In Part 1 of this series, we discussed the complex political and historical context of social unrest that influences the growing rates of Black youth suicide. We addressed how systemic racism is an umbrella under which the conditions of Black suicidology, high COVID-19 mortality rates for African Americans, and the current protest against police brutality are interconnected. In conclusion, we highlighted the importance of dismantling marginalization within the mental health system. In this second part of this three-part series, we will examine the current research and evidence-based treatments that address Black suicidology.

In general, death by suicide within the U.S. has continued to significantly increase.¹ When examining suicidal patterns by race/ethnicity, suicide rates are lower among African Americans. However, when we take a closer look, suicide among Black adolescents is increasing at an alarming rate.² The matter of concern is so disturbing that in 2018 a taskforce was pioneered by Representative Bonnie Watson Coleman (D-NJ) and leading experts engineered a bill that will help combat political and mental health factors that influence Black youth suicidology. H.R. 5469: Pursing Equity in Mental Health Act of 2019 has been introduced to the House and referred to the subcommittee of Health. The main objectives of the bill are as follows:

1. strengthen school-based mental health resources for children and teens,
2. provide mental health awareness to minorities through community outreach,
3. address racial and ethnic minority gaps in research, and
4. address racial disparities in mental health treatment.³

It is immensely important for mental health providers to contextualize the growing trend of suicide among Black adolescents, which does not only encompass suicide, but also factors in self-harm, suicidal ideation, and hospitalization. As we take a comprehensive snapshot of Black suicidology, systematic patterns of marginalization, biases, and inadequacies emerge that contribute to systemic racism.

As I have noted in Part 1, we cannot address Black suicidology without addressing the whole system. The influences of generational poverty, employment biases, housing segregation, environmental racism, and academic disparities play a crucial part in the efficacy of treatment directed at Black communities.

Research on Black Suicidology

Throughout human history, people have been intrigued by the nuances of psychology, including suicidal behavior. The contemporary written literature begins around the late 19^th century. Sociologist Émile Durkheim was among the early suicidologists who published his theories. Durkheim theorized suicide as an outcome of social isolation rather than a psychological disfunction.⁴ Durkheim’s research, primarily a European, male-focused sample, conceptualized suicide as an act exerted by the forces of external factors. This approach neglected the understanding of internal, individualistic behaviors that factor into suicide.

As we transition to more contemporary theories, the paradigm shifts to a greater collective comprehension of individualized behavior. Psychiatrist Aaron Beck centers cognitive behavior within suicidology. He interprets suicide within the framework that individuals with higher degrees of hopelessness—an emotional state referring to negative perceptions of oneself and/or positionality—are tied to more lethal means of suicidality.⁵ Cognitive Behavioral Therapy (CBT) was created by Beck to treat suicidal clients using a technique that modifies cognitive process. In comparison to Durkheim, Beck’s theory of suicide does address the emotional difficulties linked to psychological disturbances within cognition.

The interpersonal theory of suicide, coined by psychologist Thomas Joiner, conceptualizes suicidal behavior as a complex mental health problem induced by external and internal conflicts, specifically the correlation of:

1. thwarted belongingness—the psychological necessity of connectedness,
2. perceived burdensomeness—feelings of exclusion from one’s social group(s), and
3. capability for suicide—the accessibility to lethal means, increases the desirability for suicide.⁶

The study of suicide is interdisciplinary and has an extensive philosophical history. However, the magnitude of theory has provided a European, patriarchal lens that centers Whiteness as the default subject. While suicide has been considered a White male problem, the patterns we currently observe stress the importance of integrating the “other”. While we understand that racial/ethnic differences are not attributable to psychological or cognitive differences, social and cultural differences may impact a client’s suicidality.

There is limited literature/research on the phenomenon of African American suicidality. However, suicide research is beginning to be diversified due to the growing attention to Black youth suicide centralized by Black researchers, lawmakers, and mental health professionals.

Another factor in the discrepancies of suicidal research among Black participants is the communal distrust of the mental health field. African Americans, and other minority groups, have historically been subject to unethical, inhumane experiments ranging from scientific racism that naturalizes the inferiority of Black people to forced sterilization. ^7,8 In the current state, it is comprehensible and valid that these communities may hesitate to participate in modern research.

