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Research / Funded grants

2020 Young Investigator

Real-time assessments of suicidality among Black men: a mixed methods approach

5 research findings from this AFSP-funded study.

Research finding · February 2026

Racism and masculine norms can shape suicide risk and help-seeking among Black men

Suicide rates among Black men in the United States have increased over the past several decades, prompting important questions about how risk is shaped and sustained over time. Although overall suicide rates among Black Americans remain lower than those of some other groups, recent increases among Black men highlight the need for closer, more nuanced examination. Suicide risk cannot be understood through mental health symptoms alone, particularly for populations whose lives are shaped by broader social and structural conditions. For many Black men, experiences of racism, social marginalization, and constrained access to mental health care intersect with cultural expectations around masculinity, including norms that emphasize self-reliance and emotional restraint.

With her AFSP-funded grant, Dr. Leslie Adams conducted in-depth interviews with 15 Black adult men in Maryland who had lived experience with suicidal thoughts or behaviors. Using an intersectional framework, Dr. Adams explored how racial identity and masculine norms shaped participants’ emotional lives and help-seeking during periods of crisis. Many men described feeling caught in a double bind: navigating a racialized version of masculinity that emphasized toughness and emotional suppression in a society that often devalues or criminalizes Black male vulnerability. Participants spoke about learning early on that expressing distress was discouraged, whether through family messages, community norms, or broader cultural expectations, leaving them to manage trauma, fear, and despair largely on their own. This ongoing tension contributed to what Dr. Adams describes as gender role stress, a chronic strain that arose when emotional needs conflicted with rigid ideas of what it meant to be a strong Black man. Over time, this stress was linked to isolation, difficulty seeking support, and heightened suicide risk. Importantly, the findings do not suggest that masculinity or racial identity are inherently harmful. Rather, they highlight how systems of racism and narrow gender expectations can constrain emotional expression and access to care. Dr. Adams emphasizes that suicide prevention efforts for Black men must be culturally responsive and gender-informed.

Citation: Adams, L. B., DeVinney, A., Aljuboori, D., Bachman, S., Lateef, H., Habteyesus, A., & Willie, T. C. (2026). Performing Strength: Racialized Masculinity in the Lived Experiences of Black Men at Risk of Suicide. American journal of men's health, 20(1), 15579883251408351. https://doi.org/10.1177/15579883251408351

This finding comes from an AFSP-funded study — see the grant below ↓

Research finding · June 2025

Theories about suicidal thoughts and behaviors apply to Black men and racism

The Interpersonal-Psychological Theory of Suicide (IPTS) is one of the most widely used frameworks for understanding why people consider or attempt suicide. It proposes that suicidal thoughts emerge when people feel like they don’t belong and believe they are a burden to others — and that suicide becomes more likely when they’ve also lost their fear of death. Most research using this theory has focused on White populations, raising questions about how well it applies to other ethnic and racial groups. For Black men in America, racism — whether structural, interpersonal, or internalized — may deeply shape these experiences of isolation, burdensomeness, and despair. Adapting suicide theories to better reflect the lived realities of marginalized groups is essential for equitable and effective suicide prevention efforts.

With her AFSP-funded grant, Dr. Leslie Adams explored how racism intersects with the Interpersonal-Psychological Theory of Suicide (IPTS) in the lives of 15 Black men with histories of suicidal thoughts and behaviors. Through in-depth interviews, participants described experiences of racism that contributed to feelings of social isolation (thwarted belongingness), emotional concealment (perceived burdensomeness), and emotional numbness (suicide capability). Thwarted belongingness emerged as the most prominent construct of the theory, followed by hopelessness, and suicide capability. Racism was experienced as a constant presence — shaping self-perception, safety, and mental health across personal, professional, and community settings. The findings highlight the need to expand suicide theories like IPTS to account for sociocultural and structural realities affecting marginalized populations.

