel isolated, neglected or even hopeless. In 2008, the Census Bureau reported that despite the growing number of Hispanics in the United States, their living conditions are still particularly disadvantaged, marked by low-income households, low levels of employment and minimal access to health insurance.
Cultural surroundings may play their part in the rise of depressive thoughts, but the values and traditions imposed upon the girls by their families are also a factor. Duarté-Vélez & Bernal use the term familismo (familism) to describe Latino community values, an environment and system based on heritage, cultural traditions, and a strong sense of community and sharing. Parents try to inculcate these core values in their children while their teenage children are influenced by a more liberal, independent and autonomous way of thinking.
In the words of CUNY professor Jillian Báez, “They have to be two different persons at once.”
Báez teaches in CUNY’s department of Latino media. She grew up in the Bronx with her Puerto Rican family, and has witnessed some of these dynamics directly. She is especially sensitive to the connections girls must make between their parents and the other authorities in their lives, such as teachers or school counselors. “These girls have to be translators,” Báez said, “mediators for their parents.”
Undoubtedly, verbal communication creates a particular problem for girls whose parents only speak Spanish as they try to fit into the American educational system, especially for first and 1.5 generation immigrants, that is, those who migrated to the United States as teenagers. Language gets in the way of the support they need at home as well as the advocacy the young girls might need from teachers, administrators, therapists and doctors. A child’s ability to assimilate relates directly to her ability to learn English, and they often times have to tutor themselves at home.
“Within a family setting,” Báez explained, “if parents are not actually seeing what’s going on with their daughters, and seeing it as [a situation where] they would need to intervene, then she is by herself.” And as if to compound the problem, traditional Latino families tend to be secretive about physical and mental health issues. Attempted suicide is a completely taboo.
Báez maintains that with their lack of diversity, schools are of little help to Latinos, who have a 23 percent high school dropout rate, more than double the 11 percent for African Americans and nearly four times higher than for whites, according to a 2007 CDC Survey.
The diversity issue is just as pronounced at the college level, Báez said. At CUNY, “we don’t have faculty and staff that look like our students,” she said. “People complain about it all the time.”
“Ee don’t have faculty and staff that look like our students,” she said. “People complain about it all the time.”
She explained she has seen many Latina girls drop out of college after freshman or sophomore year, either because of financial strain, the familial pressure for quick employment, peer pressure or a sense that what they are studying does not seem relevant enough. To encourage more Latino success at the college level and perhaps beyond, Mayor Bill de Blasio has introduced a bill to increase diversity in the city’s specialized high schools, where 70 percent of students are black and Latino, but, according to The Epoch Times, only 11 percent are in the elite public schools,.
Statistics confirm Báez’s impressions. An article from 2014 that appeared on the site of Teachers of English to Speakers of Other Languages indicated that only around 14 percent of Latino students have a bachelor’s degree by the time they turn 25.
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At the very end of a tunnel-like corridor of Columbia Presbyterian in Washington Heights is a tiny office where a group of young researchers are trying to understand the reasons behind youth suicide. The way there involves several flights of stairs that seem to go in opposite directions as well as badging in and out of a series of glass doors. Behind other heavy doors appear a series of cubicles lit up with the same white hospital lamps that burn the eyes.
Ana Ortin Peralta, the study’s project coordinator conducted a study there that consisted of three years of recruiting. It involved 68 teenagers treated in the hospital’s emergency room after their suicide attempts, who lived in the area. Most were between 12 and 19 years old. Only five were boys and of the 63 girls in the group, 50 were Latina.
Ortin works as a research assistant under the direction of Christiane Duarte, a professor of psychiatry at Columbia University Medical Center. For up to four months, the group of researchers followed these young Latinos after they got out of the hospital. The teenagers completed questionnaires that asked about what they felt and experienced before their suicidal behavior. Their parents also took part in the discussion. “We looked at the emotional, behavioral and cognitive sides to the events during the 24 hours before they tried to kill themselves, or thought about it,” Ortin explained. “We didn’t ask about the reasons.”
The questions explored the teenagers’ ruminations, the life events that might have precipitated their actions, and how anxious, depressed or hopeless they had felt. The researchers asked the group of teenagers to walk them through that day, from the moment they woke up to the moment they took the decision to end their lives. What the psychologists learned, Ortin said, is that the day prior to the event is usually the crucial one. The abrupt aspect of self-injury can come from sensation-seeking, which is very frequent in teenagers.
