A Mental Health Crisis and Call to Action: Increasing Trends in Suicide Among Black Women in the United States

To build culturally inclusive mental health systems that lower the barriers to access, it is imperative to first expand mental health education for professionals to deepen their understanding of structural racism, racial discrimination, intergenerational trauma, and historical racial trauma (and their impacts on mental health) (4, 12). This can be accomplished through thoughtful incorporation of the elements of cultural humility (e.g., commitment to lifelong self-evaluation and self-critique, desire to address power imbalances, and developing community partnerships to advocate for change) and structural competence (e.g., understanding how the social determinants of health influence clinical symptoms, problems, and diseases) into mental health curriculum and training programs (4). Another way to lower barriers that Black women experience in getting access to mental health care is to support, partner with, and elevate culturally responsive programs, such as the AAKOMA Project, Therapy for Black Girls, Black Girls Smile, Loveland Foundation, and the Black Emotional and Mental Health Collective, to name a few (13).

As recommended by the 2020 National Academies of Sciences, Engineering, and Medicine report, committed leadership is needed at all levels, not only to support women of color in professional fields, but also to ensure that Black women attain leadership positions in their work settings (14). The landmark Whitehall II study demonstrated an association between social status at work and poor mental health in women (15). Thus, support is needed to remove the barriers that Black women often face in attempting to rise to higher-status positions in the workplace. Indeed, leaders are in the best position to institute pragmatic, evidence-based solutions, and initiate programming to build accessible and culturally inclusive systems that incorporate community input. Targeted mentorship programs, including peer mentorship and professional development opportunities for Black women, are critical for leaders to implement (16). Building capacity for leadership involves intentional sponsorship programs for Black women across all sectors of the workforce. The result will be diversification of senior leadership, building community and support, and establishing Black women as role models for the next generation of leaders.

Research that incorporates input from diverse community members and individuals with lived experiences is imperative. Community-partnered approaches to research and interventions enable sharing of resources and power and increasing trust within marginalized communities (17). Organizations like the American Foundation for Suicide Prevention (AFSP) are eager to fund research that will drive breakthroughs for suicide prevention and partner with researchers using community-based participatory research approaches. Indeed, the topic of diversity, equity, and inclusion is one of AFSP’s research grant priority areas; specifically, “suicide prevention research related to underrepresented communities, health and mental health disparities and inequities, as well as researchers from underrepresented backgrounds proposing research focused on understanding and preventing suicide” (18). In 2019, the National Institute of Mental Health (NIMH) formed the Suicide Research Team (SRT), which leads NIMH’s suicide research activities, including developing suicide-related workshops, webinars, and funding opportunities to address suicide prevention research gaps including “suicide etiology to suicide risk trajectories and risk identification to implementing practical and scalable interventions in a variety of settings that serve at-risk populations” (19). At the same time, early career researchers need research mentorship and protected time to develop competitive proposals, which may be an additional institutional barrier requiring attention.

Transparency in reporting throughout public and private mental health clinics, academic institutions, professional societies, foundations, and governmental funding agencies is critical to tracking outcomes on gender, racial, and ethnic inequities. Aggregating data collection at the intersection of gender, race, and ethnicity—rather than treating these as distinct categories—will mitigate concerns for unblinding and highlight gaps and opportunities for interventions.