Black People, the Pandemic and Suicide: Is There a Connection?

Though Suicide Prevention Awareness Month (September) has come and gone, suicide is a problem that impacts us year-round. And yes, suicide is a rapidly growing issue for Black people.

Hence, the Defender spoke with several therapists and other professionals who confront this issue almost daily. These include Dr. Xyna Bell, a private practice psychologist and founder of CURE (Coalition of Urban Resource Experts); Dr. Willie Mae Lewis, founder of the Institute for Psychological Services and the Women’s Resource Center for Women and Their Families; Dr. Gloria Batiste-Roberts, head coach of the Texas Southern University Debate Team, adjunct professor of Social Work and CURE member; Jordon Evander Williams, a licensed professional counselor associate and CURE member; and Renae Vania Tomczak, president/CEO of Mental Health America of Greater Houston.

Here, they share their thoughts on how the COVID-19 pandemic has impacted the rate at which Blacks attempt suicide; behaviors that may signal a friend or loved one is contemplating suicide; steps to take to lead to prevention; and more.

SUICIDE: A GROWING BLACK ISSUE

DR. XYNA BELL: I think the pandemic has highlighted depression and anxiety. And given the health inequities, it’s more difficult for us to access care. So, I’m seeing more people seeking out care, and there are not enough resources and the suicidal ideation has increased. As a psychologist, we talk about suicidal ideation, suicidal gestures, suicidal attempts, and I’m getting more people during the pandemic saying they have thoughts of suicide. I don’t know if in my practice, I would say I’ve experienced more suicidal attempts, but you have to take into account that it’s a skewed population. People are seeking help so that they don’t make those gestures or attempts.

DR. WILLIE MAE LEWIS: The rate was declining prior to the pandemic, to some extent. But for African Americans or persons of color, the rate is actually increasing. And it’s sort of not discussed, but it is actually increasing. And if people want to know a little bit more about it, they can go onto many different websites that will tell them, the American Psychological Association, CDC, all of them will let you know that the rate for persons like African Americans Indians, Hispanics, it tends to be increasing.

DR. WILLIE MAE LEWIS: I think the reasons are similar (to other races), but they’re exacerbated. For example, the groups that I’m speaking of, I have some Indians from India; I have many American Indians as patient; I have Hispanics and other cultural groups. Those groups tend to be more communal. In other words, they gain their strength and resilience through the connectedness that they have with each other. So, connecting is very important. The COVID situation actually removed a large degree of the connectivity. And this is why we’re seeing a large influx in the COVID, the deaths, because of the need to be connected and bonded within the family and environment. And when we speak of COVID, we’re not addressing how these things can help those situations.

DR. GLORIA BATISTE-ROBERTS: I would think that Houston would be similar to the national average as well, because the pandemic cost us to be in-house for so long. And so many people who already suffered from depression, who suffered from different forms of mental illness, did not have before, probably during the pandemic to really get the counseling that they needed, to get the support systems that they needed, to get the resources that they needed. And so I think that it probably caused a lot of people to actually commit suicide. But we may not know that that’s what it actually was, suicide. We may think that they had an accident or somebody else did something to them. But they may have indeed precipitated that happening so that they may have created an event that would cause their demise.

JORDON EVANDER WILLIAMS: In general, since 2010, we have seen the suicide rate for all the races jump and increase. And like I said, suicidality is not my bailiwick, so I wouldn’t be able to tell you exactly why that is, but that is a stat that we have that says among all races suicide has gone up. But then we see, and this is according to the U S Department of Health and Human Services that Black suicide rate has now become the second leading cause of death since 2019. And we know 2019 was right before the pandemic hit. So, the data is going to be skewed with a lot of other things. It’s not going to be just because of the pandemic, but surely if it was already the second leading cause of death in 2019, and this is right before the pandemic, then the pandemic has only exacerbated that number.

PANDEMIC IMPACT

DR. XYNA BELL: Yes. I’ve seen more people seeking my step services since the pandemic broke and I’m seeing more people say that they have thoughts of suicide. Some of the (most common themes) appear to be the isolation, not being able to connect in meaningful ways, the social uncertainty, not knowing when (the pandemic is) going to end, do the vaccines work, all the uncertainty that feeds into, “Well, should I do this, shouldn’t I do this, what’s the right way, was the wrong way, which generates more nervousness, more indecisiveness. And sometimes with depression, more irritability.