Some of these girls did not show signs of suicide ideation, she explained, nor did their peers or family members suspect their intentions. Some of their actions were even described as “impulsive,” in other words, taken without fully considering the consequences of their acts.
Specifically, the young patients were asked a set of four questions: Do you think about death? Do you think about people dying in a passive way? In the past year, have you thought about suicide seriously? If yes, did you have a plan in mind?
The team concluded that high sensation-seekers were 1.7 times more likely to have suicidal thoughts and two times more likely to have attempted to kill themselves at some point in their lifetime. Ortin explained that adolescents gain cognitive control of their emotions at the end of adolescence, at around 18 years of age. “You are not only trying to find who you are,” she said when referring to the girls’ specific cases, “but you don’t have role models you want to follow.”
Mother-daughter relationships are often key factors in these young girls’ difficulties. In most cases, fathers are absent, therefore exacerbating tensions between mothers and daughters. The female roles and power dynamics within the household subsequently begin to slowly sink into interchangeability. The likelihood that the girls have become sexually active complicating the dynamic further. In the CDC’s 2007 study, Latina girls were reported to have the highest teen birth rate at 83 per every 1,000 girls.
The female roles and power dynamics within the household subsequently begin to slowly sink into interchangeability.
In any number of clinical interviews, teenagers who have attempted suicide cite instances of domestic violence or physical or sexual abuse in their homes, often at the hand of extended family members. This makes it harder for the teenagers to tell anyone else close to them what has happened. Every study concludes that hostile and disturbing environments can deeply affect the girls’ states of mind, their self-esteem and their behavior.
The following table, representing data from 2013, indicates that Hispanic teens are engaged in more physically or sexually abusive relationships that white or black teenagers in the country.
Youth Risk Behavior Surveillance — United States, 2013. Centers for Disease Control and Prevention.
These mother-daughter dynamics take lots of turns, and can involve many phases, including strong rejection and intergenerational conflicts. Dr. Beth Silverman-Yam has met with many women who have suffered from domestic violence, primarily in the United States but also in South Africa, Asia, and other parts of the world. She worked for 20 years before her retirement as the Director of Clinical Programs at Sanctuary for Families at Columbia University, where more than 70 percent of her patients were immigrants, the majority coming from Latin-America and West Africa.
“How do you engage people in a conversation where they have to question the sensitivity to their own culture?” Silverman-Yam asked. Many of the women she cited have not received education after high school, and were more often than not involved in abusive relationships with their husbands, boyfriends, or family members. From her own experience as a social worker, one who would testify regularly at hearings to help some of her clients, she soon realized that many of these women were pressured to be “a good woman,” one who suffers in order to keep her family intact. Religion often played a major role in these women’s discourses, she said, especially when it came to their obligations as wives and mothers. And the more religious their environment was, the more silent they stayed.
Religion often played a major role in these women’s discourses, she said, especially when it came to their obligations as wives and mothers. And the more religious their environment was, the more silent they stayed.
In most cases, she immediately saw the impact this mentality had on their daughters. “They are caught in crossfires culturally,” Silverman-Yam explained. “Adolescents are exposed to so much more, and they are vulnerable to having the same kind of abusive relationships in the future.”
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In 2006, New York University was greatly shaken by the suicides of six of its students, mostly inside Bobst, the university’s main library. Even though none of them was Latino, the episode speaks to the copycat dimension of suicide. The university tried to create an academic response to the horrifying events, and asked Dr. Jess Shatkin to develop a minor in Child and Adolescent Mental Health Studies Program within the Child and Adolescent Psychiatry department. First, he and his team developed a series of classes and workshops under the names, “How to succeed in college?,” “”Success in college: Thriving at NYU,” or “Transition to College and Young Adulthood.” But while these opportunities did attract students, the team still felt the need for a more clinical response to the tragedies.
The program was the first such college minor in the country and versions of it have been started at Stanford University, Georgetown University, and The University of Vermont. The 40 classes available in NYU’s program range from the brain’s developmental process, the impact of literature in teens, to love, sex, parents’ divorce, eating disorders, and mental illnesses.
