BACKGROUND:
Suicide is a significant public health concern, particularly in historically marginalized and resource-contrained communities. Lesotho, where suicide rates have risen dramatically in recent decades, is estimated to have the highest suicide rate in the world1. Within the African diaspora rates of suicide have increased among Black Americans despite a general decline across the United States2. Current literature overlooks how intersecting and transgenerational systemic, community, and familial oppression create a context of interconnected and multilevel injustices that compounds suicide risk3–6. Research identifying multilevel expressions of resilience, resistance, and perseverance that mitigate risk is also sparse.

METHODS:
This interactive organized session presents findings from three distinct studies with Basotho and Black American communities: a qualitative exploration of suicide in Lesotho; an analysis of racialized masculinity among Black American men at risk7; and a user-centered design project adapting digital phenotyping for Black American youth. Results are synthesized through integrated theories of suicidality8–11 to bridge the gap between context and digital health innovation to improve research and service provision.

RESULTS:
Participants described navigating the complex interplay between intergenerational trauma, family conflict, poverty, restrictive gender norms, and systemic oppression. While social support and perseverance served as protective factors, chronic adversity frequently depleted these resources, leading to suicidal behaviors. One avenue for breaking this is culturally-responsive digital health applications that offer privacy, psychoeducation, and connection to services.

CONCLUSIONS:
Findings highlight that suicide behaviors are not merely individual phenomena but the product of complex and interconnected systems contributing to or mitigate risk. Future research and interventions should account for the ways in which historic and ongoing injustices interact with other risk and protective/promotive factors within diverse cultural contexts. Culturally responsive, digitally integrated approaches are essential for mitigating risk in real-time with diverse, high-burden populations.