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Melissa Harris-Perry: This is The Takeaway. I'm Melissa Harris-Perry. Last week, Academy Award-winning actor Regina King lost her only child to death by suicide. King's son Ian Alexander Jr. was just 26 years old, and was a rising musician and DJ. Since learning of Ian's death I haven't been able to stop thinking of Regina King, and of the very particular agony of losing someone we love dearly to suicide. It's how I lost one of my close friends and colleagues back in 2017, and I still haven't deleted his number from my phone.

Sometimes when something outrageous happens, something that I know he would get, something that we would've laughed about and honestly we would've been kind of snarky about, I'll start to text him and then I remember he's gone. I'm sad and I'm angry, I'm confused, and in that moment I really just want my friend.

As a kid, I didn't know why my mother would tear up at the opening credits of our family's favorite TV show M*A*S*H, but it always happened with the first notes of Johnny Mandel's theme song.

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Only later did I learn that her first husband, my sister's dad, who was a Vietnam veteran, had died by suicide. His life was lost before mine even began, but the echoes of grief shaped my mom, and by extension me. We know that suicide touches many of us and our families, and we asked you about it, and here's some of what you shared.

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Sarandon: Hi. This is Sarandon calling from Brooklyn. The question regarding suicide of a young person struck me hard today. It is the 17th anniversary of my sister's suicide just before she was 16. Even though the pain does dissipate every year, it's still a heavy burden that me and my siblings and my parents have to carry every year, particularly on this day.

It also drove me to a life of serving those in the mental health field. I've been a therapist now for almost 15 years. It does not go away but it does help you appreciate the time that you have and want people to be as happy and as healthy as possible.

Leigh: My name is Leigh and I'm calling from Brooklyn, New York. My family has been affected by the suicide of a young person, unfortunately my cousin's 15-year-old daughter. We really had to consider what the mental health supports were that our entire family needed; the young people, the older people. We had no idea that something was going on that could have led her to suicide, and at this point, we still haven't found out exactly what may have been triggers or the catalyst for her that led her to this endpoint. As a family, right now we're really rallying to support everyone in our family.

Debra: Hello. My name is Debra and I'm calling from Bellevue, Washington. About a year ago we lost a 19-year-old in our family, and this was on top of my mother having lost her husband of 40 years to COVID. It's been a particularly challenging year for the parents of my nephew. He was a wonderful, bright 19-year-old who generally didn't thrive during online learning and going to college. But time has healed all wounds that can be healed. I know for myself I have been extra mindful of being there for my daughter who is 22 and has had depression this year, but thankfully she came and talked to us and we were able to support her.

My best and warmest heart goes out to all those who have had to deal with some variation of this this year.

Melissa Harris-Perry: Suicide is the 10th leading cause of death in the United States. Although overall suicide rates have decreased in the country in 2019 and 2020, suicide rates for Black, Asian American, and Latino young people are trending upward. Suicide rates have historically been higher among white individuals across all age groups, but research shows that in the past 20 years suicide rates among Black children younger than 13 years old is two times higher as compared with white children.

Joining me now is Dr. Michael Lindsey, Executive Director of NYU McSilver Institute for Poverty Policy and Research. Dr. Lindsey, thank you for joining us today.

Dr. Lindsey: Thank you, Melissa, for having me, and I really appreciate being a part of this important conversation.

Melissa Harris-Perry: Important but difficult. I guess part of our team, what we really wanted to do in this moment was to try to understand some of this. To understand and contextualize it. Can you talk us through some of the trends? How has the rate of suicide in the US changed, and maybe particularly for communities of color?

Dr. Lindsey: That's a great question. A couple of years ago in 2019, I along with colleagues published a study that appeared in The Journal of Pediatrics. What we did was look at data from 1991 through-- at that time the latest year for which data were available were 2017. We found that among high school-aged youth in the United States, the Black youth saw a 73% increase in terms of suicide attempts, whereas other racial and ethnic groups saw a decrease in suicide attempts.

I then further looked at the most recent year for which data were available, and that was 2019. Looking at 1991 through 2019, there was 144% increase for Black youth while every other racial and ethnic group saw no significant increase in terms of suicide attempts. When you look at suicide behavior, we recently published a study that was featured in two separate articles in The New York Times, where we found that for Black youth the rate of increase of suicides have been happening increasingly over the span of 2003 through 2017. Again, these are the latest years for which data were available.

