Spikes in suicide bolster calls for overdue support

Carl Johnson will never forget his friend Jameel Smith, who took his life at the age of 22. “I like this pic a lot. lol,” Smith said. “I feel it is one of the few that captures me.”
Courtesy of Carl Johnson

The year 2010 feels like a lifetime ago for 33-year-old Carl Johnson, but the death of a close friend makes the year one he’ll never forget. Fresh out of finals week, and a week before his 21st birthday, Johnson got the phone call. His friend of four years, 22-year-old Jameel Smith, was found dead by suicide.

The conversation with Jameel’s roommate left Johnson speechless. “I remember Julius hysterical and crying on the phone, trying to get it out: ‘He’s gone.’”

Looking back, Johnson recalls what might have been warning signs, but while in the thick of finishing his senior year at Morehouse College in Atlanta, the then 20-year-old was just trying to get through himself.

“It wasn’t necessarily that something was wrong with him and then it happened; he would, like, go down these rabbit holes where he didn’t really want to talk to people and just keep to himself,” Johnson said. “Actually, around that time, I’d come over to Julius and Jameel’s apartment and asked about Jameel. He just said, ‘He’s just having one of his moments where he don’t wanna talk to anybody.’”

Condolences and an outpouring of support for Regina King have been flooding social media timelines over the death of her son, Ian Alexander Jr.

Johnson is one of many people who have been reflecting on their own tragedies with the recent suicide death of Regina King’s son, Ian Alexander Jr. Condolences and an outpouring of support for King have been flooding social media timelines around the world since news of her son’s death broke last Friday.

The shock of the 26-year-old musician’s death is an experience that more families and friends are encountering with an increase in suicides among certain segments of Black, Indigenous and Hispanic communities. Concern and awareness are growing with more attention on the risk factors exacerbated by the coronavirus pandemic as well as news reports and social media posts about Alexander and others.

For example, Cheslie Kryst, TV correspondent for “Extra” and 2019 Miss USA, died on Sunday in Manhattan, and Mayor Kevin “Scooter” Ward, 44, of Hyattsville, Maryland, just outside the nation’s capital, died on Tuesday.

Suicides have increased by 3% among Black males of all ages. The spikes are highest among 15 to 24-year-olds at 16% and 25 to 34-year-olds at 12%. These spikes are occurring despite an overall 3% decrease in deaths by suicide since 2019 across the United States, according to the 2021 Rapid Release Report from the National Vital Statistics System.

Conversely, Black women saw an overall 3% decrease across their age groups. However, suicides 10 to 14-year-olds rose 5%, from 26% to 31%, between 2019 and 2020.

“The increases haven’t been just since the start pandemic or 2019; they were happening before,” explains Sally Curtin, author of the report and a health statistician for the National Center of Health Statistics, who has been working to bring awareness to the disparate increases for years.

It’s an issue that Carl Johnson knows all too well with a decade having passed since the last time he saw his friend Jameel Smith alive. Johnson’s eyes sparkle above his mask as he smiles, recalling his favorite memory with him.

“Jameel loved Beyonce, dancing, and fashion,” Johnson said. “I remember one time the fashion show was coming up, and I wanted to audition. We were sitting in his apartment, and he put on ‘Get Me Bodied’ and tried to give me tips. Walk like this. Turn your shoulder here. … He put on his Anna Wintour pout. I said, “Look, I’m trying,” and he just bust out laughing.”

Johnson learned a year after they met that Smith had attempted suicide once before. He knew that he had his “things” or moments and that he had been prescribed medication to help him deal with them. He knew that he always bounced back, too. During the semesters following the attempt, the pills worked until Smith stopped taking them. He said he didn’t feel like himself when he was on them.

“He wasn’t in school that semester, but we still saw each other all the time unless he was down in his moments,” Johnson said. “Now, I think they were his attempt to detach himself –  like his mind from his body. He would really push people away like he was trying to separate everything before he actually did it. I see that now though.”

Behind the Numbers

The U.S. faced a steady increase in overall deaths by suicide for over two decades until 2018. Deaths by suicide increased 35% from 1999 to 2018 before finally showing a 2% decline in 2019, according to the 2021 Rapid Release Report.

Since 2019, deaths by suicide fell 3% overall, but not for certain demographic groups. In addition to the 3% increase among Black males, provisional data for 2020 showed:

  • A 5% increase in suicides among Hispanic males overall, with spikes highest among the 25 to 34-year-old age group at a 16% increase.
  • A 9% increase in suicides among Native American males overall, with consistent increases among their three most impacted age groups (15 to 24, 45 to 54 and 55 to 64).

Before COVID-19, suicide was the second leading cause of death among adults aged 25 to 34 and today remains one of the leading causes of deaths in the United States.

The pandemic has undoubtedly been a cause for concern and a great exacerbator of pre-existing and new mental health conditions, but experts say that the increase in mental health numbers among Black and Brown communities isn’t recent.

In a “Health E-Stats” report that examined suicide rates from 1999-2017, CDC statistician Sally Curtin noted the steady rise even then.

The increase in deaths by suicides among males in Black, Indigenous, and Hispanic communities has garnered growing concern and even alarm among health professionals, community leaders, and government officials alike.

In March 2021, the country’s worsening mental illness and opioid addiction crisis led the Biden administration to agree to provide $2.5 billion in funding to states and territories for treatment and prevention.

More recently, the U.S. General Surgeon, Dr. Vivek Murthy, issued an advisory on Dec. 7, warning of a “youth mental health crisis” and calling for a nationwide push to support mental health treatment and prevention for the country’s children.

“It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place,” Murthy wrote in the 53-page report.

The report came just two months after the American Academy of Pediatrics declared a state of emergency in child and adolescent mental health.

