Ashawnty Davis attempted to take her own life by hanging in November 2017. Two weeks later, the 10-year-old succumbed to her injuries. Days after Ashawnty’s death, 8-year-old Imani McCray hanged herself in her New Jersey home. And weeks earlier, 11-year-old Rylan Thai Hagan hanged himself from the bunk bed in his family’s Washington, D.C., home.

Though suicides are seldom reported by media, the names of black girls and boys who’ve taken their own lives have taken hold of headlines in recent years. Reported suicide rates tend to be higher for white Americans, particularly among white males, than they are for black Americans. But for black children, those numbers have changed.

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The suicide rate for black youths is almost double (pdf) what it was in the early 1990s, according to the American Medical Association. The study found that suicide rates for black boys increased 95 percent over a two-decade span. In 2016 alone, at least 48 black children between the ages of 6 and 14 took their own lives.

Stressors such as bullying or family turbulence can contribute to mental health challenges in children, along with biological issues such as a family history of mental health disorders. For black children, race must also be considered in evaluating risk factors for depression and mental health challenges.

“It’s impossible to separate race from the rising trends with respect to mental illness,” says Michael A. Lindsey, Ph.D., executive director of the McSilver Institute for Poverty Policy and Research.

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The relationship between race and mental health is nuanced. Numerous studies have linked racism to emotional and psychological trauma. Race is also a key factor in American poverty trends, and with 34 percent of black children under age 18 living below the poverty line, the impact of poverty cannot be ignored.

“Mental health disorders and poverty are inextricably linked,” Lindsey tells The Root. “If you’re living in a poverty-impacted situation, you’re likely to have the resultant mental health issues that relate to the stressors and strains of living in poverty.”

Lindsey and his colleagues also point to poverty as an altering factor in how black adolescents express symptoms of depression. Their work found that black adolescents who experience poverty may express depressive symptoms through relationships with others, lack of sleep, or through anger and explosive behaviors.

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The racial disparity is also glaring when taking a look at treatment rates among black Americans. Stigma surrounding mental health treatment and a lasting mistrust of medical institutions, among other barriers, can play roles in the treatment gap.

“The majority of African Americans who start treatment do not complete treatment,” says Lindsey. “And the majority of people who are struggling with a mental health issue never come into contact with mental health treatment services to begin with.”

There is one institution that could be of great service to black children, however, if provided with adequate resources: schools. But systemic barriers can prevent schools from providing the access to decent mental health services for adolescents.

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Only 29 states require schools to offer some form of counseling services, and with constant budget cuts, counselors are far and few between. In cities like Philadelphia, where black students make up nearly 50 percent of public school students in the district, one counselor could be responsible for up to 1,500 students, if the school has a counselor at all.

“When you refer a kid or their family to school-based services, they’re likely to go to those services rather than a community-based treatment center,” says Lindsey. “Every school should be equipped with a mental health provider or a school counselor that can address those issues, and it’s just really deplorable when that’s not the case.”