What was even further disturbing, Melissa, is that we perceive that suicide is a white phenomena, certainly a male phenomena, but we actually discovered in our study that among adolescence, Black girls saw a large increase in terms of their annual percentage increase in suicide, which was larger than Black boys. There's cause to be concerned even for what's happening with young Black girls.

Melissa Harris-Perry: Just a quick note to our audience. We are talking about suicide and self-harm among young people. I wanted to remind everyone listening that if you are having suicidal thoughts or you know someone who may be, please call the National Suicide Prevention Hotline at 1-800-273-TALK. That's 1-800-273-8255, or you can just text HOME to the Crisis Text Line at 741741.

Dr. Lindsey, let me come to this. On this gender piece that you just gave us and on the years, we're talking here. You're saying in analyzing these data, these are data that lag a little bit the year in which we're living. These aren't COVID-related. This isn't about being pivoted back out to households and having to learn online and not having your social community. This sounds like some kind of grief or anxiety or violence towards the self that is more endemic, more baked in.

Dr. Lindsey: Yes. That's a great point because before COVID, as you indicated, we were seeing these rates of increase, and I contribute those increases to three factors. I want to make a really important point in that research has not been reflective of looking at these trends prospectively in terms of the things that might be impacting kids, young adults in the moment. What I'm mean by that is we need to follow kids over time to really understand the ebbs and flows in their lives, what impacts them emotionally, psychologically, et cetera, to really be definitive.

What's plausible, what I think could be happening, and this is based on research that we've done, is that one, Black folks are typically disconnected from treatment when they need to be in those services, so stigma plays a big role in terms of mental illness stigma as well as service stigma. We don't want to go to a mental health professional because we think that that's something white folks do, or we might be teased or shunned in our community for doing so. I think you have to look at, over the span of the years that is reflective in our data analyses, there's been an increase in Blacks being killed by law enforcement or vigilantes.

There was a study by Jacob Bor from Harvard in 2018 that show if you're Black and you live in the community or in the vicinity of a police killing of a Black person, you're likely to report more days of psychological distress, versus if you're white and you live in proximity to a police killing of a Black person you don't report those days of distress. There's a vicarious experience of trauma related to that situation.

Then thirdly, what we've known for a very long time is that kids, Black and brown kids, are disproportionately suspended or expelled from school. This can start as early as pre-school, and by suspending and expelling those kids from school, they're not connected to behavioral health supports and services. They're penalized for having behavioral health problems that warrant behavioral health attention. By not addressing those problems early on they're allowed to fester and become problematic, obviously leading to the point of self-harm behavior.

Back to the point of where we are with respect to COVID and the pandemic. The data has shown us just a little bit but we need more. That the rate of suicide and engagement and suicide behaviors has continued to increase for Blacks during the pandemic. When we get through this, I think we're going to see that it has had an incredibly caustic effect on the mental health, psychological well-being of Blacks that might lead to even higher rates. These rates don't seem to be trending in a downward trajectory at all.

Melissa Harris-Perry: Michael, as you were talking about the rise in rates among girls and also for Black children, and we know particularly for Black girls, this rate of school pushout being among the highest for any race-gender category. My college advisor and mentor was Dr. Maya Angelou. For everyone familiar with her book I Know Why the Caged Bird Sings, she was the survivor of a brutal childhood sexual assault and became self-mute, chose not to speak for years. That book is very much in those early chapters about her teacher seeing that, noticing that trauma, and drawing her in. Pulling her in, bringing her to literacy, to books, and helping her find her voice.

When I think about what Dr. Monique Morris has taught us about school pushout, we see trauma-related behavior and we push the kids out, we suspend them, I just keep thinking what if Dr. Angelou had been suspended and pushed out? Given that trauma, we very well might have lost her to suicide or to any other set of harms. How do we get our institutions to draw our young people in instead of pushing them out?

Dr. Lindsey: It strikes me that an incredible policy imperative in our society would be that every school should have mental health providers for kids, and it should be proportionate to the number of kids in school. We just can't have, Melissa, one professional in the school. If you have a school of 2,000 kids, the behavioral health professional should be reflective of the number of kids in the school.