DR. WILLIE MAE LEWIS: Listen, this is blowing my mind. As much as I read about it, to have young children mutilating themselves at six years old, I’m finding out that they’re alone too much. Parents are out working more than one job. The person who’s caregiving for them is asleep or not available. So, they’re feeling, even at that age, isolated. So, to directly answer your question, there seems to be three groups. It seems to be a school-aged children around the time that they started school, about seven, eight-years-old maybe. And then it seems to be another one, what I’m seeing, around 30. People in the transition years, the transition periods or moving into new environments. Even people 70-something. But they’re reasons for (thoughts of suicide) seem to be more associated with pain and also separation from family. That’s why I’m asking people to really check on your relatives, call them. So be able to connect with family on a regularly schedule basis.

DR. WILLIE MAE LEWIS: I do see more people reaching out for therapy, especially veterans. It’s blowing my mind. So, more people are reaching out because they have reached, could I say a satiation level for emotion and they’re really searching, they’re really looking for groups. They’re really looking for places that they can kind of feel akin to. And talk with some of the veterans’ groups that we work with. I did not know that veterans, over 500,000 people were let out of the service because they expressed suicide. And this is what I’m finding out and working with them. So now they have increased the veterans’ mental health resources, but could you imagine if 20% of the veterans do commit suicide that are in the armed forces? We’re talking about maybe three or four a day. So, now they have instituted a therapy practice for them. And so, yes, I’m also seeing an increase in persons that are requesting services, which is good, which means that the negative thinking about it, the stereotypes are beginning to change somewhat.

JORDON EVANDER WILLIAMS: Well, you know, because a lot of people were together in close, confined quarters, I think a lot of feelings and issues came out that maybe were easily suppressed before the pandemic when we could go on out about our daily lives and get a little more breathing room from ourselves and each other. But when we’re together, we kind of bump up against those edges that we have. So, I think it might have uncovered, well, I know we’ve seen a lot of talk about domestic violence. So, that has been a big thing. And I was thinking to myself, “Wow. This is strange that now that people have to be together, there’s this increased rate of domestic violence, male-to-female and male-to-child. So, it’s like, that’s something to dig into. And then of course I think the feelings of hopelessness that’s just generally always overhanging when we talk about suicidality, there’s always idea of a feeling of hopelessness. And so yes, I think those are two big issues that have come up.

BLACK ISSUES

DR. XYNA BELL: We know that Black people in America experienced different stresses. We have a different history of racialized trauma, enslavement trauma. So, I would say there are different triggers in addition to additional stresses for Black people in America.

DR. GLORIA BATISTE-ROBERTS: When I look back at our history as African Americans, I think about coming up how suicide was not talked about much in the African-American family. We kept it quiet. Mental illness wasn’t really discussed. We knew that there was something wrong with a particular family member, but we kept quiet about it. We didn’t want to talk about it. And I can only imagine now, as I look back and I look at some of those family members, how miserable it must have been for them, Mr. Walker, to be depressed. And now that I’ve spoken with people who suffer from depression and they have explained how bad it is and how even with medication, sometimes it doesn’t help them, I just feel bad. Like, did I miss this in the past? Particularly when I was a young social worker and could have helped somebody in my family who may have also been going through that.

SIGNS

DR. XYNA BELL: When you see people withdrawing, that they’re not as talkative, they don’t interact with the family. They’ve cut off from their friends. You will hear children begin to say things like, “I wonder what it would be like if I wasn’t here” or you’ll see an increase in irritability. When people are getting close to doing something, making gestures and attempting, they will have an, “I don’t care attitude. It doesn’t matter.” So, risk taking, especially with adolescents, may increase. Dr. Rheeda Walker, a psychologist at the University of Houston calls it “low key suicidality.” So, you’ll see more risk-taking in terms of substance abuse or engaging in driving fast or engaging in risky behaviors. So, I think as a parent, watch what changes in your child’s mood that’s out of character. As a spouse, listen to that underlying theme. If someone is saying “I’m tired, I can’t get going,” sometimes that’s code for “I’m depressed. I’m thinking about is this worth at all?” So, part of it has to do with listening. Part of it has to do with observing, knowing your loved one well enough to know when something’s off.

