Suicide, Stigma, & the African American Community

By Victor Armstrong, VP Behavioral Health of Atrium Health

Victor Armstrong TW: @1of2vics

According to an article published in verywell health (1), Black men in the United States suffer worse health than any other racial group in America and, as a group, have the lowest life expectancy and the highest death rate compared to both men and women of other racial and ethnic groups.

Among the leading statistics of concern are:

  • 44% of black men are considered overweight
  • 24% are obese
  • 40% of black men die prematurely from cardiovascular disease as compared to 21% of white men
  • Black men have a  higher incidence of diabetes and prostate cancer
  • Black men are 5 times more likely to die of HIV/AIDS

For many in the African American community, these would be the “usual suspects.”

Perhaps what many, both in and outside of the African American community, would find alarming though is that suicide has become a major concern. Suicide is currently the third leading cause of death in 15 to 24-year-old African American males. In addition, according to statistics released by American Association of Suicidology, in 2016, there were 2,770 reported African American suicides in the US. Of these, 2,206 were (79.6%) were male.  

Stigma around mental illness continues to be one of the leading taboos in communities of color. Whether it’s depression, anxiety (or worst-case scenario, suicide), there is a longstanding belief in these communities that the impact of these taboo subjects is the problem of “the other.” Though communities of color, because of socioeconomic challenges, may be at higher risk for poor mental health, there is a reluctance to recognize the need for the help of a physician or therapist. It is precisely, this reluctance to reach outside our communities that may be leading to the increase in suicide.

We survived slavery; surely, we can survive sadness or anxiety

For many in the African American community, our story is one of perseverance and resilience. Anything less would be considered spiritual or moral weakness.

The problem, in part, is that we often fail to recognize that mental illness is much more than feeling melancholy or anxious. It is not a sign of weakness, and does not discriminate based on race, creed or color. We fail to recognize mental illness as an “illness,” as we would cancer, diabetes, or high blood pressure.

According to National Alliance on Mental Illness (2) approximately 1 in 5 adults in the U.S. experience mental illness in a given year. This is irrespective of race, creed or color. In addition, according to the US Department of Health & Human Services Office of Minority Health (3), adult Black/African Americans are 20% more likely to report serious psychological distress than adult whites.

Despite this, African Americans are less likely than whites to seek out treatment and more likely to end treatment prematurely. This is due, in part, to long held beliefs related to stigma, openness, and help seeking, which can make African Americans, and other people of color hesitant to reach out.

As advocates fighting to change this narrative, it is incumbent upon us all to determine how to address and overcome this stigma. If we are to address the social determinants that impact the health of communities of color, we must first understand, not only the challenges but the attitudes and norms regarding these challenges.

We must own up to the fact that underserved communities are underserved for a reason

The reason being, healthcare providers haven’t been there. As such, health care providers have yet to earn the trust of the African American community. Bridging that gap starts with listening and seeking to understand not only communities of color, but all underserved or inappropriately served communities, including the LGBTQ and socio-economically disadvantaged communities.

We must also change the narrative from a conversation about mental illness to a conversation about mental wellness. Mental health is after all, more than depression, anxiety, or a bipolar disorder diagnosis. It is your overall emotional and mental wellbeing, including both positive and negative elements.

The African American community is no different than any other community in that everyone wants to live a healthy life; physically, mentally, spiritually and emotionally. The challenge for this community, and healthcare providers alike, is defining what a healthy community looks like through the prism of stigma, and historical adversity, which includes race-based exclusion from health, educational, social and economic resources.

It is only by working together collaboratively as fully engaged partners, that we can overcome these challenges.

References:

  1. Healthy Aging
  2. NAMI Facts
  3. U.S. Department of Health and Human Services Office of Minority Mental Health. (2016). Mental health and African Americans.

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Victor and his TED talk at Natcon 1019

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Victor Armstrong

Victor Armstrong is Passionate about eradicating suicide, stomping out stigma, and eliminating healthcare disparities. He is VP, Behavioral Health with Atrium Health based in Charlotte, NC and Facility Executive of Behavioral Health in Charlotte, NC. Awards and recognition include 2018 Distinguished Alumni Award from East Carolina University School of Social Work, 2012 NAMI NC Mental Health Professional of the Year, 2018 Pride Magazine "Best of the Best", and i2i Center for Integrative Health 2018 Innovation Award for "Whole Person Care". Victor serves as 1st Vice Chair on the Board of Directors of the National Council for Behavioral Health (Secretary/Treasurer), Board of Directors of RI International, American Foundation for Suicide Prevention (AFSP) NC, and i2i Center for Integrative Health, Mecklenburg County Mental Health Task Force and Mecklenburg Provider Council Executive Board.

One thought on “Suicide, Stigma, & the African American Community”

  1. This is so important. Thank you, Victor. I am a retired hospice social worker and I witnessed un- or under-treated depression and anxiety in patients and families of color. Once in hospice care we would try to address that. Sometimes successfully, sometimes we met resistance by the patient or family. It was a delicate balance to gain trust, educate on the importance of emotional comfort and self care, all while respecting autonomy and preserving dignity. It is so critical to comprehensive health care, including end of life care.

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