The end of 2019 ushered in unprecedented challenges and uncertainty for the world. Economic fallout, job loss, food insecurity and health inequities hit all-time records across the United States with Black, Indigenous and Hispanic people consistently making up the communities most impacted and falling in the center of the overlapping factors.

survey by the Kaiser Family Foundation (KFF) and The Undefeated showed that Black parents more often than white parents have reported negative impacts of the pandemic on their children’s education, their ability to care for their children and their relationships with family members.

The COVID-19 pandemic brought with it what many health professionals feared would be the perfect storm needed to incubate the severe exacerbation of health conditions, as traditional access to care was swept off its feet. High on that list? Mental health. For Black, Hispanic, Indigenous and low-income communities across the country, it did just that.

‘We Were Hit the Hardest’

For over 20 years, Shane Perrault, Ph.D., has practiced as a psychologist, treating patients across a spectrum of needs. In all his decades of practice, the strain that the pandemic has placed on families and relationships is something no one could have been prepared for and like nothing he’s seen.

“No matter which way you look at it—economically, medically, socially—from all angles, we were hit the hardest, single or married,” Perrault said. “A lot of the time, we don’t have jobs that you can work remotely. We don’t have the resources, like savings, to survive hard times.”

While he specializes in African American couples and relationship therapy, he’s seen spikes in anxiety and depression across his entire practice, particularly among Black men.

In 2019, 1 in 10 U.S. adults reported symptoms of anxiety and or depression. As of January 2021, 4 in 10 did.

A major impact of the pandemic was the impaired ability to connect with each other. Social support is a major buffer to suicide, Perrault said, and contending with the change was a significant pain point for many people.

“We just don’t have access to that – not in the same ways or widely, anyway,” he said of social support. “People have been isolated. Some people are naturally introverted, so that’s fine. Some people are people people, and really need that support. Recalibrating expectations is a must.”

Janice Beal, Ed.D., a psychologist who has been serving the Houston area for more than three decades, said that suicide among African Americans has been overlooked for years.

“I would go so far as to say that it has been [increasing] for the last two to three decades,” explains Beale, as she reflects on trends in her career. “The numbers just weren’t large enough for people to act.”

Beale has worked across the field of psychology, wearing many hats from professor to founder of her own practice. Most recently, she partnered with The Steve Fund, a nonprofit dedicated to supporting the mental health and emotional well-being of young people of color, to create a program that removes barriers to understanding mental health.

She and other experts agree that the suicide crisis is multi-faceted and that it cannot be solved in silos. They say that barriers to prevention are deeply rooted in racial bias that results in underfunded research, lack of diagnosis, and inadequate medical treatment.

From the start of the pandemic, Beale has sought out ways to uplift her community. While partnering with the Houston Health Department, Beale started two suicide crisis hotlines.

As the nation saw a 47% increase in calls to mental health crisis lines, Beale’s were no exception. What stood out among the huge spike in calls to Houston’s suicide helplines was that over half were from Black men.

“Black and Brown people lost the most,” Beale said. “The way we grieve was forced to change. Elderly were dying en masse.”

She proudly recalls one particular night, when her team of five received a call that would go on into the next morning, testing her faith in her work.

“It was about three in the morning when we got the call,” she said. “A young Black man from Chicago called. I later found out that he’d seen one of our posts on social media and reached out. He wanted to give up. He just kept saying he didn’t want to do it anymore, and he was tired.

“We spent the next couple of hours on the phone with him, trading off whenever one of us got fatigued, but we were always there. He didn’t want us to call the police, because he was afraid they’d shoot him or take him to jail. I learned that he’d done time and automatically switched with him. I knew how to talk to him and get him to open up.”

“We stayed on the phone the entire time while he drove himself to the hospital,” Beale continued. “I spoke to his doctors and gave them his information. We did that from right here and would again. We have to be willing to meet people where they are.”

Beale has learned a lot in her career, and the most consistent lesson she’s found is that depression doesn’t discriminate.

“Mental health is an equalizer,” she said. “It doesn’t matter how much money you have, it feels the same. The darkness, the pain, it’s the same whether you’re using Medicaid or paying out of pocket. The difference is access to care.”

“Accessibility has always been an issue,” Beale explained. “It’s hard to get Black men to go to the doctor when they’re sick. It’s even harder when it’s emotional.”

Inequities in Health-Care Access

While connecting with friends and family has been a significant area of struggle for so many, being able to connect and access health care has taken an even larger toll.

“We tend to use the ED (emergency department) for treatment as opposed to the doctor or more consistent care, and sometimes it’s too late.”, says Beale. “And with most people, especially with severe or pre-existing mental health issues, if they have the choice between buying something or seeking help, they’re going to buy something.”

Mental health-care providers across the country say the pandemic has and continues to have a daunting impact on their work and ability to treat patients. For Dr. Danielle Hairston, this inaccessibility has been a major contributor to stressors for struggling patients and surges in admission to the emergency department at Howard University Hospital, where she is the director of Psychiatric Residency.

“At the beginning of the pandemic, around March or April of 2020, it started,” she said. “Normally, we’d get a couple of patients a week who were being treated for suicidal ideations or attempts. … We were seeing multiple a day. Most of them are Black men.”

“It’s not a surprise if you’re actually looking at it,” she says of the increase. “It’s definitely a multifaceted issue.” With overwhelmed hospital systems, COVID-19 restrictions and inadequate access to support, patients are struggling to get the help they need.

At the core, she says, research hasn’t really focused on Black people and youth, which raises questions. “So, is it actually just rising, or are they just now paying attention, or has it been a problem?”

Katherine C. Gilyard, whose goal is to become a physician and public health communicator, specializes in covering health for HUNewsService.com.