WASHINGTON – A decade after she tried to take her life as a college freshman, Victoria Waltz, a gifted child who played the harp, is only beginning to understand how things got so bad.
"It's been a journey and a process from then to now," said Waltz, now 28. "It was a slow build up over time, starting in middle school. I had a lot of challenges trying to fit in and not knowing to talk about how I was really feeling."
Girls started to bully the too tall, too smart girl with acne and glasses, who grew up middle class in Prince George's County, Maryland, one of the wealthiest black counties in the U.S.
Aabrielle Spear remembers the first time she felt truly hopeless. She was in kindergarten and also bullied by classmates.
Spear had suicidal thoughts by third grade, compounded by her parents’ separation, strict teachers and her mother's career and graduate studies, which sometimes kept her from home until late at night.
Now 14 and more than a year from her last suicide attempt, Spear joins Waltz among black teen suicide survivors. Both are speaking out to dispel misconceptions about treatment and to raise awareness.
The African American teen suicide rate was already rising far faster than for white teens. Now these "quaranteens" of color have to deal with the disproportionate COVID-19 death toll in black communities, social isolation and what Washington psychologist Charlayne Hayling-Williams calls the "vicarious trauma" of police violence, which is "particularly deleterious in our weakened conditions" from the pandemic.
A recent 16-year-old black client at Hayling-Willliams' core service agency Community Wellness Ventures threatened to kill himself at home with a knife. He "didn't want to be here anymore," and the compounding stress of the pandemic made it all too much, she said. Fewer than five clients have been hospitalized since the start of the pandemic because of suicidality, but she said "people are underreporting and avoiding hospitals" because of COVID-19.
"Suicide is sort of the tip of an iceberg," said Hayling-Williams. "There are so many challenging conditions leading up to that. Take extreme depression, anxiety and grief and add the increased reports of child abuse, neglect and domestic violence the child is likely witnessing because they would have been at school."
Calling black youth suicide a "crisis," the Congressional Black Caucus issued a report in December showing suicide attempts by black adolescents of both sexes rose 73% from 1991 to 2017. Injuries from attempted suicides increased 122% for black boys during the same period. White youth still die by suicide at a higher rate,but the rate of black youth suicide is increasing faster than any other racial or ethnic group. Black youth under 13 were twice as likely to die by suicide than their white counterparts.
"We must get at the bottom of why,” said Michael Lindsey, executive director of New York University's McSilver Institute for Poverty Policy and Research, who worked on the black caucus' report. "With COVID and the continuous loop of news cycles we've seen in recent weeks around law enforcement and blacks, we not only have to be concerned about vicarious trauma, but the fears it incites for kids."
Rep. Bonnie Watson Coleman, D-N.J., introduced the Pursuing Mental Health Equity Act of 2020 when the Congressional Black Caucus' report came out in December. There was little movement once coronavirus hit. Now the House Appropriations Committee member is citing the dual traumas of coronavirus and urban violence to argue for similar boosts in research and access to mental health treatment for minorities in COVID-19 funding measures.
The numbers and the stories challenge public perception black youth don't die by suicide, a misconception that helped prompt actor Taraji P. Henson to start the Boris Lawrence Henson Foundation. It's named after her father, who had mental health struggles after his Vietnam service.
"We've got to do something; we're losing our kids," said Henson. "Believe a friend when they say they are not in a good head space, believe your friends when they post about suicide. It is very real."
'Amazing they survive'
Spear began chronicling her mental health journey in the fall of 2018 for a class assignment. She wound up with a 7,000-word essay that became testament to the power of treatment. In it, she shared the time her mother found her self-inflicted cuts and took her to the emergency room.
“'No, Mama! Please! I’m begging you! I’ll be fine, Mama!' I started to yell as she grabbed my arm and dragged me downstairs," she wrote. "I fought with all I had inside me, but she kept pulling me as if I were a rag doll. 'I’ll get better, I promise! Don’t take me!'”
Dr. Joycelyn Elders, a pediatrician who was surgeon general under President Bill Clinton, said the life stressors for African American youth, particularly those in low income households, makes it even more “amazing that they survive."
In 2018, Joe Massa, 24, decided to produce a Web "docuseries," My Suicide Story, after he learned childhood friend Kenny Serrano attempted suicide a decade earlier. Massa had no idea and knew little about depression or suicide.
He wanted to tell others' stories so searched Instagram for the hashtag #suicideattemptsurvivor.
"I wasn't considering race as a factor in relation to suicide," said Massa, who lives in West Haven, Connecticut. "I opened it up to anyone willing to share their story."
But other than Serrano, who is Hispanic, everyone was white and straight. He decided he needed diversity, and found Philip Galbert, who is gay. It took more than a year to find Waltz, who will be featured in an upcoming episode.
"Many of the few African American survivors that I could find were either not interested or did not answer," he said.
Melanie Warner, who is African American, also is talking. Early last year, she joined the Facebook group for the nonprofit Suicide Prevention Rocks, started by friends Bill and Dawn York after their son Josh died by suicide. She wanted to support others and promote awareness around suicide prevention. Members of the group paint colorful rocks with inspiring messages to commemorate loved ones who died by suicide.
