OPINION: Preventing Suicide and Caring For Black Men’s Mental Health The Right Way

The tragic loss of Regina King’s son, Ian Alexander Jr., is a stark reminder of how important it is to understand what is behind the disproportionate number of Black men who choose to end their lives.

Recently, actress and director Regina King’s son, Ian Alexander Jr., only 26 years old, died by suicide. While the circumstances around what took him to that point remain unclear, it is but another sobering reminder that young Black men are dying by suicide at rates that are increasing faster than any other racial/ethnic group in America.

In 2020, suicide rates decreased for some racial/ethnic groups, but in Black youth, suicide rates continued to increase—even in very young children. Research from the Association for Psychological Science shows that Black boys as young as 5 are twice as likely to die by suicide compared to their white counterparts,, and according to a recent study in Journal of American Academy of Child and Adolescent Psychiatry, from 2003 to 2017, the suicide rate of Black boys as young as 5, increased every year.

And is it really any wonder? According to other research from the APS, Black boys as young as 5 are more likely to be seen as aggressive, and data from the U.S. Department of Education shows Black boys are significantly more likely to be suspended than white boys for the same behaviors, which feeds into the school to prison pipeline. Black boys grow up to become Black men, and must deal with the stress of racism, which can cause depressive symptoms, thereby contributing to suicide risk.

It is known that Black men have multiple barriers to accessing mental healthcare. What is talked about much less is what occurs when Black men do access the mental health system. We need to start talking about the racism exhibited by mental health providers, and the ways in which the mental healthcare system can do better for Black men.

As a Black psychiatrist, I firmly believe that mental illnesses are just as important as physical illnesses. But I have also personally observed, over and over again, the ways in which the mental health system alienates Black men, and I firmly believe that plays a role in the effectiveness of their treatment.

Mental health treatments are for the most part, not tailored to Black men, or Black people for that matter. Suicide predictor algorithms show poor sensitivity for Black populations, and treatment is largely delivered by white mental health professionals, who do not have the lived experience or training to help Black men navigate racist spaces, where they are commonly made to feel that they must work harder than their white counterparts.

If we want to improve the mental health of Black men, and reduce rising suicide rates, in addition to encouraging Black men to seek mental health help, we need to also ensure that when Black men do seek care, that they are adequately helped. We need to hold mental health providers, like psychiatrists and therapists, accountable for treating Black men with respect and dignity, instead of arrogance and disdain.

Once, I asked one of my young Black male patients what he thought about therapy. “I hate therapy. I don’t need another therapist who looks like Judge Judy looking down on me. Can’t you be my therapist instead?”

I have heard this countless times, but as a Black person, I make up less than 2% of psychiatrists and less than 4% of psychologists are Black. The mental health system can do better for Black men, and that starts by investment in the pipeline of Black mental health professionals, like psychiatrists and psychologists. We need to invest in having a mental health workforce that racially reflects our patient population and continue to support the existing mental health programs that are tailored for Black men and the Black community at large, such as the Boris Lawrence Henson Foundation, and Therapy for Black Men, among others.

But it goes deeper than that.

I firmly believe the reason why Black patients frequently request that I be their psychiatrist is because I incorporate the patient’s experiences with racism and racial identity into my work with them, using my acquired knowledge and lived experience. I am constantly educating myself on the historical and current underpinnings of racism and how they affect Black Americans, something that is not a part of standardized medical education, but it should be.

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Additionally, non-Black mental health professionals need to be proactively trained in how to monitor their own racist behaviors, so that they are not alienating Black male patients when they do seek help. And if all else fails, Black men should be routinely advised how to reflect on their mental healthcare experience, as outlined by National Alliance on Mental Illness, and empowered to change providers if needed. Perhaps a Black man is not getting better because his therapist is not treating him well, not because mental healthcare doesn’t work—because it does.

But at any rate, it is high time for the mental health system to truly address suicide in Black men. Their lives depend on it.

Dr. Amanda Calhoun is an Adult/Child Psychiatry Resident at Yale Child Study Center/Yale School of Medicine. She is also a Public Voices Fellow of the OpEd Project at Yale University.

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