Suicide research has contributed to the marginalization of suicidal Black clients by neglecting to examine the complex and unique social/cultural factors that impact Black people experiences. In addition, minorities might be hesitant to participant in studies due to the historical centering of racism within mental health.⁹

In addressing these concerns, here are a few things to keep in mind when conducting research:

1. Re-valuate the Research Question.
   If your objective is to study a diverse sample, check that the research question(s) reflects that purpose.
2. Expand Recruitment Techniques.
   While recruiting participants from university settings (i.e., college campuses, university hospitals) are possibly more convenient, these settings may not be helpful in collecting a more diversified sample. If applicable, think about networking directly with local community clinics, non-profits, religious institutes, and organizations. These groups tend to be the pillars of community engagement and trust.
3. Integrate Diversity among Researchers.
   Diversifying the scientific community is equally important as including minority participants in research efforts. Providing diversity inclusion within academia is not merely an act of diversity for the sake of diversity, rather providing opportunities for people of color to share their expertise with other professionals within leadership roles.
4. Highlight the Importance of Research.
   Sometimes scientific jargon is dense, and to the non-scientist can be intimidating. If applicable, highlighting the importance of your study to the participants may be helpful in bridging the trust divide. What is the big picture? Why is this important? Adding the individual, community, and social importance of research integrates a humanistic approach to science.

Treatments for Black Suicidology

In this section, we will discuss the efficacy of two main evidence-based treatments that have been shown to efficiently treat suicidal behavior: CBT and Dialectical Behavioral Therapy (DBT). We will also examine relevance of CAMS as a therapeutic framework in treating Black suicidology.

Cognitive Behavioral Therapy (CBT)
As a cognitive-centered intervention CBT focuses on modifying the mental processes that influence suicidal thoughts. Fundamentally, at its core, CBT is a behavioral modification technique.¹⁰ CBT training that directly addresses suicidal cognitions and behaviors have shown to be very effective in treating suicidal clients.¹¹ There is limited information on the efficacy of CBT treatment specific to Black suicidal behavior. The available empirical findings concentrate on depressive disorders, post-traumatic stress disorder (PTSD), and substance abuse. The findings show a mixture of support on integrating multicultural specific interventions.¹¹

Dialectical Behavioral Therapy (DBT)
Dr. Marsha M. Lineman, designed DBT as an evidence-based practice to treat chronically suicidal clients. An off shoot of CBT, DBT is a mindful-based, behavior modifying treatment that centers the client-therapist relationship to alter processes such as emotional regulation and build coping mechanisms.¹³ DBT has shifted to primarily treat Borderline Personality Disorder (BPD). While there are a multitude of research that supports the efficacy of DBT with BPD clients that express suicidal behavior, the limited literature that discusses African Americans, centers on Black adolescent males diagnosed with Conduct Disorder or display aggressive tendencies.^{14, 15}

The Collaborative Assessment and Management of Suicidality (CAMS)
CAMS is a therapeutic framework that centers on a collaborative, client-focused approach to treating suicidal clients. It is administered with other treatments, and research supports its validity in supplementing suicide-related therapy.¹⁶ Research indicates that CAMS has significant potential in multicultural clients, though the efficacy of CAMS Treatment™ on African American suicidology is limited.¹⁷

There are a handful of evidence based, suicide-focused treatments. CBT and DBT appear to be highly beneficial to suicidal clients due to their direct modification of suicidal thoughts. The inclusion of client-centered therapeutic frameworks may contribute to increasing support for minority clients. There is a balancing act between sticking to the foundation of these therapies and integrating multicultural awareness.

