Suicidal Symptoms of Black Teen-agers Differ From Whites

African-American teen-agers contemplating suicide may not receive the help they need because their behavior doesn't fit a model of suicidal teens based primarily on white, middle-class youth, says George Washington University psychology professor Sherry Davis Molock.When a child appears sad and withdrawn, other people may recognize the symptoms as possible indications of depression and, as such, question the child carefully to see if suicide is on his or her mind, said Molock.But when a child behaves defiantly and opposes authority, it's unlikely parents, teachers and possibly even mental health professionals will consider the need to evaluate the possibility of suicide, said Molock."There's evidence that in this (African-American) culture, depression may be expressed in a different way, and that African-American adolescents are more likely to have conduct problems when they're depressed," she said. "We do know that depression occurs in a cultural context."Molock says it is important for people working with teens to recognize these differences among races and explore underlying reasons for a wide spectrum of behaviors, whether they appear to stem from sadness, anger or defiance. An understanding of cultural issues surrounding depression will help professionals treat African-American young people appropriately.The suicide rate among African Americans is increasing dramatically each year, says Molock, citing a 1998 national Centers for Disease Control and Prevention finding that suicide is the leading cause of death among black youth 15 to 24. During the last three decades, suicide rates have increased by 93 percent for black females and by 214 percent for black males. While blacks still commit suicide less frequently than whites, the gap is closing.Also, the actual number of suicides among black adolescents may be higher than official reports indicate, Molock said. Many young people die in instances described as "victim-precipitated homicides." Though the young people technically are killed by another person, they have put themselves in harm's way because they no longer want to live, she explained.For example, she added, a drug-dealer patient of a colleague died of a gunshot wound. One of his friends, another drug dealer, in a state of great distress entered "enemy territory" and fell asleep standing up. He was shot and killed before morning. "This kid was streetwise and savvy. He knew he couldn't do that and expect to live through it," Molock said. "His family agreed that he just didn't want to go on."While this youth probably wouldn't have admitted his suicidal feelings, Molock said, she considers it a form of suicide nonetheless.Molock said to address the needs of such young people, the mental health community must look outside the traditional models of treatment. According to Molock, the black community remembers past abuses and still holds some justified distrust of the white mental health establishment, and this distrust inhibits blacks from seeking treatment. And more important, this establishment may not recognize how a history of oppression and racism influences the experience and needs of African Americans.Black churches, which have long served as providers of social services, have programs available to young people whether or not they belong to the congregation."There's a lot in the community that mental health professionals don't know about," Molock said. Many churches have mentoring programs, midnight basketball and other offerings that provide youth with a place that's safe and where they can feel someone cares for them.One of Molock's African-American clients, a prime candidate for victim- precipitated homicide, found support at a church-based Rites of Passage program, she said. Here he found mentors who taught him about his African-American heritage and helped him research his art form, rap music, and trace its connection to African traditions. He also found a sense of purpose in teaching younger children to create, record and publish their own raps."It made a big difference for him, because he was really interested in how his music connected to Africa," Molock said. "He was taught that you come from a proud line of ancestors and that when you don't live up to your potential you let them down, and that you let down the next generation that won't have your strengths as a resource."It was the first time he really felt connected to the community and the first time he talked to other kids who had feelings similar to his own."Another program offered through a church provides resources primarily for women, but also has been helpful for adolescent girls. SHOUT (Sisters Helping Others Understand Themselves) addresses depression and suicide within a cultural framework, said Michele DeLeaver Balamani, director of Baraka Pastoral Counseling and founder of Dancing On Our Graves Institute for Life Enrichment.Small groups of women or girls, she said, trace their lives, examining their strengths, trials and available support systems, Balamani said. They go through a series of steps that culminate in accepting accountability for addressing issues in healthier ways.Women who have completed the program have started businesses, changed careers and left or changed unhealthy relationships, Balamani said. Although it was started to address depression among church-going women who may feel ashamed to be depressed, viewing it as a sign of less-than-rock-solid faith, it has worked well for younger girls."This is absolutely a model for suicide prevention for African Americans," she added. "It takes their cultural heritage into account. It includes discussion of the history of slavery and looks at oppression as a life issue."

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