Social Work Research on African Americans and Suicidal Behavior: A Systematic 25-Year Review
Joe, Sean, Niedermeier, Danielle M., Health and Social Work
Suicide is one of the leading causes of death worldwide; in 2002 alone, approximately 877,000 deaths worldwide were due to suicide (World Health Organization, 2003).The recent Institute of Medicine report, Reducing Suicide: A National Imperative (Goldsmith, Pellmar, Kleinman, & Bunney, 2002), draws attention to the importance of training professionals capable of developing suicide prevention and treatment services. Because approximately 30,000 Americans die from suicide annually, there is increased national attention explicitly focused on the goal of reducing suicide, including suicide among members of racial and ethnic groups. Although African Americans have lower rates of suicide completion than do white Americans, epidemiological research has documented dramatic changes in the rates of suicidal behavior among this population (Centers for Disease Control and Prevention [CDC], 1998). Most disturbing about the trend in suicide among African Americans is that the burden of self-destructive behavior disproportionately affects young male African Americans ages 15 to 24 (CDC, 1998).
There is a common perception that African Americans, particularly adolescents and young adults, do not engage in suicidal behavior at levels comparable to that of white Americans, but recent research disproves this assumption when looking across the life span. Young male African Americans complete suicide at rates comparable to those of white male Americans (Joe & Kaplan, 2001), the rates of firearm suicide have increased more precipitously for this subpopulation (Joe & Kaplan, 2002), and male African Americans are more likely to report engaging in nonfatal suicidal behavior, that is, attempted suicide (Joe & Marcus, 2003). According to the CDC (2004), the prevalence rates of attempted suicides in 2003 were higher among older African American (8.4 percent) and Latino (10.6 percent) high school students than were the rates for their white (6.9 percent) peers. These statistics reflect a dramatic increase in the rates of suicidality among male African Americans. As a result of these and other changes, the Institute of Medicine and the U.S. surgeon general have called for increased research on the suicide risk factors for African Americans and other ethnic minority populations and for empirically tested treatments (Goldsmith et al., 2002; U.S. Public Health Service, 1999).
Social workers are the largest occupational group of mental health professionals (Manderscheid et al., 2004), providing 70 percent of mental health services in the United States (Zlotnik & Solt, 2006), and are well positioned to intervene with suicidal African Americans. However, because of conventional wisdom that African Americans do not commit suicide (Early, 1992), social work clinicians may be unaware of the patterns of suicide or of the risk and protective factors among African Americans. This lack of awareness could cause misinterpretation of self-destructive behaviors among this population. Social work clinicians have a significant role to play in the national strategy to prevent suicide, but little is known about social work's empirical knowledge base for practice in this area or the extent to which social work researchers have focused on this topic.
It is important to review the state of social work knowledge regarding suicide risk factors and effective treatment approaches for African Americans because the largest increase in the professional mental health workforce has been among social workers. During the period 1992 to 1998, there was a 309 percent increase in the number of social workers serving mental health institutions, in contrast to a 119 percent increase among psychiatrists and a 204 percent increase among psychologists (Manderscheid et al., 2004). Most clinical professionals rely on their own profession's literature as their primary, but not only, source of practice knowledge, so it is important to ascertain to what extent social work researchers have contributed to the knowledge base. …