A new statewide initiative seeks to reduce suicides among people of color by expanding outreach, providing more culturally relevant resources, and initiating potentially uncomfortable conversations about race, privilege, and how they affect access to mental health services.
The project, which grew out of the Massachusetts Coalition for Suicide Prevention’s Alliance for Equity, includes a range of actions to engage communities and spur dialogue. It’s focused around a detailed 100-page “tool kit” released last month to help guide mental-health and suicide prevention organizations in rethinking their approaches to communities of color.
“In many cultures, there’s a lot of preconceived ideas about mental health,” Pata Suyemoto, chairwoman of the coalition’s People of Color Caucus and one of the tool kit’s authors, said in a phone interview Friday.
“Certainly in Asian-American culture you don’t speak of it,” said Suyemoto, who is of Japanese ancestry. “It’s an inside-family thing; you don’t go outside and talk to a stranger. . . . That creates a difficulty and barrier for people to get help.”
Statewide, an average of 90 people of color die by suicide each year, according to research by the coalition — that’s about one Massachusetts resident every four days.
Existing services that were designed by and for white people aren’t always effective in reaching communities of color and meeting their needs, according to Jennifer Kelliher, the coalition’s managing director.
The tool kit, Kelliher said, helps providers begin to address racial disparities in access to care and to explore how their internal systems and assumptions can play into those disparities.
“We wanted to provide resources for people in organizations to really start to have these difficult conversations that, in suicide prevention, just aren’t happening,” she said.
That includes discussions among service providers about “ways structurally that our organizations are unwelcoming to people and communities of color,” she said, and how to make their events and services more accessible and comfortable.
The tool kit, she said, isn’t intended to offer “a one-size-fits-all approach. We really encourage people to go through the tool kit and think about what would work best for their organization and go from there.”
Longstanding issues of access to mental health care recently have come to the fore in the African-American community, according to Tanisha Sullivan, president of the NAACP’s Boston branch.
The branch launched a project with McLean Hospital in 2017 — the year the coalition began its work in racial equity — to increase outreach and provide more services to Boston’s black community.
Sullivan said in a phone interview Friday that the coalition’s initiative is “very much in need, and it’s long overdue.”
“We’re happy to hear about these efforts and hope that they will bolster work that’s already done by many organizations,” she said.
Too many people of color with mental illnesses suffer in silence, in part because of cultural messages that say it’s normal to be constantly exhausted or overstressed, that say “you have to quote-unquote ‘push through’ ” hard times, Sullivan said.
“There is a stigma in communities of color around mental health that says going to a therapist or taking medication in connection to a mental health challenge means that you’re weak,” Sullivan said.
Tanoy Burton, founder of DeeDee’s Cry Suicide Prevention and Family Support, said there aren’t enough mental health services available in Boston’s heavily African-American neighborhoods of Roxbury, Dorchester, and Mattapan.
And because of the stigma, she said, some residents aren’t comfortable walking into a clinic and asking for help, so it’s vital to meet people where they are.
“The people I’m trying to reach with DeeDee’s Cry is somebody who may not go to the health care center, but they’ll go to the Easter egg hop,” said Burton, who is also a member of the coalition’s People of Color Caucus and contributed to the tool kit.
Burton said some people of color are skeptical of the medical profession because they have sought care from doctors who dismissed their concerns and denied them tests and treatments they feel they might have received had they been white.
She knows that a person who’s struggling may not offer obvious signs. Burton named DeeDee’s Cry for her older sister, who died by suicide in 1986, at 23.
“I thought she was fine,” Burton recalled. “She had attempts before, but at that point I thought she was fine.”
Along with the tool kit, the initiative includes a push for more funding for culturally competent mental health care, an effort to collect more data, building more partnerships with and providing a platform for communities of color, educating white supporters about the role they can play, and launching a bilingual English/Spanish suicide prevention advertising campaign.
The kind of organizational change the coalition encourages is difficult, Kelliher acknowledged, as its members found when they began examining issues of racial justice in their own work.
“We didn’t start at a perfect place, certainly, and we’re not at a perfect place, because I don’t think that even exists,” she said. “But anyone can do this work.”