It wasn’t until her teen daughter was facing depression, anxiety and thoughts of suicide, that Warner turned to the group. Members gave her advice and encouragement on how to connect with her child. "Hearing words of affirmation" and knowing resources were available helped her and her daughter find treatment that worked. The social isolation has actually helped some and with medication and therapy, her daughter is thriving.
"Never feel like you're alone because there is always someone willing to listen," said Warner. "That's what I got from the group."
Stuck, lost and scared
Waltz, who always was "the smart kid," got a nearly full scholarship at 17 to attend Howard University, where she was to study mechanical engineering. Everyone always expected her to go to college and "major in something great," so engineering seemed logical. Except she did terribly her first semester and was placed on academic suspension.
Home over the year-end holidays, she overheard her parents discussing how they couldn't afford Howard without the scholarship. She knew she was in jeopardy of losing it.
"I felt really stuck, really lost and really scared," said Waltz. "I didn’t think I wanted to hurt myself. I wanted to go to sleep and not wake up."
Her mother found her after she attempted suicide with prescription pills in the bathroom. She was rushed to the hospital. Waltz doesn't remember if she was officially diagnosed there with depression, but she was referred to a counselor at Howard – a service she had no idea existed. She went for about two months and then stopped. She wasn't encouraged to go back.
Because of lapses in insurance coverage in the years since, Waltz said she hasn't been able to stay in therapy for more than a four-month stretch. Now with a new job and new insurance, she's been back in therapy for a month.
"We all need therapy," she said. "Why aren’t we talking about it?"
Many African Americans, especially men, may be hesitant to get treatment or take prescription antidepressants, said Dr. Sidney Hankerson, a New York City psychiatrist and researcher. Not only are men resistant to talking about their feelings, there are "racial norms tied to the distrust piece."
Black men have historically been far more likely to be involuntarily hospitalized for mental illness, said Hankerson. The thinking becomes, "Why engage in mental health treatment if I'm going to be brought to the police. It's very, very stigmatizing," he added.
Hankerson, a assistant professor of psychiatry at Columbia University College of Physicians and Surgeons, works with black churches on mental health outreach. Many churches offer their clergy the option to become certified in Mental Health First Aid, a program that certifies people to be "first responders" when they detect mental illness symptoms in others.
When parents fail to talk openly about emotions, as was the case in Waltz's home, teens are more likely internalize their feelings. That's especially common in black families.
"It’s an unfortunate cultural trait," said Waltz. "That's why I wanted to talk."
Even African American therapists can hit walls of mistrust when treating black patients.
Medication isn't the only way to address mental health issues, but Washington psychiatrist Dr. Terry Jarrett said she has to work hard to convince both parents and teens that it's often needed in combination with therapy. She keeps a model of a brain handy to illustrate how it's a part of the body that, like any other, may need treatment.
Washington psychologist Bruce Purnell, who runs the Love More Movement, uses "transformative life coaches" to help young people think positively. By helping young people feel good about themselves and their futures, it “builds a resilience that can be a filter against all of their problems," he said.
Jarrett said she will ask, "Is there a chance for you to create a scenario where you break the cycle so you and your future generations don't have this as a cultural norm?"
A new bully every year
When it came to bullies, Spear said she "would have a new one every year" until fifth grade. Toward the end of sixth grade, Spear said she "started to cut and burn myself.”
In October 2018, when Myrna Spear first noticed the cutting, she took her daughter to the emergency room. Aabrielle was placed on a 72-hour hold and then sent by ambulance to inpatient treatment at the Loma Linda Behavioral Medical Center. That was followed by months of outpatient treatment through the Behavioral Medical Institute's “Shield Program." It provides teens with coping mechanisms to prevent self-injury and promote open communication with parents, who are part of the therapy with other parents and their children.
“Shield was developed by our hospital in response to the number of people coming for in-patient care,” said Glen Scott Jr., director of Loma Linda’s Youth Partial Hospital Program.
The 15-year-old program started after an "epidemic of young people engaging in self-harm,” said Scott. It uses "dialectical behavioral therapy" approach, which uses mindfulness, emotion regulation and other tools.
“Eighty percent of our patients are one and done and there is a very small percentage that need to come back,” Scott said. “Family involvement is a huge success.”
While in treatment for the cutting, Myrna Spear and doctors learned Aabrielle had tried to take her own life. Then, in January 2019, Aabrielle tried a second time to die by suicide despite her mother’s attempts to hide everything sharp. After more in- and out-patient treatment through the Loma Linda behavioral health programs, Spear has been relying upon virtual therapy and Prozac.
After initially dreading the start of high school last fall, Spear has hit her stride. She remains on the honor roll, has consistent friend groups, was in the black student union and played junior varsity basketball but lost her track season to coronavirus.
“I had social anxiety before I got into high school really bad,” said Spear. “I was by myself a lot, but now I want to go out more than just stay home. I want to be around people my age.”
For Myrna Spear, the change in her daughter is remarkable.
“There is really good communication between she and I now; we talk very openly,” she said. “She’s really upbeat and happy. She actually often helps her friends cope with stressful situations based on the strategies she has learned.”
Aabrielle Spear’s advice for those resistant to help: “Accept treatment and let yourself be happier.”
Contributing: Sierra Lewter, Rhea Warren and Davon Harris of the Urban Health Media Project
The National Suicide Prevention Lifeline is available for you any time you need it: 1-800-273-8255
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