Citation: Adams, L. B., DeVinney, A., Aljuboori, D., Brooks Stephens, J., Watts, T., Cook, B. L., Joe, S., Wilcox, H. C., & Thorpe, R. J., Jr (2025). Investigating the Role of Racism in Black Men's Suicide: Revisiting the Interpersonal-Psychological Theory of Suicide. Archives of suicide research : official journal of the International Academy for Suicide Research, 1–14. Advance online publication. https://doi.org/10.1080/13811118.2025.2462528

This finding comes from an AFSP-funded study — see the grant below ↓

Research finding · July 2024

Smartphone apps can help researchers understand more about suicidal thoughts and behaviors in Black Men

To help prevent suicides, researchers are looking into using smartphone apps that collect real-time data about people's thoughts and feelings throughout the day. This method, known as ecological momentary assessment (EMA), could provide valuable insights. In the United States, the number of suicides among Black men has been rising, but the EMA method hasn’t been well studied with Black men experiencing suicidal thoughts and behaviors (STB).

To examine whether Black men find it acceptable and practical to use a smartphone app for tracking STB, Dr. Leslie Adams recruited 10 Black men aged 18 and older with a history of suicidal thoughts or behaviors. For a week, participants received four daily prompts for short surveys on their mental state, depression, social isolation, and feelings of being a burden, along with nightly surveys on sleep quality and discrimination experiences. An end-of-study interview was also conducted. Most participants found the app acceptable and practical, despite some technical issues and repetitive questions. Some participants reported they felt worse after answering questions about suicide, which has not been found in other studies with different populations. These results indicate that smartphone-based data collection is feasible but more understanding about accounting for cultural differences is needed to improve effectiveness and user experience for Black men.

Citation: Adams, L. B., Watts, T., DeVinney, A., Haroz, E. E., Thrul, J., Stephens, J. B., Campbell, M. N., Antoine, D., Lê Cook, B., Joe, S., & Thorpe, R. J., Jr (2024). Acceptability and Feasibility of a Smartphone-Based Real-Time Assessment of Suicide Among Black Men: Mixed Methods Pilot Study. JMIR formative research, 8, e48992. https://doi.org/10.2196/48992

This finding comes from an AFSP-funded study — see the grant below ↓

Research finding · April 2024

Ethnic identity in Black adolescents may play a role in suicidal thoughts and behaviors

Understanding the role ethnic group identity (i.e., the meaning and significance individuals attribute to their racialized social status) plays in relation to suicidal thoughts and behaviors (STBs) is an understudied area. In populations like Black adolescents, who have seen a recent increase in suicide rates and are underrepresented in research, ethnic identity may be relevant to both understanding risk factors and designing prevention strategies. Key dimensions of ethnic identity that could be significant for Black adolescents include centrality (how much they identify with their Black ethnic group), private regard (their feelings about being Black), and public regard (how positively they perceive others view Black people).

Dr. Leslie Adams examined data from 1,170 African American and Caribbean Black adolescents and identified three patterns of ethnic identity based on these dimensions: Undifferentiated (a cohesive sense of ethnic identity across all dimensions), Low Ethnic Identification (below-average public regard and significantly low centrality and private regard), and Alienated (significantly low scores on all three dimensions). The Undifferentiated group constituted 84% of the sample. In relation to STBs, 8% of the total sample reported suicidal thoughts and behaviors, with 75% of those with ideation and 71% of attempters in the Undifferentiated group. Further research is needed to fully grasp the relationship between ethnic identity and STBs.