The closest subject to the theme of suicide falls under the “adolescent risky behavior and healthy decision-making” section, where one course is entitled “Risk & Resilience in Urban Teens: Mental Health Promotion and Practicum.” This two-semester course involves training students to be peer mentors and counselors in a public high school during the spring semester. First, they are taught the principles and theories behind mental disease prevention methods. They then apply these directly in a pre-designed curriculum aimed at a group of 9th graders who they advise and talk to openly about risks.
“We realized that the program benefited the college students more,” Shatkin pointed out after explaining that they stopped offering the course. A semester- long training was not enough, and they did not see a particular response from any of the middle school students. The department has thought about focusing on a class about suicide, about what Shatkin calls “big cutters,” but it would evolve into a group therapy class which would not be academic enough for a university curriculum.
One of Shatkin’s colleagues, Lori Evans, is a clinical assistant professor at the Department of Child and Adolescent Psychiatry at NYU. She assists teenagers as they go through their adolescence, counseling them on everything from standardized testing to depression. For Evans, it is clear that not every community gets the same access to help. Studies show that there are clear disparities between minority groups and their access to mental services, especially prior to a suicide attempt. From her own experience, Evans said, white populations are also more attuned to seek help immediately, while Latino patients seemed more reticent, and were quite often looking for non-medical methods of healing often through religious sources.
But Evans argues that there is an even more important layer to the issue. The uneven availability of mental health services reflects the patients’ race and income. “The problem is the treatment’s cost,” Evans argued. “So much of it is not covered by insurance.” The 2014 CDC Health Insurance Coverage showed Latinos to be the most uninsured racial and ethnic group with 27 percent uninsured versus 11 percent of whites, and 15 percent of blacks. One in three Latino children has no regular source of medical care and 33 percent experienced problems getting specialty care. And on the occasion that families decide to talk to a mental health professional, Evans explained, they might even be assigned to a therapist who is either not professionally trained or who does not speak Spanish.
The problem is the treatment’s cost,” Evans argued. “So much of it is not covered by insurance.”
In a New York Daily News in the summer of 2014, U.S. Sen. Kirsten Gillibrand (D-NY) called on Congress to “help strengthen the safety net for youth in crisis.” “With the growth of the nation’s Hispanic community, the number of girls at-risk for mental illness and suicide rises daily,” she wrote “All of us must work together to end this epidemic.”
Gillibrand introduced the Garrett Lee Smith Memorial Act Reauthorization which passed the Senate and House of Representatives last year. This is a prevention and intervention program started in 2004 by the American Foundation for Suicide Prevention, which gives money to 35 states, including New York. It offers funding to educational institutions through a campus suicide prevention program. With a renewal of $7 million dollars, this reauthorization plans on offering more assistance by employing more trained personnel, and increasing treatment services, information on the subject and awareness campaigns.
Evans argues that talking more openly about suicide in order to prevent it, even though it can be of great help for some, can also have ambiguous results for others. For Latina girls, the problem is especially acute. Many scientists and doctors do not want to take risks by conducting research that will negatively impact the patients they are questioning, especially if they are young and vulnerable. The New York Community Trust indicated that Latina girls submitting to mental health care programs does not mean they will fully recover. “Although more Hispanic girls are hospitalized for depression than girls of other ethnicities, for many, mental health care isn’t enough; 60 percent of Latinas who have received mental health care attempt suicide again.”
“We have to be careful when we educate,” Evans said. There is a clear necessity to create hope for those who keep negative thoughts to themselves. Even though it is hard to hear a cry for help when it stays silent, suicide attempts can be predicted if the community knows how to pay closer attention to signs of a problem brewing.
Even though it is hard to hear a cry for help when it stays silent, suicide attempts can be predicted if the community knows how to pay closer attention to signs of a problem brewing.
In terms of available treatments such as antidepressant medications for children and adolescents, some have been proven to lead a small number of patients to suicidal behaviors. The Food and Drug Administration issued a “black box” public warning in 2004 towards specific medications for patients with “major depressive disorder” that caused suicidal behaviors and endangered youth up to age 25. Evans said it is difficult to find the right treatments and solutions for the right people as they experience depression.
She also cited another recent approach, via the Columbia-Suicide Severity Rating Scale, as the most recent and effective suicide rating scale to date. Created by Kelly Posner, the director of the Center for Suicide Risk Assessment at Columbia University, the rating scale was adopted by the CDC and is used nationwide to assess suicide ideation. It deploys a questionnaire similar to the one Ortin used for the Presbyterian study. It is now being used in high schools and universities, in the military, in fire departments, in the justice system and in scientific research. It has has been translated into 103 languages.
