Black Men and Suicide: The Stigma of Seeking Help

The line between public and private in the Internet age became blurrier last week following the case of Abraham Biggs, the 19-year-old Floridian who committed suicide by overdosing on prescription medication as a populated chat room watched him via his live webcam. The voyeuristic nature of Biggs's death is disturbing, but it draws attention to the equally disturbing rate of suicide among young black men. According to the American Association of Suicidology, the rate of suicide among black men ages 15-24 increased 83 percent in the '80s to early '90s. While the rate has fallen since, suicide is still the third leading cause of death among young black men, who are seven times as likely to commit suicide as black women. Dr. Sean Joe is an Assistant Professor of Social Work at the University of Michigan who studies suicide and other self-destructive behaviors among young black men. He spoke to NEWSWEEK's Joshua Alston. Excerpts:

NEWSWEEK: What was your initial impression of the Biggs case?
Sean Joe: My first reaction is, obviously, one of sadness. It's a sad situation. But there was also, for me and for many, surprise that this was an African-American male. Also there's the issue of the content provider, their efforts to control or block access to the content, and the shocking nature of the voyeurism involved.

Why were you surprised that he was African-American?
As someone who studies this area, I wasn't surprised in that black men engage in suicidal behavior. I was surprised, though, by the nature of the suicide: both the means, the use of a substance, and the exhibitionist aspect of it. Generally speaking, firearms are most often used in suicides, followed by some type of asphyxiation, and then poisoning. But the rate at which firearms are used is higher among African-Americans. Also there is still a lot of stigma in the black community with mental-health issues and seeking help for them. Because this young man did it in this extremely public way, it's clear that he was not as affected by that stigma. That's what makes this such a unique case. Many families have trouble talking about suicide even after the fact because it's such a major source of stigma. That's not specific to blacks, obviously, but it is very common among black families.

Is there a perception in the black community that suicide is not a problem?
There was an idea in the black community, and to a certain degree in the mental-health community, that blacks didn't engage in suicidal behavior. But there was a large increase in suicides among African-Americans, particularly young black males that began in the late 1980s and rose to its peak in the late 1990s. The current rate of suicide among black males ages 15 to 24 is not higher than that of whites, but it is parallel with it. There are still things we don't yet understand, but there is an increased understanding that, yes, young black males do engage both in suicide and suicidal behaviors that don't lead to death. And in order to help those young men, it's important to understand that they are at risk as well.

Was the increase only among young black men or were there increases in young black women too?
Actually, if we were to look at the most recent data, some of it suggests some decreases in the rates of suicide among black males and an increase in that of black females. But that data doesn't represent a dramatic shift because when you talk about black females and suicide, you're talking less than two cases per 100,000. So any slight increase in the numbers looks like a large jump in the data. Suicide among blacks is still primarily a young and male phenomenon.

In a recent interview, Dr. Alvin Poussaint said that it's possible that the rates of black male suicides could be underestimated because of so-called "victim-precipitated homicide" incidents, wherein someone engages in behavior that will likely get them killed, like provoking a police officer. Do you agree with that?
I would caution any jump to conclusions with situations such as those because it is very difficult to prove the person's intent, particularly in the suicide-by-cop cases, when someone engages with police in a way that causes the police to fire on them. It's hard to figure out in that case whether or not the person meant to die that way. But there could be an underestimation of behaviors among young black men, or men in general, in which they understand that death could be a likely result of that behavior and engage in them anyway. To knowingly engage in behavior that in all likelihood will result in mortal harm, that could be considered suicidal. But I'd caution against suggesting that the data on black male suicide is inaccurate because of those cases, particularly the suicide-by-cop cases, which don't happen very often.

Are black men less likely to seek treatment for mental-health issues?
Yes, for a variety of reasons, including their attitudes toward health-care providers and attitudes toward the efficacy of those services. The bigger challenge is redrawing black masculinity in general, and the ways in which men perceive what it means to seek help for mental-health issues. The degree to which we can reduce the stigma around seeking help, and get men to understand that it isn't weak to seek help for your issues will greatly affect our ability to reach that community.