Based on these possibilities, here are few suggestions to consider when treating Black clients:

1. Provide Affordable & Accessible Treatment.
   There are not enough treatments accessible and affordable to low-income, disadvantaged communities. Some reasons for this deficiency are due to factors outside of the mental health field. However, they can be addressed through the client-therapist relationship.
2. Acknowledge Cultural Differences.
   It is essential within the client-therapist relationship to acknowledge the cultural and social disparities that influence the client’s suicidal behavior. As the mental health provider, it is important to not dismiss or ignore their concerns.
3. Affirm: The Client is the Expert on their Experiences.
   My key ideology when addressing clients is to affirm the expertise of the client. Affirming that their experience is valid is crucial in building trust and rapport.
4. Establish Space for Black Mental Health Providers.
   As in research, creating a diverse workforce of mental health providers should be normalized. Black therapists are situated in a unique space where they might have an insider understanding on the complex challenges of treating suicide within Black communities.

Conclusion

The study of suicide and suicidal behavior has an extensive history, yet there is a limitation on the understanding of impacts on Black clients. Whiteness has played a central role in our understanding of suicide, but current research illustrates an alarming uptake in suicidal behavior by Black children and teens. In strengthening research and treatment, we must consider our clients’ experiences and the impact of systemic racism on institutions.

In Part 1, we analyzed the context of systemic racism and its psychological toll on Black consciousness. In this Part 2, we reviewed current research and treatment centered on Black suicidology. Now what?  In the comprehensive conclusion to this series, we will address where we go from here with an in-depth look at the necessary measures needed to strengthen treatment for suicidal Black youth.

1. https://www.cdc.gov/nchs/data/databriefs/db330-h.pdf
2. https://www.nyu.edu/about/news-publications/news/2019/december/BlackYouthSuicideRatesRising.html
3. Suicide by Émile Durkheim
4. https://www.ncbi.nlm.nih.gov/books/NBK223847/
5. Why do People Die by Suicide by Thomas Joiner
6. Medical Apartheid by Harriet A. Washington
7. https://www.smithsonianmag.com/science-nature/disturbing-resilience-scientific-racism-180972243/
8. Eliminating Race-Based Mental Health Disparities by Dr. Monnica Williams, Dr. Daniel Rosen, & Dr. Johnathan Kanter
9. https://beckinstitute.org/get-informed/what-is-cognitive-therapy/
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780394/
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547560/
12. https://www.dbtselfhelp.com/DBTinaNutshell.pdf
13. https://www.sciencedirect.com/science/article/abs/pii/S1359178914000147
14. https://psycnet.apa.org/fulltext/2014-49443-001.html
15. Managing Suicidal Risk: A Collaborative Approach by David A. Jobes
16. Choi, J.L., Rogers, J.R., & Werth Jr, J.L. (2009). Suicide risk assessment with asian american college students: A culturally informed perspective. The Counseling Psychologist, 37, 186-218.

These past months, I have been engulfed in a haze of 24/7 media coverage. It began with the COVID-19 pandemic, filling me with increasing anxiety. The mortality rate for COVID-19 has been disproportionately affecting the African American, Latinx, and Indigenous communities.¹ I worried about my family members whose positionality reflects comorbidities, older age, and minority populations. The hospitalization/death of family members and family friends has left me physically exhausted—experiencing insomnia and feeling mentally drained. I was still glued to the television when the recorded murder of George Floyd literally ignited America.

We Black professionals have learned how to master navigating through the murky waters of microaggressions and institutionalized oppression. Over a duration, I thought the clout of respectability politics – the discourse that professional minorities can rise above racism due to their professional status – would shield me from this. I was wrong. I have awakened, this week, with a complete comprehension of my positionality as a mental health professional, and a clear understanding of the context of suicide among Black Americans.

This article, the first in a series, is written with the objective of examining the social-political context of Black suicidology. We will examine the historical catalyst that has created the “perfect storm” of racial civil unrest and trauma within the Black community. The main goal is to understand how this impacts the growing trend of suicide among Black youth.²

Psychological Theories on Black Suicide

Postulated by Dr. Joy Degruy, the theory of Post-traumatic Slave Syndrome asserts that chattel slavery (which allowed people — considered legal property — to be bought, sold, and owned forever) left a legacy of intergenerational, psychological trauma on the descendants of enslaved Africans.³ It is represented in the current mental health crisis and racial disparities that we observe today. Another theorist, psychiatrist Dr. Alvin Poussaint, elaborates that the stigmatization of depression/suicide within the Black community, compounded with the minimalization of the mental health crisis by mental health professionals, constructs the current rise in suicide among Black boys and men.⁴ These scholars argue that suicide is a symptom of a larger trauma that Black people endure.