However, Evans said, “Even though it deeply increased awareness, it is still too imprecise.”
At Gibney Dance Company, movement, dance and therapy come hand in hand when it comes to preventing traumatic experiences. For that matter, Gibney Dance is much more than two sunny spacious studios in downtown Manhattan. Its website describes its Community Action initiative as “the first program to unite dancers with survivors of domestic violence.” At Gibey, dancers use movement to help victims of domestic abuse prevent the perpetuation of these patterns for future generations and themselves. Its mission is to find ways to help such victims heal both mentally and physically. The organization serves women (and some men) from many ethnic communities including Latinos.
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Now that Silverman-Yam has retired from Sanctuary, she has joined the company as its full-time counselor. For the past 15 years, she has helped out on the side. “I believe that healing through the arts — any kind of art — is one of the best non-stigmatizing ways to change yourself,” Silverman-Yam said.
“I believe that healing through the arts — any kind of art — is one of the best non-stigmatizing ways to change yourself.”
The center offers 500 free annual workshops to domestic violence survivors, as well as counseling and dance workshops that are therapeutic in nature. Through these various programs, trained professionals engage participants in debates over what well-being really means, and how to stay mentally and physically healthy. So far, the actions taken at Gibney Dance have helped 40,000 women change their lifestyles. The program served to open 5,000 shelter workshops, some of which got extended to other countries, including South Africa and Amsterdam. In February, the team organized the Hands Are For Holding campaign for Teen Dating Violence Awareness Month, which served to educate high school and middle school students about some of the wrong and dangerous movements that can delineate an abusive relationship.
“We teach women and girls to claim their space,” Silverman-Yam concluded. “We need a cri du coeur from schools, community centers, organizations, the arts, media. This is everybody’s problem.”
This is one of the goals set by the suicide prevention program La Vida Es Preciosa — Life Is Precious in English. It was co-founded in 2009 by Dr. Rosa Gil, founder of the organization Comunilife, and Beatriz Coronel, the director of the center. They offer a wide variety of projects, activities and plans to girls from ages 12 to 17 who have attempted suicide. And they invite strong Latina voices to meet with the girls, share their experiences, and discuss their lives and careers.
Sarita Tabarez would be a model speaker at Life Is Precious. She is the director of business development for the five-star hotel group Faena, located in Buenos Aires and Miami. It’s a job she has held for more than a decade. Even though she was never suicidal, her future did not always seem promising growing up. “There was no consistency in my life,” Tabarez recalled as she sat at her immense dining table, in the middle of art deco lamps and photography books. A blizzard was making violent noises outside the large windows that surround her living-room near the New York Stock Exchange building just a few feet away.
This apartment was far away in more than time from the homes of her childhood. She remembers moving around a lot with her single mother and little sister, always ending up in poor neighborhoods with no real access to extra-curricular activities. But she remembers well the laborious days spent trying to get better grades, handwashing her two pairs of pants, and waiting for her Dominican mother to come home from one of her three jobs to cook dinner for Tabarez and her sister.
“I always tried to be studious, but nobody tutored me English,” she recalled. “I would do everything by myself.” Every summer, the girls would be sent to visit their aunts in the Dominican Republic, while their mother kept at her job.
Tabarez remembers seeing other girls getting pregnant in high school, and gangs being formed early. Of the suicide attempt rates today, she affirmed calmly: “That doesn’t surprise me at all.”
She is well aware of her success at prevailing over difficult circumstances. When she was nine, she found a non-profit dance studio that offered classes every Saturdays from 9 a.m. to 3 p.m. She was the only young girl in her circle who left the neighborhood on weekends to go dance. The commute easily became a habit, which soon evolved into a reason enjoyable enough to not be in the streets with her friends. By eighth grade, she had the opportunity to enter a private high school. “I had some nice teachers that cared,” she said, “I started coming into my own.” She became class president and graduated at the top of her class.
“I had some nice teachers that cared,” she said, “I started coming into my own.”
From high school, she went to SUNY Oneonta to study communications and political science. “Not having a premier education has set me back,” Tabarez explained. However, she recognizes that she was lucky to find the right teachers, and had opportunities to meet significant people and organizations that all helped her along the way.
