Social service and health professionals kicked off an annual week dedicated towards suicide prevention. The week celebrated the decrease in suicides among Black males, while also pressing Black families to become more cognizant of warning signs of self harm among Black children between the ages of five and 11.

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A 2015 study from the Centers for Disease Control found that for the first time, the suicide rate of Black children between the ages of five and 11 doubled between 1993 and 2013 – while the rate among Black male teens 15-24 had decreased by 8 percent. The findings, according to the CDC study, were so surprising that researchers spent an extra year re-analyzing data.

“Many families want to keep information to themselves when a family member expresses suicidal ideas, attempts suicide, or dies by suicide. This is why suicide outreach needs to be culturally aware of varying perspectives including environments in which suicide, suicidal self-harm, and mental health conditions tend to be ignored and shamed,” Kimya N. Dennis, a sociologist and criminologist for the American Foundation for Suicide Prevention, said in a news release.

The findings of the CDC study, which appear in the American Medical Association’s Pediatrics journal, suggest questions about what factors might influence increasing suicide rates among young Black children. And while there are few concrete answers, author of the study Jeffery A. Bridge said he believes early exposure to trauma to be a consistent indicator.

“Black children may experience disproportionate exposure to violence and traumatic stress and aggressive school discipline. They are also likely to experience an early onset of puberty, which increases the risk of suicide, most likely owing to the greater liability to depression and impulsive aggression,” Bridge concluded. “Other potential influences include differential changes in social support and religiosity, factors that have traditionally been hypothesized to protect Black youth from suicide but shifted significantly during the two decades in our study.”

Citing cultural differences – even within Black communities – Dennis said the need for outreach and being aggressively vigilant in noting signs of depression among different groups is important. With many young children taught early to “suck it up” or “get over it,” many have grown hesitant of speaking up about sadness, anger, or wanting to harm themselves.

“There are cultures and communities in which suicide is not considered a problem to be shared with people outside the community. There’s a history of medical experts violating Black people’s trust. They’re not eager to relive that and so seeking that care is looked down on in Black communities,” Dennis said. “A lot of families rely more on spirituality to heal. Going to a professional would be a betrayal of faith– regardless of your faith base.” Even though church populations are dwindling, the report says that while fewer Blacks may be attending church, their religious values continue to dictate staying away from psychiatric help.

Carl Tishler, a physician with the Society for Academic Emergency Medicine, said suicidal behavior in young children often screams for intervention that adults, unfortunately, overlook. Warning signs, Tishler notes, include: identification with a depressed or lost parent; shouldering the blame or distracting from family problems such as divorce; self-punishment; escape from an unbearable life situation; attempting to regain control; acting out the covert or overt desire of the parent to be rid of the child; and feelings of hopelessness and anger.

The largest rates of increase in suicide came from White women and White men, whose rates increased by 60 percent and 28 percent, respectively.