To enhance our comprehension of these theories, let us visualize the traumatic stress of the Black community in comparison to a rubber band. A moderate amount of stress, which is a natural reaction to stimuli within our environment, is intrinsically linked to our survival. Similarly, a rubber band is engineered to be elastic and handle a moderate amount of stress and tension. However, when too much force is exerted, without any release, the rubber band will snap.

In recent years, suicidal behavior among Black youth has significantly increased.⁵ As experts across a multitude of specialties continue to work in understanding the methodology behind this trend, we can look to previous and current events to paint a snapshot of what in the world is happening. In my opinion, the vicarious trauma experienced by the Black collective – because of repeated exposure to stress – has cultivated the internal and external stress that is currently present.

This stress is not random nor coincidental; it is systemic. African Americans have been funneled through imperialism, the trans-Atlantic slave trade, chattel slavery, Jim Crow, the Civil Rights Movement, and a “post-racial” America. In between these defining moments, space has not been created to holistically heal and breathe.

The COVID-19 pandemic, which disproportionately impacts African Americans, has increased these tensions. African Americans mostly reside in densely populated cities. Their homes are often intergenerational and contain extended family. They are more likely to lack medical/mental health resources, preventive care, are overrepresented in the prison system, are essential/critical workers, have little to no sick time, and work under horrible working conditions. ⁶

These stresses are heightened by the political racial divide that has resurfaced as a result of the killings of Ahmaud Aubrey, Breonna Taylor, and George Floyd. The global protest we are witnessing in this historical era is directed at police brutality. Within their lifetimes, Black boys and men are at the highest risk of being killed by police than any other racial group.⁷

The Role of Social Media

I think it is important to also understand the role social media plays in all of this. On one hand, it serves as a platform to facilitate the quick distribution of information to a large mass of individuals. This helps to circulate instances of police brutality and other discriminations to the masses, which helps mobilize movements within activism.

On the other hand, the lack of filtering violence has repeatedly exposed adolescents to images of brutalized Black bodies. You can easily find, as you scroll through your social media feed, at least one if not several uncensored videos or images of Black traumatization. For Generation Z, where technology and social media are embedded in their daily lives, these images may have adverse effects.

How does the repeated exposure to these images influence the psyche of Black youth? Does it correlate with or contribute to the increased suicidal behavior among Black youth? The present pandemic and police brutality together cultivate the conditions for a global protest and increase mental health dysfunctions that are currently apparent. Comparable to the upward trend of Black youth suicide, the disproportionate mortality rate of COVID-19 and police brutality may be linked to the systemic overlap of marginalization.

Connecting Systemic Racism to Black Youth Suicide

What does this all have to do with Black youth suicide? Black suicidology does not exist within a vacuum. It is situational and framed by a multitude of factors. Therefore, it is important to contextualize the collective experience. And in a society with a history of racial division, we cannot separate the system from the context. The growing trend of suicide among Black youth is a symptom of systemic racism and the systematic marginalization of Black experiences.

For example, a recent study documented that several White doctors hold racial beliefs that “Black people have physically tougher skin” and “have a higher pain threshold than White patients”.⁷ Perceived racial biases such as these contribute to the systematic mistreatment of Black people by the medical field. Black women have a maternal mortality rate that is three times higher than White women. ADHD Black youth are often underdiagnosed or misdiagnosed with Oppositional Defiant Disorder (ODD).⁹

Although Black youth are the fastest growing group within adolescents for suicidal behavior, Black people are underrepresented in suicide-related research and treatment, and as mental health professionals. The patterns that we are observing are conditioned upon institutionalized racism. How do we address Black suicide without acknowledging the whole system?

It is like a hive of hornets have built a nest in your attic, and instead of removing the whole nest, you spend your days and nights shooing away the hornets around you. The underlying causes of the problem persist.

The Role of Mental Health Professionals

The Black mental health crisis is a residual effect of a system that needs reforming. This state of emergency has been afire for over four-hundred years. What steps can we in the mental health field take to increase the efficacy of treatment for Black suicidal behavior?