“I don’t have any friends left from high school or college,” she later confessed. After graduating, Tabarez worked as a waitress when her boss told her she was a really good sales person. Two years later, they opened a restaurant together. She was 26 at the time. Even though the adventure didn’t last long, she was able to take online business classes at Hunter College and met a businessman and real estate investor with whom she developed projects, including the Soho Grand Hotel and Tribeca Grand Hotel. She later joined the Faena group where she is today with her good friend Alan Faena, founder and owner of the upscale company.
Surely, she attributes some of her progress to her own confidence, which still emanates from her strong dark eyes and deep velvety voice. “It takes a lot of strength to grow up in a poor household,” Tabarez said. “You find yourself in very unfortunate circumstances, yet you have so many values.” Proudly, she recalls her dedication to help her mother, who taught her how to “clean, cook, and be a lady,” or that time she finally got her hands on a pair of $1.99 Converse Factory Rejects. The family also attended church every Saturday and Sunday, without fail. All of these memories were nourished by the sweet taste of home cooked plantains in the evening.
Her mother is surely the most valuable example she has of courage and hard work. She lived with her until a few months ago when her mother decided to retire to Florida.
Life Is Precious is the first suicide prevention center that offers medical and mental health services to individuals in need. The center welcomes pre-teens and teenagers who have attempted suicide at least once. It took two years for Comunilife and the Puerto Rican Family Institute to raise the $225,000 they needed to get the center started. A new location opened recently in Long Island City, making it the third such center. The other two are in Brooklyn and the Bronx.
These centers give the girls access to a wide range of activities, from support groups to drawing classes and or creative writing workshops, all available in Spanish and English, all aimed at healing and recovery. Specific workshops for mothers are also available, where they can share their own struggles and learn how to address certain issues with their daughters. Once a week, they can reunite in tertulias, or social gatherings similar to the more ancient version of salons, where they discuss recent news, share poems or stories they wrote. Similarly, fathers can join a dominoes club and hang out together.
Open on Mondays and Wednesdays for a few hours in the afternoon, and on Saturdays from 10 a.m. to 2 p.m., the center is usually full of life, with more than 150 girls enrolled. Every event or activity is free of cost; it requires self-will and some free time from parents to show their support and be involved with their daughters’ recovery.
“My desire is that more Latinos go into the field of psychiatry so that when they approach the issues these girls have, they can do it from a cultural perspective, from a standpoint that promotes cultural sensitivity,” said Raquel Cepeda, a friend of the director who works as a filmmaker. Cepeda went to the Brooklyn center to discuss identity and self-esteem with the group of teenagers, before going back to meet with the group living in the Bronx. “Life is Precious is such a powerhouse,” Cepeda said. Every trained female who works at the center is closely linked to the Latino culture and heritage, and can therefore offer perspectives for the girls.
“My desire is that more Latinos go into the field of psychiatry so that when they approach the issues these girls have, they can do it from a cultural perspective, from a standpoint that promotes cultural sensitivity,”
Cepeda immediately felt a strong bond with the group and decided to follow seven teens at the Bronx location, which evolved into her yet-to-be released documentary, entitled “Some Girls.” The film was shot over the course of three consecutive years, and is centered in New York, especially the Bronx, Santo Domingo, and the Dominican Republic.
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Cepeda believes there is a strong need for more such centers, not only in New York but nationwide. “I’m not white enough and I’m not black American enough,” was the kind of comment she heard while she was shooting the film five years ago. With the girls’ permission, she accompanied them and interacted with their families in weekly group meetings. Most came from single mother households living in low-income housing. Some had been abused or abandoned by their fathers. Twenty years after her own childhood memories, the stories the girls told sounded achingly similar to her own path as a Dominican girl growing up in Washington Heights.
The film serves in one sense as a sequel to Cepeda’s autobiography, Bird of Paradise: How I Became Latina, in which she recalls growing up with her step-mother and abusive father. However, the film leaves her personal story behind to focus on the group of girls she met at Life is Precious. “Teenagers really tell you how they feel,” Cepeda said. “They are not polite.” She emphasized that the girls that the center welcomes are usually “left in a very dangerous environment where they are often times sexually assaulted, molested or attacked in other ways by the men in their lives.”
“Teenagers really tell you how they feel,” Cepeda said. “They are not polite.”
