Suicides among Black People May Be Vastly Undercounted

Ian Rockett has been researching the epidemiology of suicide for many years. One of the questions the West Virginia University investigator has pondered over many years in the field is why the rate of suicide among black people in the U.S. is recorded as a third of that of white people.

The extent to which medical examiners and coroners have lacked sufficient data to accurately determine causes of death has been shown by Rockett. Black American deaths are 2.3 times more likely than white American deaths to be classified as "unexplained" at the time they occur.

The Centers for Disease Control and Prevention reported a rise in Black suicides earlier this year, but Rockett and his colleagues thought it was an underestimate. He says the numbers probably went up more than shown.

There are a lot of reasons for the lack of good statistics. Black Americans have been left out of the mental health care system. Black people are less likely to get a mental health diagnosis due to the lack of access to medical professionals.

In a study published in the Journal of Racial and Ethnic Health Disparities, researchers found that Black suicides were more likely to be classified as undetermined because coroners and medical examiners have less information to go on. They are more likely to be labeled as undetermined intent when there is less psychological documentation. This leads to suicides.

This conclusion is confirmed by the language that appears in death reports. A study published in the journal Suicide and Life-Threatening Behavior found that the incidence of mental health information in white suicides was higher than in other races. White narratives were more likely to have words such as depression and anxiety in them. Phrases such as "nothing" and "questionable" were common in black narratives. The study found that accounts for Black people contained less words and lesslexical diversity.

Nusrat Rahman, an author of the study and now a senior researcher, says that when a medical examiner writes a narrative for a black person, there is less information recorded. Black people are more likely to die than other people. A study found that a fifth of black Americans who die by suicide leave notes, compared with a third of white Americans.

The stigma of suicide within the Black community may be a factor in the differences. Rahman wants to know why Black death reports are shorter and if racial bias is a motivator. There isn't enough text to conclude that a death was intentional. Without information about mental-health related diagnoses, suicide notes or interviews with family members, medical examiners are less likely to label the cause of death as a suicide.

According to the director of the National Institute on Drug Abuse, there is a higher prevalence of suicide in people who use drugs. The explanation is a combination of both. Drug users are more likely to die by suicide because they don't see a way out.

White people were more likely to be prescribed drugs for pain than black people were. One of the things that protects minority groups early on is discrimination. The landscape changed after the introduction of the narcotic Fentanyl, which is mixed with illegal drugs such as heroin and cocaine. The drug overdose mortality rate increased in black Americans.

Coroners and medical examiners don't always label drug deaths as suicides. The suicides of black people are misclassified as drug overdoses. It is estimated that 15 percent of drug overdoses are likely suicides. The suicide rate for Black Americans would be 67 percent higher than the official rate if 15 percent of the overdose deaths were misclassified.

Drug deaths aren't properly investigated. The spread of coroners and medical examiners was too thin before the Pandemic. Increasing numbers of drug-related and violent deaths have led to an increase in the medical examiner's workload. She says the problem was worsened by the COVID-19 Pandemic. When coroners examine the victim's body, including scars, surgical incisions and medical devices, they now investigate with medical records alone. These records don't exist for black Americans.

White men are more likely to die by suicide than any other group. There is a chance that a Black man's suicidality could be missed. The data impacts a doctor's risk assessment in emergency rooms across the country according to Paul Nestadt.

More resources need to be directed to prevention if the rate of suicides by black people is higher than acknowledged. Lawmakers created a task force to address the issue of high suicide rates in Baltimore County after Nestadt warned of the problem. He says that they took steps to prevent suicides after they realized that Black people were at risk. Black people at risk of suicide will feel less isolated if they understand the real numbers. He says that knowing they are not alone makes them feel like they are not the only ones struggling.

If you or someone you know is having suicidal thoughts, help is available. You can call the National Suicide Prevention Hotline, use the online chat, or text the line.