For more than a decade, suicide rates have been increasing in Black children and adolescents, and a new study says the sharpest rise was among young girls.

The study, published Thursday in the Journal of the American Academy of Child and Adolescent Psychiatry, found that more than 1,800 Black children died by suicide between 2003-17, and while most of the deaths were among boys, the gender gap is narrowing. The suicide rate of the girls increased an average 6.6% each year — more than twice the increase for boys, the study said. Nearly 40% of the girls were 12 to 14 years old.

"That was just like, 'Whoa' — what's going on with our Black girls?" said Arielle Sheftall, the study's lead author.

Mortality data show that suicide rates of U.S. teenagers and young adults remain highest in boys, particularly whites, Native Americans and Alaskan Natives. But in recent years, researchers have found that the suicide rate of Black youth is increasing. A study published in May, for example, found the suicide rate of Black males ages 15-24 rose by 47% between 2013-19 — and by 59% for Black females of the same age — but it decreased in white youth.

"I think in the past, suicide — or suicidal behavior — was just thought of as a white thing," said Sheftall, a principal investigator at the Center for Suicide Prevention and Research at the Abigail Wexner Research Institute in Columbus, Ohio. "And that's not the case."

Another recent study said that over the past two decades, the biggest increase in self-reported suicide attempts was among Black adolescents. And in 2018, Sheftall and other researchers revealed that Black children younger than 13 are dying by suicide at nearly twice the rate of white children the same age.

Sheftall and her colleagues have no definitive answers as to why. They pulled data from a state-based surveillance system to better understand the characteristics of those who died and factors that may have led to their deaths.

They found that most of the Black children who died by suicide did not have a current mental health concern, but of those who did, the younger children were far more likely than the older kids to have been diagnosed with attention deficit hyperactivity disorder, or ADHD. The younger kids were also more likely to have experienced problems in school or within their families.

For the girls, a diagnosis of depression or anxiety was more common than for the boys. About 9% of the older girls experienced a relationship crisis before the suicide, and nearly 20% had an argument within 24 hours of their death, suggesting that conflict resolution skills and coping mechanisms might be possible interventions for Black girls, the authors wrote.

The most common methods of suicide among youth are hanging, strangulation and suffocation, which is reflected in this study as well, Sheftall said.

A study limitation was that one of the data sets contained only 35 states and did not include information on potential risk factors like poverty, exposure to trauma, difficulties accessing mental health care, or LGBTQ status and experiences with racism.

"The experiences of the African American child are like none other in the United States," said LaVome Robinson, a clinical psychologist and professor of psychology at DePaul University in Chicago who has studied suicidality in Black adolescents. "We live in a society that marginalizes us — more so probably than any other group — and has historically for years."

In the Black community, suicide as we typically define it remains rare, Dr. Robinson added, but the numbers may be higher than we think because of indirect suicide, she said, where adolescents deliberately put themselves in harm's way.

"The question you should ask is, 'Why is it that their will to live was so weak, or not strong enough, to prohibit them from engaging in those very risky behaviors that could in fact be deadly?'" Dr. Robinson said.

Certain protective factors, like positive messaging and a sense of pride about one's racial and ethnic group, can reduce the effects of racism on mental health, said Kate Keenan,a clinical psychologist at the University of Chicago whose research includes racial disparities in health.

"If experiences with racism and discrimination are increasing at a faster rate than we are increasing protective factors, then that might be related to the reported increase in suicidality among Black youth," she said.

Suicide is rare in young children, but it remains thesecond leading causeof death among all adolescents.

If your child is having thoughts of suicide, call the National Suicide Prevention Lifeline: 1-800-273-8255.