Citation: Bernard, D. L., Adams, L. B., Lateef, H. A., Azasu, E., & Joe, S., (2023) Investigating the Role of Suicidality and Ethnic Identity among Black Adolescents: A Latent Profile Analysis. Archives of suicide research : official journal of the International Academy for Suicide Research, 27(4), 1261–1277. https://doi.org/10.1080/13811118.2022.2114868

This finding comes from an AFSP-funded study — see the grant below ↓

Research finding · December 2023

Mental health equity can be achieved in suicide prevention efforts for Black males

Though still low when compared with other groups, the suicide rate among Black males has increased recently and is now the third leading cause of death for Black males aged 10-34, and the 12th leading cause of death for Black males overall in 2021. An emerging mental health equity priority is to enhance the ability for future suicide researchers to fully characterize and intervene on suicide risk factors for this group, but there is a lack of empirical evidence for them to build on. In response to this, Dr. Leslie Adams reviewed the existing literature and wrote a prospective article to outline gaps and offer recommendations to the field for reducing suicide death among Black males.

Dr. Adams identified a gap in sampling strategies for a vast majority of suicide research studies in that they have mainly been conducted among persons of European descent, and that when Black males are included, they are compared to White, middle-class participants. Her recommendations for future efforts included: (1) prioritizing funding for strategic frameworks centered on Black male suicide prevention, (2) identifying innovative solutions to maintain continuity of care for Black males in the health care sector, (3) leveraging crisis support hotlines and safety planning to better serve Black males, and (4) placing community advisors at the forefront of solution-driven suicide prevention research.

Citation: Adams LB, Thorpe RJ Jr. Achieving mental health equity in Black male suicide prevention. Front Public Health. 2023 Mar 30;11:1113222.doi: https://doi.org/10.3389/fpubh.2023.1113222

This finding comes from an AFSP-funded study — see the grant below ↓

The grant behind this work · 2020 Young Investigator

Real-time assessments of suicidality among Black men: a mixed methods approach

Leslie Adams, PhD, MPH

Leslie Adams, Ph.D., MPH

Johns Hopkins Bloomberg School of Public Health

Mentor: Sean Joe, Ph.D., Washington University at St. Louis

Amount awarded
$90,000 Focus area
Psychosocial

Inside the Research

Black men are experiencing increasing rates of suicide in recent years, signaling an emerging public health crisis. Little is known about how racial discrimination functions as a potentially important risk factor for suicide in this population. By integrating digital health strategies, such as ecological momentary assessment (EMA) using smartphones, to assess individuals’ experiences in social environments, including instances of racial discrimination, the goal is greater understanding of experiences that increase Black men’s risk for suicide.

Full scientific abstract

The need for more robust evidence to predict risk and prevent suicide among Black men is critical in light of the rising rates of suicidality in this population. In the past decade, the rates of suicide death among Black men increased by 25.3%, signaling an emerging public health crisis. Yet, there is a fundamental gap in suicide research focused on Black male populations due to limited investigations of race-related (e.g. discrimination) stress as a potentially unique risk factor. Ecological momentary assessment (EMA) methods using smartphones may help bridge our understanding of Black men’s suicidality by assessing time-varying risk factors as they naturally occur. Thus, the goal of this proposed project is to meaningfully integrate digital health strategies using a mixed methods approach to better identify suicide risk heterogeneity among Black men. Specifically, the applicant plans to address the following specific aims: (1) Qualitatively assess proximal, momentary suicide risk factors among Black men, (2) Adapt an existing EMA smartphone application to assess Black men’s suicidality; and (3) Determine feasibility and acceptability of EMA data collection project to identify risk of suicidal ideation among Black men. The proposed AFSP Young Innovator’s Award project enhances the applicants’ prior research in Black men’s mental health disparities and health services research, with an innovative application in digital health technologies to address the critical suicide crises. This training will uniquely position the applicant to enhance risk prediction models using mobile technology with an emphasis on race-salient risk factors and their associations with suicidality. To achieve these research objectives, the applicant will work with a highly skilled mentorship and consultant team (Drs. Sean Joe, Benjamin Lê Cook, and Todd Reid) to build on three areas of expertise relevant to this research agenda: (1) intensive longitudinal design and analysis, (2) Black men’s suicide risk and prevention research, and (3) mixed methods analysis. Results of the proposed research will enhance current understanding of heterogeneous risk in Black male populations and temporal risk factors that place them at enhanced risk of suicidal behavior

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