DR. WILLIE MAE LEWIS: Well, some of the signs are being isolated by themselves, a big change in behavior. I pay attention if people are trying to give you a lot of things or if they’re writing their will all of a sudden, cleaning their closets out, changing their dress, and maybe they are grumpy people, but all of a sudden, they’re just so happy or vice versa. That we have to pay attention to because that’s when they’ve really made up their minds. They have really made peace with what they’re going to do. And so, we need to monitor. But those are just some of the symptoms that we need to pay attention to: changes, pay attention to sleeping. If you find a person sleeping all of a sudden more than they usually sleep, that’s a big indicator, particularly change in dress, changing habits, all of those kinds of things.

DR. GLORIA BATISTE-ROBERTS: I work a lot with young people, with students. They carry their feelings on their sleeves. So, with young people, if you see them all the time moping around, looking sad all the time, and not unhappy, not satisfied, just mad with the world, “Nobody likes me,” these are some of the things they’ll say: “Nobody likes me. They don’t want to be with me.” Those are serious signs where that person, you need to get closer to them so that you can say, “You know, I see a lot of times that you don’t look happy. How are you feeling? Tell me how you feel. What does a typical day like for you and can I help to make you feel better?” They’re usually going to tell you that they’re not feeling good. You have to slowly bond with them first, before they will accept your recommendations.

WAYS TO SUPPORT OR HELP PREVENT

DR. XYNA BELL: You have to be comfortable enough to talk about feelings, to put it out there, to ask questions, to be encouraging. That we have to make time for each other in the present. So, it’s not one of those conversations where you have with your cell phone in your hand. It’s that eye-to-eye contact. It’s that actual bringing up the conversation that we’re so uncomfortable talking about. The next step is that if your loved one is saying, “I don’t know what to do,” there are professionals in the community. There are crisis hotlines. I hate to recommend self-help books because sometimes they don’t speak specifically to a person. But get educated. That’s what I’d say. Education is important. And the other thing I talk about is making emotions a part of our everyday conversation. Helping a child to label how they’re feeling when something happens—you’re happy, you’re sad. But introducing those words first, the being comfortable with emotions.

DR. WILLIE MAE LEWIS: If you think that they are thinking about it or whatever, make sure you remove from your home or your kitchen, all knives or things that could hurt them. That’s the very first thing we want to pay attention to. The other is get them involved in some activities together with you or within the home. I have people setting up board games, having competitions within the home. Get them involved in some activities out of the home, but you’re participating. So, I’m really working hard to get parents to participate in activities. And get them in activities like football or something, exercises moving, and even music. There’s something about music and movement and dance that actually helps the person become connected mind, body and spirit

JORDON EVANDER WILLIAMS: Definitely check resources like the Suicide Resource Prevention Center and the US Department of Health and Human Services. They have a list of websites and they go local. Also, CURE, the Coalition of Urban Resource Experts, do that kind of work. We host and “Healing Circles.” So, when people call out to us, they give us the topic. If someone wanted to do a topic on suicide and suicide prevention, then we would respond to that with information and stats, then we would come and we would host the Healing Circle for the group that wanted to deal with that. So, that’s a lovely local resource. Also Houston LISC does a lot of leadership work in the community and they are training leaders to deal with problems such as these in the community.

Q&A With the Mental Health America of Greater Houston

The Defender was able to connect with the Mental Health America of Greater Houston for a Q&A on the topic of Blacks, the Pandemic and Suicide. The organization’s president and CEO, Renae Vania Tomczak, provided answers along with these resources:

• American Foundation for Suicide Prevention: Southeast Texas contact: Cammy Hazim, chazim@asfp.org or 281.757.1394
• Harris Center for Mental Health, Media@TheHarrisCenter.org.
• Mayor’s Challenge to Prevent Suicide Among Service Members, Veterans, and Their Families

DEFENDER: What is the attempted suicide rate for Houston in general, and then broken down by race?