That's first and foremost, because what we know-- and again, we've done these analyses, we've mined the data. We know this to be a fact that when kids have access to a behavioral health professional in the school, especially Black kids, they're likely to go to that professional versus being referred to a community-based provider. Also, when that professional is in the school, it can help to socialize the environment to have an appreciation for providing an opportunity for a kid to talk to a professional in lieu of suspending or expelling them from school.

I think in so many ways it's so important for that professional to be in the schools. As part of what we were fighting for in our legislative work, working with the Congressional Black Caucus, developing the report Ring the Alarm: The Crisis of Black Youth Suicide, and then that report being the basis of federal legislation, the Pursuing Equity in Mental Health Act.

That was one of the key points in that bill that we put more resources into providing that behavioral health support in school for kids.

I also think that the way that we look and observe behavior, the way we interpret it, there's all kinds of implicit biases in the frame that we put on the behavior of Black and brown kids that lead them to be suspended or expelled from school to be deemed a behavioral problem. There needs to be a lot of training with teachers and other school personnel on these kinds of implicit biases that tend to have them perceive Black and brown kids in different ways that lead to their suspensions and expulsion. Those are two critical issues with respect to that.

Melissa Harris-Perry: I want to ask about one more issue, and I want to ask it carefully because we know that how we have these conversations publicly can actually have an effect on community experiences of suicidality and attempts. I guess part of what I want to understand is when we start talking about completed acts, how much of that has to do with available deadly means and most specifically firearms? I'm wondering if the uptake is in part related to guns being available. That the suicidal ideation, even an attempt, may have a very different outcome if there isn't a firearm.

Dr. Lindsey: Yes. One subtle implication from the study we did that found that Black girls are trending upward in terms of completed suicides, could be that they are increasingly engaging in more lethal means by which to attempt, and obviously in this case complete suicide. I think that it bears to really monitor, restricting the means by which folks have access to the kinds of weapons or means by which to die by suicide. Even in some of the work that we looked at with respect to attempting suicide, we found that there was a trend upward for Black youth in terms of using increasingly more lethal means.

That's a really, really important policy perspective in all of this, is how do we ensure that kids don't have access to the means by which to attempt suicide and unfortunately die related to the suicide attempt?

Melissa Harris-Perry: Dr. Michael Lindsey is Executive Director of NYU McSilver Institute for Poverty Policy and Research. Thank you so much for your time.

Dr. Lindsey: Thank you. Thank you, again, for having me participate in such an important conversation.

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Maria: Hi. My name is Maria from Daytona. We lost my cousin when we were very young adults and he had young children. It's not been the same for my family. Almost as if you're not supposed to speak ill of the dead, but we don't speak of him at all. I feel like I'm the only one who ever mentions him or brings him up and says, "Oh, he would have loved this," or, "What do you think about this memory?" It's become like this wound that's never healed for us, and I don't know how to heal it. I especially don't know if it ever comes up on his children [unintelligible 00:19:51] which it will, how we talk about it as a family. I don't know, and I wish there was more for those of us left behind.

Scott: This is Scott from Martinez, California. I met a woman from Nova Scotia on Facebook a couple of years back. We started a relationship and I'm probably going to move there next year. One night last year she texted me, told me that her beautiful, talented 14-year-old daughter who left a note saying that she just felt like her life meant nothing and that she was worthless, and I got a text a few minutes later saying that she was gone.

The first year anniversary of that is coming up on February 6th. It's obviously something that impacts my friend's life every day and impacts my life every day because my daughter has cut herself and I worry about her all the time.

Natalie: My name is Natalie calling from Portland, Oregon. Our family was deeply affected by the suicide of my son two weeks before his 21st birthday. He'd been experiencing many personal demons for a few years, so a lot of guilt and blame was spread amongst the family almost like a meteor crashing into our world, and now we no longer speak. I'm not sure if I will ever be able to recover from my son's suicide in such a way that I can engage with my family again authentically, but I have found some peace within myself and I think of him every day. I hope that he has found peace from his demons, wherever he is.

Melissa Harris-Perry: One last time, the number for the National Suicide Prevention Hotline is 1-800-273-8255, or you can text the word HOME to the Crisis Text Line at 741741. Take care of yourselves and each other y'all. It's The Takeaway.

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