A new survey of black Americans finds that they have about the same rate of
attempted suicide as the rest of the U.S. population, according to University
of Michigan researchers.
In the past, suicide was seen as a more significant problem for whites, but
apparent differences in suicidal ideation may reflect lack of comprehensive
data, they said.
A national household probability sample found a lifetime prevalence of 11.7
percent for suicidal ideation and 4.1 percent for suicide attempts among
African Americans and Caribbean Americans. About 4.9 percent of all Americans
report attempting suicide.
The highest lifetime prevalence for attempts occurred among Caribbean black
men, followed by African-American women, wrote Sean Joe, M.S.W., Ph.D., and
colleagues in the November 1 Journal of the American Medical
"This kind of study is long overdue," Donna Barnes, Ph.D., a
member of the research faculty and an instructor in the psychiatry department
at Howard University Medical School in Washington, D.C., told Psychiatric
News. "In the past, research had shown low rates of completed
suicide but said little about ideation."
Barnes, a sociologist, is also president of the National Organization for
People of Color Against Suicide, an advocacy group based in Washington, D.C.
In the past, strong ties to the church and the interlocking social fabric
of segregated black neighborhoods may have been protective factors against
suicide among black people, said Barnes.
The University of Michigan researchers used data from the National Survey
of American life, which included 3,570 African Americans, 1,621 blacks of
Caribbean descent, and 891 non-Hispanic whites, aged 18 or older.
Respondents were initially screened for suicidality by being asked if they
had ever seriously thought about committing suicide, if they had attempted
suicide, and if so, how serious the attempt was. They were also asked about
comorbid mental health conditions. Those with any one of 20 DSM-IV
disorders were more than five times as likely to develop ideation and eight
times as likely to attempt suicide, compared with persons with no psychiatric
disorder. Respondents were also asked whether they had seen a psychiatrist,
mental health professional, or a general health provider; used complimentary
or alternative treatments; or had sought help from a religious or nonmedical
About 44 percent of those reporting suicidal ideation and 24 percent of
those who attempted suicide had never sought treatment for mental health
Among the 11.7 percent who reported suicidal ideation, 34.6 percent had
made a suicide plan, and attempts were more likely among women (4.9 percent)
than men (3.1 percent). There were other ethnic and gender differences as
The highest risk of initial onset of suicidal thinking, planning, or
attempts, occurs in the late teens or early 20s. The authors noted that the
risk of a suicide attempt is higher than the risk for making a plan, implying
that unplanned, impulsive attempts are common in that age group. Within three
years of ideation onset, 90 percent of those who attempted suicide had made
their attempt. Statistically, risk of ideation or attempts in the entire
sample were associated with being younger, having a low education level, and
living in the Midwest.
"The prevalence of suicide attempts was highest for Caribbean black
men (7.5 percent, followed by African American women (5.0 percent),"
wrote Joe and colleagues. "Caribbean black women had the lowest
prevalence of attempts (2.7 percent), while attempts were only slightly more
prevalent for African-American men."
Further research will be needed to tease out the relative roles of
ethnicity, place of origin, and immigration experience, along with race, in
establishing risk of suicidality in this population, they said.
"This article from Dr. Joe and colleagues reveals some unexpected
subcultural and gender differences among African Americans and people of
Caribbean descent in rates of suicide attempt and completion," said
Annelle Primm, M.D., M.P.H., APA's director of minority and national affairs."
This underscores the fact that when we characterize psychiatric illness
or outcomes like suicide, we cannot afford to paint people of African descent
or, for that matter, other racial and ethnic groups with a single, broad
brush. We must look at the specificity of within-group differences, because
one size does not fit all."
African Americans and Caribbean Americans come from two fundamentally
different cultural backgrounds, said Barnes. Those born in the United States
have grown up being in a minority, while Caribbean immigrants were born into
societies in which they were in the majority. While that may boost their
confidence in some settings, it is also possible that encounters with
discrimination may cause depression or anxiety.
"Much of this suicidality really comes from untreated depression and
not getting the help you need," said Barnes. Depression in the black
community is still often viewed as a character flaw, not an illness, so people
are less likely to seek help.
"Education is really important," she said. "We have to go
into other community health organizations and help educate people about
"Prevalence of and Risk Factors for Lifetime Suicide Attempts
Among Blacks in the United States" is posted at<http://jama.ama-assn.org/cgi/content/full/296/17/2112>.▪