When we address Black suicidology, it is essential to address the impact of racism on our clients’ experiences. It is essential to evaluate institutionalized oppression holistically – meaning, examine how housing, financial, economic, environmental, and other social factors directly impact your client. As we address and acknowledge systemic oppression, we as mental health professionals must strive to understand the whole picture.

I think that as mental health professionals it is our responsibility to acknowledge and strive to understand and act upon the uniqueness of the Black life experience. I conclude that there are five main components in reforming the ways we deal with racial disparities within Black suicidology.

1. Provide more inclusive research. As with research in general, the general body of suicide research currently focuses on Whiteness. We need to fund more research tailored to addressing the unique experiences of Black people. We cannot be under the assumption that research impacts people of color similarly to Whites. It is essential to acknowledge and address how cultural/social differences should effect specialized nuances in assessment and treatment methodology.
2. Integrate the community. The survival of Black America is built on community, family structure, and the church. To address suicide, we must meet clients where they are. As CAMS and other effective treatments understand, the individual is the expert on their own experience. People know what they need, and it is our objective to provide them with the tools and terminology for their mental health. For example, many in the Black community may describe suicidal behavior as a manifestation of physical pain (ex., “I’m feeling pain in my stomach” or “my head hurts”) or as a symptom of “strange” behavior (i.e., “my child is being lazy” or “her behavior has been changed”). Mental health professionals not versed in these cultural differences may dismiss, overlook, and misdiagnose their clients.
3. Introduce accessible mental health services. Accessibility refers to providing services in communities of color and services that are affordable. We have discussed the political and social disparities that make accessible mental health services difficult. Accessibility is crucial in the struggle to combat suicide in the Black community.
4. Fund evidence-based treatments that support multicultural therapy. There is limited research on the efficacy of treatments/therapies directed specifically towards Black trauma and suicide. We are not fully adept at understanding what works; however, of the literature available, treatments that are multicultural in nature are most effective with this community. Multicultural treatments integrate a collaborative (client-led) and community-centered approach.
5. Educate and hire more Black mental health providers. Due to a history of medical/mental health racism, there is distrust of the mental health field by Black people.¹¹ Is it fair to expect marginalized people to freely interact with a system they perceive to be oppressive? Instead, it is more beneficial to validate and empathize with our clients, and Black mental health providers are most inherently suited for this. Therefore, we need more Black mental health professionals who more likely possess an acute understanding of the lived experiences of those they are treating.

Next Steps

We are experiencing a shift in the American conscious. As Black Americans continue to deal with stressors of racism, mental health services are a necessity.

What is our responsibility in providing preventive measures and intervention to this community during these extraordinary times? How do we continue to address the growing trend of suicidal behavior among Black youth? What is our responsibility as mental health providers in comprehending the pain of our clients, colleagues, and students?

These questions form the basis of conversations that need to happen in our field, but it starts with acknowledging the reality of systemic racism, the impact of institutionalized marginalization and racial disparities, and the psychological toll it takes to survive.

References:

1. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html
2. Degruy, Joy. (2005). Post traumatic slave syndrome: America’s legacy of enduring injury and healing. Milwaukie, Oregon: Upton Press.
3. https://www.npr.org/templates/story/story.php?storyId=5070636
4. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html
5. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html
6. https://www.pnas.org/content/116/34/16793
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/

While the American public was preparing for the Holiday season, on December 17, 2019 Rep. Bonnie Watson (D-NJ) introduced a bill to U.S. House of Representatives.¹ H.R. 5469, or more commonly known as the “Pursing Equity in Mental Health Act of 2019”, proposes to allocate funding to organizations to address mental health problems among youth of color. This bill specifically pertains to addressing the epidemic of suicide among Black adolescents. In the early months of 2019, an emergency taskforce was formed by the Congressional Black Caucus (CBC), which included research findings that were based on the collective work of Black professionals within numerous fields of expertise.