RENAE VANIA TOMCZAK: The resources above may be able to help you with some local numbers; however, in 2021, our national MHA organization analyzed the data collected from 725,949 individuals who took a depression screen (PHQ-9) in the United States in 2020. Of those individuals, over one-third (38 percent, N=273,680) reported experiencing thoughts of suicide or self-harm more than half or nearly every day of the previous two weeks. State-Level Suicide Risk • The three states with the highest number of people reporting frequent suicidal ideation in 2020 were California (N=13,856 reporting thoughts of suicide or self-harm more than half or nearly every day), Texas (N=9,490), and Florida (N=6,130). This information can be found in the attached Suicide and COVID-19 report that was released this past May.

DEFENDER: Did these rates change during the pandemic (Jan 2020 – Present)?

RENAE VANIA TOMCZAK: While the number of U.S. suicides fell last year according to several sources, we must not discount that attempts and death by suicide remains a concerning problem as we have yet to see the full effect of the pandemic on mental health.

This is especially true in our community. Here in the greater Houston region, we have had to deal with trauma as a result of not only the pandemic, but devastating hurricanes, and school shootings, as well as the February 2021 winter storm—and that’s just in the last four years. From our experience in addressing trauma, particularly as related to a disaster, recovery occurs over time and in phases, and reactions can be delayed until the immediate crisis is over.

The events of 2020 had profound impact on those from different racial and ethnic groups. Looking at our MHA national screening data, 30% of Black people seeking support – the highest percentage of any group – cited financial problems as a reason. In addition, 27% of people with mixed race seeking support cited current events. Seventy-four percent of Hispanic/Latina/o/x help-seekers cited loneliness or isolation. Thirty-nine percent of Native American people seeking support cited loss or grief, 63% cited past trauma, and 44% cited relationship problems. And 27% of whites and Hispanic/Latina/o/x people seeking support cited coronavirus.

DEFENDER: Where do economic stresses and lack of access to healthcare rank (if at all) in terms of reasons Blacks give for attempting suicide?

RENAE VANIA TOMCZAK: Those who struggle in meeting their needs for a better quality of life are at a greater risk for mental health challenges that could lead to attempting suicide. Persons dealing with food insecurity, economic risk, unstable housing, lack of access to transportation, lack of access to healthcare, and unsafe neighborhoods face impacts on their overall health. Some experts have said a person’s zip code is a stronger predictor of their potential health outcomes than genetics.

DEFENDER: Are there any signs that a person may be contemplating suicide, and if so, are those signs the same regardless of race?

RENAE VANIA TOMCZAK: Any one of these signs does not necessarily mean the person is considering suicide, but several of these symptoms may signal a need for help:

• Verbal suicide threats such as, “You’d be better off without me.” or “Maybe I won’t be around”
• Expressions of hopelessness and helplessness
• Previous suicide attempts
• Daring or risk-taking behavior
• Personality changes
• Depression
• Giving away prized possessions
• Lack of interest in future plans

DEFENDER: What can parents, spouses and others do to help prevent loved ones and others in their circles from attempting suicide?

RENAE VANIA TOMCZAK: I cannot stress enough how important it is to take threats of suicide seriously. If you think someone is considering suicide, trust your instincts that the person may be in trouble.

• Talk with the person about your concerns. Communication needs to include LISTENING
• Ask direct questions without being judgmental. Determine if the person has a specific plan to carry out the suicide. The more detailed the plan, the greater the risk
• Get professional help, even if the person resists
• Do not leave the person alone
• Do not swear to secrecy
• Do not act shocked or judgmental
• Do not counsel the person yourself

Please note that MHA of Greater Houston offers AS+K About Suicide To Save A Life basic training which provides education on recognizing the warning signs and the initial intervention steps to support a person they think might be at risk for suicide.  

DEFENDER: What organizations, resources, etc. exist for those contemplating suicide… or those dealing with the loss of a loved one via suicide?

