Barriers to suicide prevention for the Black community

While the national suicide rate appears to be going down, the rates among Black Americans are going up, as noted by The New York Times.


To understand the intricacies of suicide and what leads someone to make such a permanent decision, especially without reaching out for some sort of mental health treatment, it is important to look at context. Black people are at higher risk for Adverse Childhood Experiences (ACEs). The Center for Disease Control (CDC) defines ACEs as “potentially traumatic events that occur in childhood (0-17 years).” Examples include experiencing or witnessing abuse or violence, or growing up in a household with substance abuse or mental health problems.


The CDC also states that “several racial/ethnic minority groups” have a higher risk of experiencing “4 or more types of ACEs.” Compounding ACEs can have additional lasting impacts on those affected.


“It definitely can be said that young people in the Black community, or anyone in the Black community, that has grown up under systemic inequities that can certainly lead to having adverse childhood experiences that later increase their risk of suicidal behavior or ideation,” said Morgan Tubbs, Data and Communications Director for the Tennessee Suicide Prevention Network (TSPN). Being part of a minority group provides a certain level of trauma due to the level of harassment and bullying that tends to go hand in hand with it.


The Philadelphia Ace Project conducted an expanded study on the impact of ACEs in 2012 and 2013 with 1,784 adult participants. They surveyed a wide variety of people from different backgrounds in order to have a more conclusive result, as the original study in 1998 focused on white, middle-class college students, and included more community-level stressors along with the original ACEs. According to their website, their study found that, in Philadelphia where around a quarter of the population lives in poverty, “almost seven in ten adults had experienced one ACE and two in five had experienced four or more.” Additionally, “40 percent of Philadelphians had experienced four or more of these expanded, community-level ACEs,” which are living in foster care, witnessing violence, bullying, feeling unsafe in one’s neighborhood, and experiencing racism and discrimination.


While that study was conducted in Philadelphia, anyone can experience ACEs, especially due to systemic racism. Black children, and all children of color, have a high chance of facing racism in schools. The U.S. Department of Education states that Black students are “suspended and expelled at a rate three times greater than white students.” This data can be examined in Knoxville, as well. In 2017, in Knox County, despite only making up 13.4 percent of the student body, Black students made up 30.5 percent of all in-school suspensions, 34.8 percent of out-of-school suspensions, and 35.6 percent of expulsions, according to the Civil Rights Data Collection.


Facing racism and discrimination, especially as a child, can lead to thoughts of suicide and suicidal ideation, even later in life. According to 2019 data reported by the CDC, the age-adjusted suicide rate for Black Americans was 7.4 per 100,000, which was “over half the overall U.S. suicide rate of 13.2 per 100,000,” as stated by the Suicide Prevention Resource Center. Suicide is an unspoken epidemic that is not going away.


One part of the reason people do not reach out is a lack of cultural awareness or access to resources, according to Tubbs. Studies have shown that patients tend to react better to therapy or mental health treatment when their therapist fully understands their culture. In some areas, finding a therapist who fits this criteria is much easier said than done. In recent years, there has been a rise of online platforms that attempt to fill this niche, such as Therapy for Black Girls or Therapy for Black Men, but there is still another obstacle to getting care: insurance.


As of 2019, 11.4 percent of Black adults do not have health insurance, according to the Kaiser Family Foundation. Even if someone has health insurance, there is no guarantee they can find a therapist that suits their needs and also takes their insurance. This is another massive barrier preventing Black Americans from getting therapy or mental health care, which can help prevent suicide attempts.


Some nonprofits, such as Black Men Heal, offer a certain amount of free therapy sessions. This can help in some crisis situations, or if the reason someone attends therapy only requires a few visits to handle. However, if someone cannot afford to continue care when they need it, they still lack access to necessary resources.


Suicide is a complicated subject with many layers and barriers to proper preventative care. If you or a loved one is experiencing suicidal thoughts or ideation, please call TSPN’s hotline at 1-800-273-TALK (8255) to speak with a trained counselor.


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