The report states that suicide is the second leading cause of death among Black adolescents between the ages of 10-19.² The report further states that Black youth disproportionately die by suicide at higher rates than other races/ethnicities. In the last decade, suicide rates for Black adolescents have increased by 73%.³ Contrary to the trends we observe with Black adolescents, current research finds that the suicide rates among Black adults are relatively low in comparison to White counterparts.⁴

Focus of the Pursuing Equity in Mental Health Act

The Pursuing Equity in Mental Health Act of 2019 aims to:

• Increase research on the risk factors, preventative factors, and methodology of suicide within Black youth, and
• Support organizations focused on providing holistic, mental health treatment.

The current literature of research tackling the suicidology of Black adolescents is minimal. An explanation for this conundrum maybe explained by implicit bias within research. The congressional report mentions a study that found that Black researchers are denied funding 10x the rate of White researchers.¹¹ There is a necessity for research and treatment concentrated on the alarming trend of suicide among Black youth.

Based on my research with CAMS (Collaborative Assessment and Management of Suicidality), my research interest aligns with examining suicidal behavior within marginalized individuals (i.e., racial/ethnic, gender, and sexual minorities). In this article, I provide suggestions for the allocation of future research, treatment, and interventions supported by the proposed bill.

But first, why do we observe this alarming trend among Black youth? There are a few risk factors that influence suicide and suicidal behavior among this demographic.

Risk Factors

Trauma & Social Media

The image of a dead or injured Black body flashes across the screen of a personal computer or smartphone.

While scrolling through any of multiple, popular social media sites, a teenager may view dozens of these images. In the age of technology, sharing information across platforms is instant, and unfiltered. Whether accurate or appropriate, the information is available.

This increased exposure to graphic images shared among social media has been shown to increase depression and suicide among adolescents.^5,6 In addition, other psycho-social stressors such as SES, academic opportunities, and systematic marginalization may contribute to suicidal behaviors among black adolescents. ⁷

LGBTQ+ Identity

Individuals who identify as LGBTQ+ experience higher rates of suicidal behavior than other groups. ⁸ Association of this risk factor is often linked to bullying, lack of social acceptance, and heightened occurrence of homelessness. These trends are evident across race/ethnicity and age.

Implicit Bias and Stigma

There is a history of mistrust and bias that permeates the therapeutic relationship between the African American community and a “white” mental health field, stemming from the origins of racist pseudo-science and unethical experimentation.⁹ This is among several reasons Black people are often reluctant to seek mental health support. Another factor that may contribute to an increase in suicidal behavior among Black youth is perceived social stigma. Black adolescents with mental illness experience stigmatization from family, communities, and the larger society.¹⁰

Future Research and Treatment

It is appropriate for allocations of funding to go towards organizations/individuals who are already working with suicidal Black youth. These individuals would already have established rapport within the community and possess advance knowledge on implementing research and providing support. By focusing attention on the existing expertise within this area, we help to lessen the “learning curve” and improve training towards other professionals who have Black clientele.

There are a multitude of established literature on the effectiveness of treatments for suicidal individuals. When working with marginalized groups, it is important to incorporate what works. Why fix what is not broken? Just adapt.

Research has shown that Cognitive Behavioral Therapy (CBT) and Dialectic Behavioral Therapy (DBT) are effective in treating suicidal behaviors.^12,13 Furthermore, research also highlights the effectiveness of CAMS as a therapeutic framework.¹⁴ What makes these treatments work? The use of client-focused therapy and incorporation of holistic methods (e.g., collaborative approach, community engagement, cultural inclusion, etc.) are the foundations that stabilize these interventions.

A CAMS Hypothetical Randomized Control Trial (RCT)

The efficacy of CAMS was initially measured using RCTs. Suicidal clients (whether recruited through outpatient centers, universities, etc.) were split into a treatment as usual (TAU) group in comparison to the CAMS administered group.¹⁵ The Suicide Status Form (SSF) was used as a guide to administer CAMS between the clinician and client. The TAU and CAMS groups were compared after the initial and consecutive sessions.

A similar design could be applied when using an RCT to compare TAU with CAMS in a sample of Black adolescents with a history of suicidal behavior. These participants possibly could be recruited from outpatient centers, counseling centers on college campuses, middle school and high school programs, and through other organizations. Of course, these individuals must meet the requirements of race/ethnicity and a history of suicidal behavior and/or mental health.

