Lay My Burden Down: Unraveling Suicide and the Mental Health Crisis among African-Americans - Hardcover

Poussaint, Alvin F.; Alexander, Amy

Hardcover

ISBN 10: 0807009601 ISBN 13: 9780807009604

Publisher: Beacon Pr, 2000

Synopsis

Suicide is now the third leading cause of death among Black males ages 15-19, after homicide and accidents. Although lifestyles in many cases differ dramatically, there have been no studies to determine whether or not the risk factors among African-Americans differ significantly from those of whites. These startling statistics demonstrate a real crisis in America's social landscape, and more specifically in our health care system. Leading child psychologist and co-author of the classic RAISING BLACK CHILDREN, Dr. Alvin F. Poussaint and award-winning journalist Amy Alexander, both of whom have lost siblings to suicide, offer LAY MY BURDEN DOWN as a serious and urgent response to a national medical emergency. Beginning with a concise analysis of the often troubled realtionship between African-Americans and a white medical establishment, Poussaint and Alexander trace the culturual factors that inhibit Blacks from seeking any type of medical treatment, let alone the much stigmatized mental health care, and the lack of a concerted response by white health care professionals. Most importantly, however, they ask us to look again at drug abuse, gang-banging, and the increase in HIV not as issues of poverty, but instead as medical/mehtal health issues--suggesting that they are in fact examples of suicide attempts that have never before been evaluated as such. Intervention is possible, and Poussaint and Alexander cite a number of ways that our national health care system and health care professionals may offer help, while noting the programs and policies that have already begun to make a difference.

About this title

About the Author:

A former consultant for The Cosby Show, Alvin F. Poussaint, M.D., is clinical professor of psychiatry at Judge Baker's Children's Center and Harvard Medical School in Boston, Massachusetts. He lives in Chestnut Hill, Massachusetts. Amy Alexander is a freelance journalist and editor of The Farrakhan Factor. She lives in Cambridge, Massachusetts.

From The New England Journal of Medicine:

Shrouded in misunderstandings, both cultural and medical, the psychological anguish of blacks has been all but invisible throughout most of our nation's history. As late as the 1950s, some articles in medical journals still pronounced blacks too intellectually uncomplicated to suffer from depression and considered suicide an all but unknown problem among blacks. More recently, the pendulum has swung the other way: perusal of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, the psychiatrist's bible, reveals that being black means being at heightened risk for nearly every form of serious mental disorder. But why?

Today clinicians, scholars, and even the news media are closely examining this tapestry of angst. But because of knotty epidemiologic issues, the mental health crisis among blacks is subject to denial, oversimplification, and misinterpretation, especially in its most extreme manifestation -- suicide. A 1998 report from the Centers for Disease Control and Prevention detailed a doubling of the rate of suicide among young black men over just a few decades and highlighted the failure of medical models and popular institutions alike to explain, to predict, or to stem the rate of suicide among blacks.

This book, by Alvin F. Poussaint, M.D., a clinical professor of psychiatry at Harvard Medical School, and journalist Amy Alexander, sets out to change all that. Its title echoes that of a book of slave narratives that referred to suicide as an escape from slavery, and its subtitle declares its intention to unravel the phenomenon -- a daunting task in 194 pages. It succeeds admirably and will be an invaluable addition to the libraries of clinicians, scholars, journalists, and patients.

Lay My Burden Down is a remarkable achievement, and because of its largely accessible language, it will prove valuable to both laypersons and clinicians. The authors have exposed the scourge of suicide among blacks, with a cogent analysis that is emotionally powerful. The book's wrenching prologue sets the stage with vivid portraits of two young black men, each of whom is the brother of one of the coauthors. The early promise of each man is squandered as he spirals downward into depression, drug abuse, brushes with the law, estrangement from his family, and finally, self-inflicted death. One death is an unambiguous suicide -- a leap from a church roof. The other results from the ravages of long-term drug abuse.

The first two chapters describe the suicides of black people from all classes and of various temperaments. Leavened with personal stories, this opening section humanizes the victims, countering the featureless pathologic checklist that characterizes so many medical case histories. Poussaint and Alexander then offer statistics and analyze the growing rates of self-destruction among young blacks. Suicide is now the third leading cause of death among blacks who are 15 to 24 years old -- "a burgeoning that falls far below the radar of national public consciousness." The authors then explain how this could occur.

Drawing on theories from Durkheim, Adler, and Freud, the authors deftly deconstruct the calculus of despair. A typical victim is a young man who has a mental illness but who does not take his medication as prescribed. His experiments with drugs (possibly in an attempt at self-medication) lead him to drug abuse and contact with the criminal-justice system. He becomes estranged from his family and is preoccupied with the "white-dominated system." He tries but fails to free himself from drugs and, after years of struggle, resorts to suicide. Fatalism, erosion of options, and other classic analyses cannot adequately explain this phenomenon.

By tracing rises in suicide to the many factors that disproportionately limit the prospects of young blacks, Poussaint and Alexander reveal how racism helps drive young black men to suicide. The authors clearly make the point that various African-American psychological theories have often failed to gain acceptance in mainstream American thought. Whatever the reason, there is astonishingly little communication among psychiatrists about the effects of race on mental health.

But racism is not the only factor in the suicide of blacks. The book also traces the effect of violence with guns, drugs, weakening of the family structure, and the decline of traditional black social support systems and coping skills. It entertains the troubling possibility that the communal strength that sustained blacks through almost three centuries of slavery and social marginalization is eroding. The book also examines the role of religion and spirituality -- the strong legacy of Christian values that condemn suicide and prize faith and spiritual strength in dealing with a psychological crisis.

Poussaint and Alexander attempt not only to explain but also to redefine suicide among blacks. Their basic premise is that European and American models of mental health and illness are too limited. Many experts have taken European psychiatrists to task for their tendency to equate ethnic differences with abnormalities. Poussaint and Alexander go further, insisting that whole categories of behavior in blacks are unrecognized manifestations of self-destructiveness. They propose that violent racist behavior among both whites and blacks is due to mental illness and deserves to be studied and treated as such. They also characterize drug and alcohol abuse, violence, and even overeating among blacks as unrecognized suicidal behavior, and they discuss "victim-precipitated homicide," in which a mentally ill person induces an authority figure to kill him or her as an indirect form of suicide.

The authors will make you think about suicide in new ways. There is, for example, the fact that as the rate of suicide among black men has skyrocketed, the rate among black women has remained very low, at about 2 percent, for decades. But since the authors repeatedly call earlier data on suicide among blacks "unsophisticated" and refer to the historical reluctance of physicians to classify the deaths of blacks as suicides, might the dramatic 200 percent increase be artificially inflated by the low rates reported earlier?

Lay My Burden Down proposes to do more than alert Americans to the problem of suicide among blacks; it also offers solutions for laypersons, clinicians, and policy makers. These run the gamut from reducing the availability of drugs, alcohol, and firearms to eliminating racist stereotyping and fostering new types of culturally competent mental health care.

Harriet A. Washington
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Beacon Pr
• Publication date: 2000
• ISBN 10: 0807009601
• ISBN 13: 9780807009604
• Binding: Hardcover
• Edition number: 1
• Number of pages: 194