Suicidal Ideation and Attempts Among Black Youth

Recently, I've come across a number of newspaper articles — for example this one from WTTW — discussing an increasing trend in death by suicide among Black youth and interventions to address the issue. The Youth Risk Behavior Survey (YRBS) asks high school students (grades 9-12), a series of questions on mental health and suicide. I wondered whether the data would show a similar trend and provide further insights. For this analysis, I focus on Black versus White youth only, while noting that there is also major cause for concern among Hispanic and other non-White youth.

Feeling sad or hopeless

There is a question that asks whether a student has felt persistently sad or hopeless:

During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?

Note that this is a very specific question - you must feel so sad and hopeless for two weeks that you stop participating in your own life.

The chart below shows that for almost two decades (from the start of data collection in 1999 till 2017), self-reported feelings of sadness stayed below 30% , and the trend was flat. Then from 2019 onwards we see large increases in feeling sad, jumping from 30% to 40%. The jump and the levels are troubling, however we don't observe any differences between Black and White youth in the feeling of sadness.

Considered attempting suicide

The survey then asks a series of questions about suicide, progressing from general feelings to more specific behaviors. The first asks whether a student has considered it:

During the past 12 months, did you ever seriously consider attempting suicide?

Between 1991 and 2009, the percent of students who seriously considered attempting suicide consistently fell. White students, who had the higher initial rates, saw the steepest declines, falling from 30% to 13%. Black students, who had lower rates, also saw a decline to 13%. But from 2017 onwards, we see sharp increases. In this period, the rates for Black and White youth rise together and are not significantly different. Notably the mean for Black students is always below those for White students.

Made a plan to attempt suicide

The survey then asks whether a student has planned a suicide:

During the past 12 months, did you make a plan about how you would attempt suicide?

The pattern here is similar to what we observed with considering suicide. In the most recent years, both groups have trended upwards, and there is no difference observed between Black and White youth.

Attempted suicide

The picture is dramatically different when the question turns to whether a student attempted suicide:

During the past 12 months, how many times did you actually attempt suicide?

This is the only metric where Black students are consistently above White students. From 2007 to 2021, the confidence intervals don't even overlap, except for one year. In 2023, after over decade of an increasing trend in Black youth, the trendreversed sharply. The key point here, is that Black and White youth consider and plan suicide at similar rates, but Black youth are actually carrying through with the plan at much higher rates. At the peak, the rate for Black youth was 14.5% compared to 9% for White youth, about 60% higher.

What this means: at the 2021 numbers, if you had random groups of 20 Black youth, on average 3 in each group would have attempted suicide; for White youth you would need a group of 34 to see a similar number. Both numbers are troubling, but do you see how much worse it is for Black youth? The positive note is that based on the 2023 numbers that gap has narrowed, and hopefully this trend will continue. But still the numbers are high. Based on the 2023 data, if you had random groups of 20 Black youth, on average 2 of them would have attempted suicide.

Is the pattern the same across gender?

The panels below split attempted suicide by gender.

Black girls are attempting suicide at much higher rates than Black boys, in some years the observed percent for girls is double that of boys. The distribution across the years looks similar, except the rates are shifted up for both Black and White girls.

To facilitate the comparison, the chart below shows Black boys and girls on one chart. The average difference across years is 4.1 percentage points. In relative terms, girls average about 1.6 times the rate of boys.

Given the similarity in the patterns across years for Black boys and girls, it appears that many of the factors impacting them are common. But for girls, something is causing them to attempt suicide at higher rates. In planning interventions for Black youth, the data suggests that the approaches need to be different for girls versus boys.