Based on previous CAMS RCT research, a hypothetical study is outlined in the flowchart below:

Figure. A flowchart depicting an RCT examining the efficacy of CAMS treatment within a sample of suicidal Black adolescents.

Conclusion

If the Pursuing Equity in Mental Health Act of 2019 is passed into legislation, it will be a milestone for research and treatment of suicidology within Black adolescents. The rising trend of suicide among this group rings warning signs, which call to action experts who provide an interdisciplinary lens to research and treatment.

More extensive and intense research into the risk and preventative factors of suicide among Black youth may begin to tackle a stressor of systematic marginalization. Implementing more efficient mental health treatment specifically designed for this demographic may provide holistic and cost-effective interventions.

As I continue my work as a Black researcher and clinician, I am discovering that integrating a client-focused, community-centered, and culturally inclusive approach into therapy/research is the difference between life and death for our clients.

1. References World Health Organization. Suicide Rates (Per 100,000 Population); World Health Organization: Geneva, Switzerland, 2019.
2. U.S. House of Representatives, Emergency Taskforce on Black Youth Suicide and Mental Health. (2019). Ring the Alarm: The Crisis of Black Youth Suicide in America. Retrieved from https://watsoncoleman.house.gov/uploadedfiles/full_taskforce_report.pdf
3. Runcie, A. (2019, December 17). Proposed legislation attempts to address rising suicide rates among black children. CBS News. Retrieved from https://www.cbsnews.com/news/proposed-legislation-attempts-to-address-rising-suicide-rates-among-black-children-2019-12-17/
4. Leong, F. T. L., Nagayama Hall, G. C., McLoyd, V. C., & Trimble, J. E. (Eds.). (2014). APA handbook of multicultural psychology (Vols 1 & 2). Washington, DC: American Psychological Association.
5. Twenge, J.M., Joiner, T.E., Rogers, M.L., & Martin, G.N. (2017). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among u.s. adolescents after 2010 and links to increased new media screen time. Clinical Psychology Science, 6, 3-17.
6. Feuer, V., & Havens, J. (2017). Teen suicide: Fanning the flames of a public health crisis. Journal of the American Academy of Child & Adolescent Psychiatry, 56, 723-724.
7. Hope, E.C., Hoggard, L.S., & Thomas, A. (2015). Emerging into adulthood in the face of racial discrimination: Physiological, psychological, and sociopolitical consequences for african american youth. Transitional Issues in Psychological Science, 1, 342-351.
8. Pritchard, E.D. (2013). For colored kids who committed suicide, our outrage isn’t enough: Queer youth of color, bullying, and the discursive limits of identity and safety. Harvard Educational Review, 83, 320-345.
9. Washington, H.A. (2006). Medical apartheid: The dark history of medical experimentation on black americans from colonial times to the present. New York, NY: Doubleday.
10. Rose, T., Joe, S., & Lindsey, M. (2011). Perceived stigma and depression among black adolescents in outpatient treatment. Children and Youth Services Review, 33, 161-166.
11. U.S. House of Representatives, Emergency Taskforce on Black Youth Suicide and Mental Health. (2019). Ring the Alarm: The Crisis of Black Youth Suicide in America. Retrieved from https://watsoncoleman.house.gov/uploadedfiles/full_taskforce_report.pdf
12. Stanley, B., Brown, G., Brent, D.A., Wells, K., Poling, K., Curry, J., …Hughes, J. (2009). Cognitive-Behavioral therapy for suicide (cbt-sp): Treatment model, feasibility, and acceptability. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 1005-1013.
13. Ougrin, D., Tranah, T., Stahl, D., Moran, P., & Rosenbaum, A. (2014). Therapeutic interventions for suicide attempts and self-harm in adolescents: Systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 97-107.
14. Jobes, D.A., Moore, M.M., & O’Connor, S.S. (2007). Working with suicidal clients using the collaborative assessment and management of suicidality (cams). Journal of Mental Health Counseling, 29, 283-300.
15. Jobes, D.A., Au, J.S., & Siegelman, A. (2015). Psychological approaches to suicide treatment and prevention. Curr Treat Options Psychiatry, 2, 363-370.