·       The Harris Center for Mental Health and IDD

·       24 Hour Crisis Line; 713-970-7000

·       Crisis Intervention Hotline of Houston

Operates free, confidential, anonymous crisis and suicide prevention counseling, 24 hours a day, seven days a week.
832-416-1177   For Teens: 832-416-1199 (CALL)    For Teens: 281-201-4430 (TEXT)

• Disaster Distress Hotline: 1-800-985-5990: Txt 66746 to connect with a LCSW

·       LGBTQIA+ Switchboard Houston; 24 Hour Helpline: 713-529-3211

·       United Way of Greater Houston Helpline, 2-1-1 or 713-957-4357

• National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
• The TrevorLifeline for LGBTQIA+ Youth: 1-866-488-7386⠀
• Crisis Text Line: Text ‘MHA’ to 741741
• Veterans Crisis Line: Dial 1-800-273-8255 and Press 1 to talk to someone or send a text message to 838255 to connect with a VA responder.

DEFENDER: Have you seen the demand for therapists go up during the pandemic?

RENAE VANIA TOMCZAK: In Houston, the State of Texas and nationally, there is a workforce shortage of mental health professionals across the spectrum, and the pandemic has certainly seen demand for services increase. Thus, preventing mental health disorders and getting help at the first warning signs is so important. Encouraging people to visit our website at www.mhahouston.org and taking a mental health screening is a great first step to assessing one’s mental health. The screening is free, anonymous, and confidential. The results can be printed and shared with your doctor to begin the conversation to get yourself on the road to recovery.

Dr. Gloria Batiste-Roberts Shares a Personal Family Tale of Dealing with Suicide

I hail from Louisiana, a little town called New Roads, right outside of Baton Rouge. On the Creole-speaking, paternal side of my family, my grandfather would always exhibit strength. You know, being strong. “We are strong in our family. And we take care of our own and we take care of each other and we help other people, as well.” So, he never talked much about inner feelings, and “How do you feel today? How are you interacting today?”

And I had a cousin who was always quiet when we were coming up, who didn’t say much. I never knew what he was thinking. As an adult, I got to talk to him a little bit more and realized that there were a lot of things that he was bothered about as we were coming up, but he never explained it. I’d never inquired.

Later on, the same cousin ended up in what was reported by the police as a murder-suicide, of a young lady who he had been dating. And nobody in the family thought it was suicide. They said that this other young man who didn’t like my cousin slashed his tires two weeks earlier, and all of these circumstantial incidents that occurred before this murder-suicide allegedly happened.

I felt as a social worker and as a family member, I wasn’t getting the information I needed. So, I decided to go to the police department and I talked with the police chief and I said, “Why did you label this a murder-suicide? Couldn’t this have been a murder; that somebody came in and murdered them both (my cousin and his girlfriend)?”

The police chief explained to me that it happened that there was an expert in murder-suicide who happened to be in Baton Rouge at the time. They contacted him and asked him to investigate. They said that also our family doctor who had been seeing my cousin, and a lot of the family members, I don’t think they knew that, he had the determination to say “Undetermined.” He did not have to put on the death certificate that it was murder-suicide. The family doctor said he had a choice. He said that most physicians want to make sure that they’re positive (before declaring cause of death) because they don’t want any kind of court case to come back on them. And this man had been our doctor, all of us since we were kids. So, he had been treating my cousin, I think he knew something that I did not know.

And my aunt, his mother, was with me as I spoke with him and I asked her directly, I said, “Was it something going on that you think he may have killed himself?” She believed that it was a murder-suicide, but she couldn’t tell the family that. She couldn’t say it, but I could. And there’s still family members today who believed that it wasn’t murder-suicide. And I sincerely believe that the findings were correct. Because I remembered him as a kid growing up and how he never talked much. He never said much. So, you didn’t know what he was thinking at the time. And I never inquired. So, I feel it’s a big thing with our family. But 20 years later, it’s very, very painful. And a lot of family members still cannot talk about it.

So, I realized that in a lot of incidents that happen, like car accidents, that some of those people couldn’t understand. Family members would talk, “I don’t understand why he was going 102 miles an hour at night on a dark street.” Well, you know, this guy was probably depressed. You know, he had broken up with a particular girl and nobody thought that maybe he did it on purpose, that maybe it was a suicidal attempt and not an accident as was reported.

A lot of African American families think that we don’t commit suicide.