No Longer an Afterthought: Suicide Prevention for Black Youth

Dr. Sonyia C. Richardson is the John A. Tate Early Career Distinguished Fellow for Children in Need and an Assistant Professor in the School of Social Work and Department of Psychiatry at UNC Chapel Hill. She focuses on developing clinical practices and interventions that make life worth living for Black youth populations.

During Minority Mental Health Awareness Month (July), I am reminded that for many of us, suicide prevention is personal and urgent. But I am also reminded that change is possible when we are willing to listen, learn, and move forward together, recognizing that our individual well-being is shaped collectively by the community's well-being.

My journey with suicide prevention did not begin with a career decision, but with a lived understanding that this kind of pain matters and that too many people carry it alone.

Over time, that understanding became a calling which led me to my role as a suicide researcher and clinician. I found myself drawn to the question of how we can prevent suicide in ways that are not only clinically sound but also culturally meaningful and humane. I wanted to know what it would look like to build prevention efforts that truly see Black youth, honor their families, and respond to the realities of their lives. I also wanted to see these interventions respond to the intersecting identities of diverse youth. That question has stayed with me and continues to guide my work.

What I have learned is that Black youth are often asked to navigate systems that were not built with them in mind. They are expected to trust services that may not reflect their experiences. They are expected to open up in spaces that may not feel safe. And when they do seek help, the care they receive is not always enough to meet the complexity of what they are carrying. That reality is part of why this work matters so much to me.

As one Black male adolescent shared during a focus group with Black youth who were helping to co-create a suicide prevention intervention, “Why do you all even care about us? No one cares about us as Black youth.” That question stayed with me. It captured something deeper than frustration and reflected the pain of being unseen, unheard, and unsure whether help is truly meant for them. It is a reminder that trust must be developed.

In one of our suicide research team studies, we found that Black youth receiving suicide care coordination used mental health and medication management services at lower rates than White youth. On paper, that may sound like a disparity. In real life, it reflects something much deeper: the presence of barriers that do not disappear simply because a service exists. It tells us that access alone is not the same as connection, and that connection is not the same as care that feels trustworthy, relevant, and culturally responsive.

That lesson has shaped the way I approach research. I have come to believe that the best suicide prevention work begins by listening, really listening, to the people most affected. Through community-engaged research, focus groups, and intervention adaptation (which is the process of tailoring an intervention to a specific population), my team and I have learned from Black youth, caregivers, and community partners about what support actually needs to look like. For instance, Black youth and caregivers have requested that our suicide interventions don’t use potentially stigmatizing language like “having a desire to kill yourself” (which may reinforce stereotypes of Black people being violent) and instead use language such as “felt like giving up on life” or “I just can’t do this anymore.” They also told us they want to learn about how to be mentally and emotionally healthy as a Black person in an oppressive society. They have told us that trust matters. That youth voice matters. That autonomy matters. That racial socialization, faith, family, and trusted community networks matter. These are not small details. They are the foundation of meaningful prevention.

I am especially moved by the role of hope in this work. Black youth have shared with us that hope is not abstract. It is something they actively hold onto. It is tied to faith, agency, and the belief that life can still hold possibility. At the same time, caregivers and adults have named the barriers that make hope harder to sustain, including the systems, the inequities, and the exhaustion of trying to find care that fits. Both truths matter. And both truths remind me that suicide prevention must do more than reduce risk. It must help create conditions where hope can survive. We have documented these findings in the research.

That is what I want my work to do. I want it to help develop research and interventions where Black youth are not treated as an afterthought, where their pain is not minimized, and where their strengths are not overlooked. I want prevention to be culturally inclusive, not an add-on but a basic expectation. I want communities to be recognized not only as people in need of services, but as sources of wisdom, resilience, and knowledge.

I carry my own story into this work, but I do not carry it alone. I carry the stories of families, youth, and communities who have trusted me enough to keep learning. I carry the responsibility for ensuring their experiences shape the science, practice, and policies that follow. That is what keeps me committed. That is what keeps me hopeful.

For Minority Mental Health Awareness Month, I hope the message is clear. Suicide prevention must include all youth, and it must be culturally responsive if it is truly going to save lives. We cannot afford for racially and ethnically diverse youth to be an afterthought.

Dr. Sonyia Richardson, featured with members of the North Carolina Black Youth Advisory Board, presenting at the UNC clinical lecture series.

Dr. Sonyia Richardson and Victor Armstrong, featured with members of the North Carolina Black Youth Advisory Board, at a Let’s Save Lives training at North Carolina Central University.