The center is still struggling to find funding, but its objectives are clear. There is a wish to expand in other parts of the country, build bigger facilities, raise awareness in national conferences about health and add more therapists to the staff. The New York Community Trust showcased Life Is Precious in its newsletter to show some of the results of giving grants to such organizations. Between 2007 and 2009, the center received $225,000 to create a location in the Bronx.
The process is definitely taking longer than expected, but early results are encouraging. The Comunilife website reports that all of the participants in the Life is Precious program have continued their education (“where once 50 percent were held back or dropped out of school”) and none has attempted to end her life since getting involved with the center.
Comunilife also created the Latino Youth Suicide Prevention Training Center in the Bronx, which is coordinated by Miriam Steinberg. Thanks to the New York State Office of Mental Health, the organization received a $70,000 grant that lasted five years. Steinberg and her team were able to hold intervention workshops on the themes of “How to connect people to the right resources” and “What to do if someone tells you they want to kill themselves.”
“We were taking some time with people through their personal history,” Steinberg explained. “The response was immediate.” Word-of-mouth proved especially successful in getting people to join the trainings, even those who had never been affected by these issues before but were interested enough to take part in the discussion. “Most [suicidal] people would not approach a social worker, but a friend instead,” she said. This emphasizes the need for parents and school communities to be trained as effectively as counselors or therapists. Participants at the trainings were 15 years old and up. The workshops lasted between a few hours, two days or a month.
Through programs such as CONNECT: Postvention is Prevention, professionals instructed participants in how to be prepared to handle the kind of distress that follows a suicide within a community. For Steinberg, training should start directly with parents, close relatives and friends, and the school staff. She brought up suicide clusters as another issue. Clusters emphasize the alluring aspect of suicide.
“We don’t want to romanticize suicide,” Steinberg pointed out. “Planting a tree [in memoriam] is not recommended, because it’s too permanent. Instead, we encourage walks, community service opportunities, writing notes in paper to put in a school counselor’s office.” These are methods of remembrance that are less likely to influence others to imitate the deathly action..
Cepeda recalled her own experience being taunted by white and African-American girls at her school, who called her “Mexican” and “illegal,” neither of which she was. Her response at the time was to fight back, but that nearly landed her in jail. The girls in her documentary also suffer from racial stereotypes attributed to them by others.
Now 41 and a mother of two, Cepeda remains deeply moved by the stories she collected. As a journalist, author, mother and filmmaker, she considers it her duty to raise awareness about these issues. “It shocked me how similar the mother and daughter stories were to my own,” she said about her first encounters with the teenagers. As a volunteer, Cepeda got to directly witness the complicated relationships they have with their mothers. They rapidly identified with her story and did not mind her presence as they were slowly regaining confidence.
As part of her project, Cepeda decided to explore the girls’ identity through an ancestral DNA test that she conducted on a trip with them to the Dominican Republic. They learned about their family roots which led them to feel more powerful and proud of their culture of origin. It was an important step in making them understand their heritage in order to be confident enough and embrace both cultures. “Finding out my roots – what I was before becoming Dominican, was fascinating and empowering and life affirming,” she recalled. “I wanted to share that experience with them.”
“Finding out my roots – what I was before becoming Dominican, was fascinating and empowering and life affirming.”
She asked for their permission as well as their mother’s to conduct a mitochondrial DNA test, which uses the mother’s DNA to discover the teenagers’ maternal ancestors, or their own “Eve,” as she puts it. “Your DNA is a history book and you’re going to be burning this book if you do something to yourself. This is what I try to instill in them instead of trying to not feel like it doesn’t matter if they die or if they live.
The reactions following the test results were mixed. Most of the girls realized they came from indigenous people brought to the continent from West Africa during colonial trading. “One of the girls was upset that she came out to be West African,” Cepeda said. “She wanted to be Japanese, she said, or white.” Everyday, these young women are bombarded with messages and faces that are hard to connect with, with physical appearances that are distant from their own, hence their own desire to look whiter, or darker, as if they needed to belong somewhere more certain and questionless. These models seem unreachable, both physically and socially.
“You’re always stuck in the middle,” Cepeda said. “There is this whole negotiating of not fitting anywhere, of living in the grey space.” She plans to return to the center as a volunteer as soon as her film project is completed. Her wish for the future is to start a program where the girls will write chronicles. “There should be more voices,” she argued. “Sometimes you find diamonds in the rough. You never know who can write. I believe that our experiences, even if they are dark and Latino, are all part of the American narrative.”