New Data on Suicidal Behaviors in Black Americans May Guide Interventions
• Science Update
The prevalence of attempted suicide among black Americans is higher than previously reported, but near the levels reported for the general population. However, certain risk factors for suicide in this group differ from the general U.S. population. The results of a nationally representative household survey called the National Survey of American Life (NSAL), funded by NIMH, were published in the November 1, 2006 issue of the Journal of the American Medical Association.
Suicide is the 11th leading cause of death in the United States, with older white men having the highest suicide rate. Significant increases since the mid-1980s in reported suicide and suicidal thoughts and actions among young blacks have highlighted an emerging and serious health issue. Sean Joe, M.S.W., Ph.D., of the University of Michigan, Ann Arbor and colleagues sought to identify the prevalence of suicidal thinking and attempts among black Americans in order to document the burden and advance development of interventions to prevent suicide in this population.
In reviewing data from 5,181 African Americans and Caribbean Americans ages 18 and older, the researchers found that the lifetime estimate for attempted suicide among African Americans and Caribbean Americans is 4.1 percent, higher than the 2.3 percent1 reported previously, but similar to the 4.6 percent2 for the general population.* In addition to prevalence, the researchers assessed risk factors for suicidal thoughts (ideation), plans, and attempts among black Americans. The presence of an anxiety disorder was the strongest risk factor compared with other mental or substance use disorders, which differs from other studies in the general population where depression is often the strongest predictor. Caribbean black men and young people aged 15-24 years had the highest prevalence of attempted suicide and the risk of suicide attempts was highest during the first year following suicidal ideation. Marital status, often closely linked to suicidal behavior, was not a significant predictor of suicide planning or attempts.
Of special importance to clinicians, the researchers found that the majority of blacks who attempted suicide sought treatment from a health professional. The researchers suggested that physicians and mental health professionals should be "skilled in talking with black patients about the risks for suicide, providing interventions for those at imminent risk for suicidal behavior, and referring patients for expert diagnosis and treatment." Further research on the transition from planning to attempts may provide better methods of screening for and preventing suicide in at-risk individuals.
Joe S, Baser RE, Breeden G, Neighbors HW, Jackson JS. Prevalence of and Risk Factors for Lifetime Suicide Attempts Among Blacks in the United States . JAMA. 2006 Nov 1;296(17):2112-2123.
1 Moscicki EK, O'Carroll P, Rae DS, Locke BZ, Roy A, Regier DA. Suicide attempts in the Epidemiologic Catchment Area Study. Yale J Biol Med. 1988 May-Jun;61(3):259-68.
2 Kessler RC, Borges G, Walters EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry. 1999 Jul;56(7):617-26.