Congress Considering Bills to Curb Black Youth Suicide

First, Rep. Bonnie Watson Coleman (D-N. J.) realized there was a problem through her Facebook page. It was there that she began seeing more and more unsettling reports of Black youth dying by suicide.

So she told her aides, “I can’t fix this, but I can elevate the discussion around it.” Watson Coleman was tapping into a grim reality: The rate of suicide among Black youth has been increasing for years (see Psychiatric News).

In 2018, Watson Coleman convened a congressional hearing to discuss the problem, and last year the U.S. Congressional Black Caucus convened the Emergency Task Force on Black Youth Suicide and Mental Health, of which Watson Coleman is chair. The task force created a working group of Black mental health experts and advocates, and over the course of eight months the task force and working group held hearings, forums, events, and listening sessions to identify not only the causes of the crisis, but also potential solutions.

Altha Stewart, M.D., then the immediate past president of APA, was a member of the working group. “It was an honor to have been invited by the representatives,” she said. “It was a once-in-a-lifetime experience, and I cannot stress enough how meaningful it was.”

The task force released a comprehensive report, titled “Ring the Alarm: The Crisis of Black Youth Suicide in America” in December 2019. In conjunction with the report’s release, Watson Coleman introduced the Pursuing Equity in Mental Health Act of 2019 (HR 5469). In July, Sens. Bob Menendez (D-N.J.), Cory Booker (D-N.J.), and Catherine Cortez Masto (D-Nev.) introduced companion legislation to Watson Coleman’s bill, the Mental Health Equity Act of 2020 (S 4388). APA supports both pieces of legislation.

“If we fundamentally believe that today’s youth are the future of America, then unmet mental health challenges, especially in minority communities, are putting that future at risk,” Menendez said in a news release.

The working group, Stewart explained, offered numerous practical recommendations to address this problem through the report. “But we also laid bare some of the challenges that have impeded our ability to make headway in this area before.”

The Urgency to Learn More

Very few research dollars have been dedicated to investigating mental illness and suicide among Black youth. “Black scientists—those most closely connected to this population—are 10 percentage points less likely than white scientists to be awarded [National Institutes of Health] research funding,” the report stated. “[The] lack of evidence pertaining to Black youth mental health and suicide can be explained in large part by the documented disparities that exist in funding for Black investigators.”

“Oftentimes, researchers focus on what the interest of the funder is,” Stewart said. Yet the working group was composed of individuals dedicated to the interests of the community. “This is a group that has been trying for decades to make the case that funders need to expand the range of research topics they fund, and they’ve never been able to get a significant audience response from the funding community,” she said.

A provision of the House and Senate bills seeks to increase the amount of funding related to Black youth mental health and suicide research through the National Institutes of Health (NIH) and National Institute of Mental Health (NIMH). “We haven’t done enough research in this area, and to me, it is vitally important to understand this problem better,” Watson Coleman said.

The bills would also call on the National Institute on Minority Health and Health Disparities (NIMHD) to research mental and physical health disparities and authorize $650 million to NIMHD annually for five years. Among other provisions, the bills would authorize $20 million annually for five years to community health clinics that predominantly serve people of color. The funds would establish interprofessional teams to provide behavioral health care in primary care settings.

“Our nation must eliminate the pervasive structural inequities that are increasing suicides and mental health disorders among Black youth, including those in economically and socially disadvantaged communities,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., said in a news release. The legislation “can help to promote culturally competent, evidence-based mental health and substance use care while generating research designed to help us all better address existing disparities.”

Pandemic Intensifies Urgency

The challenges that Black youth face are not new, Watson Coleman said. “I think the pandemic has created a greater sense of urgency,” she added, by increasing isolation and depression.

Stewart emphasized how much is not known about how kids and families are faring during the pandemic. How are they coping with virtual learning, the loss of jobs, the loss of human life, and the inability to participate in cultural rituals around grieving and celebrating? “You can’t have funerals, you can’t have weddings, you can’t have gatherings, and these things are known to be supportive psychological activities,” she said.

“We’re fighting the pandemic, we’re fighting to try to retain some of our cultural identity and support system, and then we’re fighting structural racism, discrimination, police brutality, and a whole lot of other societal issues,” she continued.

The task force’s report is not just a roadmap for legislators, Stewart explained. It contains actionable recommendations that anyone—particularly those who work with children or who are in the mental health field—can use to inform their everyday work.

As so much of the country’s attention is focused on voting, Stewart recommended harnessing that momentum and talking to legislators about how they plan to curb the increasing rate of Black youth suicide.

“People who don’t pay attention to keeping kids alive may not be the best people to represent you,” she said. “We can’t educate children who aren’t alive, we can’t house children who aren’t alive. First, you’ve got to keep them alive.” ■