A new study published in the Journal of Adolescent Health explores whether English proficiency is associated with suicide attempts among U.S. adolescents.

The article, “Suicide Attempts Among Adolescents With Limited English Proficiency in the United States: A National Study,” was led by Saurabh Kalra, M.S., M.P.H., a Ph.D. student in epidemiology at the University of Miami Miller School of Medicine.

Examining a National Dataset

The research team analyzed data from the CDC’s Youth Risk Behavior Survey (YRBS) collected between 2015 and 2019. The YRBS is a nationally representative survey of U.S. high school students that captures information on health behaviors, mental health indicators, experiences with suicidal thoughts and behaviors, and demographic characteristics, including English proficiency.

Adolescents who reported speaking English “less than very well” were classified as having Limited English Proficiency (LEP). While LEP is well established in adult health disparities research, its relationship to adolescent mental health has been less understood at a national level.

Findings From the Study

After adjusting for demographic and behavioral factors, the study found that adolescents with LEP were more than three times as likely to report a suicide attempt that required medical attention compared to their English-proficient peers.

This measure represents one of the most serious outcomes captured in the YRBS and signals a critical need for attention to youth with language-related vulnerabilities.

The study also identified contextual differences among adolescents with LEP, including patterns related to stress, social integration, and access to supportive services, factors that may shape mental health trajectories and help-seeking behaviors.

Why Language Proficiency Matters in Public Health

The study places language proficiency within the broader framework of social determinants of health. Language influences communication, school engagement, access to healthcare, and the ability to navigate support systems. National initiatives such as Healthy People 2030 identify “Language and Literacy” as core conditions linked to health outcomes.

Prior research shows that individuals with LEP often face challenges such as delayed medical care, limited preventive services, difficulty accessing mental health support, and higher uninsured rates. For adolescents, these barriers can impede access to counseling, crisis assistance, and school-based resources during critical periods.

Opportunities for Action

The authors note that the findings highlight the need for mental health interventions designed with cultural and linguistic relevance in mind. Potential areas for strengthening support include:

• School-based mental health services that address the needs of students with LEP.
• Crisis support systems that offer multilingual communication.
• Family-centered approaches that consider language dynamics in the home.
• Clinical and educational settings equipped with adequate interpretation resources.
• Prevention programs that reflect the experiences of linguistically diverse youth.

Advancing Knowledge on Language and Mental Health

This study provides new national evidence on the relationship between LEP and severe suicide attempts among adolescents, offering data that can inform future research, program development, and policy efforts aimed at improving mental health care for linguistically diverse populations.

Written by Deycha Torres Hernández, published on November 13, 2025.