Increased Suicide Rate for Blacks Puts Prevention Efforts in Doubt

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School health experts are questioning whether suicide-prevention programs adequately serve black youths in the wake of a federal study showing a sharp rise in suicide rates among African-American adolescents.

Suicide rates among black teenagers, which historically had been low, more than doubled over the past 15 years, according to the study released last month by the Centers for Disease Control and Prevention in Atlanta.

In 1995, the suicide rate for 15- to 19-year-old blacks was 8.1 per 100,000, a 126 percent increase from 1980, when the rate was 3.6 per 100,000, the report says. In comparison, the suicide rate for 15- to 19-year-old whites was 11.1 per 100,000 in 1995, a 19 percent increase from 9.3 per 100,000 in 1980.

Historically, the suicide rate among youths has by far been highest among whites, but in recent decades the gap between black and white teenagers has narrowed significantly, the study found. In 1980, the suicide rate for white children ages 10 to 19 was 157 percent greater than the rate for African-Americans in the same age group. But by 1995, the suicide rate for whites in that age bracket was just 42 percent higher. To complete the study, researchers looked at the death certificates of 31,000 black and white adolescents across the nation who died between 1980 and 1995.

The increase in black adolescents' suicide rate may reflect the stressors associated with a transition into the middle class during the past two decades, said Tonji Durant, an epidemiologist at the CDC's National Center for Injury Prevention and Control and the lead author of the study.

"As [black] people move into the middle class, they may experience some stress and lose social-support systems," Ms. Durant said in an interview last week. They may also be more likely to adopt some of the responses of the larger society to such feelings as hopelessness and depression, she said, and those include suicide.

Missed Diagnosis?

But some educators say the pressures of socioeconomic advancement may be only a small part of the reason behind the increase in self-destructiveness among black youths.

Kevin P. Dwyer, the assistant executive director of the National Association of School Psychologists in Bethesda, Md., said the increased rate has less to do with the pitfalls of upward mobility and more to do with the fact that the mental-health community often misses the signs of depression in black children.

"A tremendous number of African-American kids--and kids from different cultures than Anglo-Saxons--demonstrate their depression by acting out more than Anglo kids do," he said.

Depression is often associated with being withdrawn and sullen, but some depression is manifested by angry, aggressive behavior and inattentiveness, Mr. Dwyer said. "Lots of times we are missing the boat in diagnosing it among the African-American population."

Suicide-prevention experts contend that another explanation may be the limited mental-health services in the black community, as well as a cultural predisposition to eschew assistance for mental-health problems.

Discussion of suicide is taboo in a culture that prides itself on overcoming adversity, said Kenya Napper Bello, the president of Free Mind Generation, an Atlanta-based nonprofit group that works to prevent depression and suicide among blacks.

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