OhOn September 25, 2023, the Biden-Harris administration announced that it would invest 200 million dollars in the youth mental health crisis. Since youth mental health was declared a national priority emergency in 2021, several experts, including the United States General surgeoncited, among others, social media and the COVID-19 pandemic as major contributing factors.
But what hasn’t been talked about to the same extent is how anti-Black racism is fueling the youth mental health crisis. Racism has a crucial impact on the mental health of Black youth, and the current mental health system is not equipped to address it.
As a child and adolescent psychiatrist, I have witnessed the depressive, even suicidal, effects of racism on black youth. The kindergarten student who was sad and withdrawn for weeks after her white classmates said her skin was too dark to play with them. The fourth grader who said she wanted to die because her white neighbors told her her black skin was ugly. The wealthy high school student who was hospitalized after a suicide attempt because she was ostracized by her peers and excessively punished by teachers at her predominantly white prep school. Each time, I was the only mental health clinician involved who cited the crucial contribution of anti-Black racism in his mental health assessment. Interpersonal experiences of anti-Black racism play an important role in the mental health of Black youth and the current youth mental health crisis, but they are largely left out of discussions in the mental health field.
The truth is that the effects of racism on the mental health of Black Americans begin before birth. The stress of racism experienced by black mothers has been linked to low birth weight babies, which puts these children in greatest risk to develop depression and other mental health problems in children. Prenatal anti-Black racism can also have other lingering effects. Maternal reports of racism affect the socio-emotional development of Black children during their first year of life, with links to negative emotionality.
Yet another indication that America’s distinct experiences of racism affect Black birth outcomes in ways that do not apply to other racially minority groups: foreign-born Black mothers experience better birth outcomes in birth weight terms lose the “healthy immigrant effect” after only A generationaccording to a 2020 study published by Princeton University, while foreign-born Hispanic mothers retain it for generations.
Indeed, black children and adolescents are suffering at an unprecedented rate, and have been since over 20 years old. Black youth commit suicide at high rates increasing faster than any other racial or ethnic group: black children as young as five are 1.8 times more likely to commit suicide than their white peers. Suicide rates for other ethnic groups, except for Latinx and American Indian/Alaska Native youth, remained virtually the same. identical or refusedSame as 2019 to 2020 at the height of the pandemic.
Learn more: The physical toll that systemic injustice takes on the body
By preschool ageBlack children have their own experiences of anti-Black racism, in addition to those of their mothers and families. A study showed that anti-Black racist beliefs emerge from the age of four. In particular, white children have been found to have more negative attitudes toward their black peers and prefer white children over black children as playmates. Black children also experience racism from adults and are disciplined more harshly in schools from a very young age. Black preschool children, particularly black boys, are significantly more likely be expelled than their white peers. This is not surprising given that teachers complain more on the behaviors of black boys and white adults, consider them to be more dangerous than their white peers.
Although sometimes overlooked, black girls are not spared. harder school discipline compared to white girls. This criminalization of black students leads to bad grades and overall academic performance, which has been linked to low self-esteem, depressive symptoms, and even suicidality.
These “zero tolerance policies” in schools lead to the expulsion, suspension, or even arrest of children, especially black children, by police in schools. It also puts them at greater risk of being funneled into the juvenile detention system, a racist phenomenon known as school-to-prison pipelineand is linked to higher rates of depression among black men. Many of these children have learning problems and struggle with abuse and neglect. In other words, they need psychiatric, not punitive, measures.
The harsh punishment meted out to black children is intertwined with the phenomenon of “adultification”, the perception of black children as being older and more mature than them. Adultification has anti-Black racist origins dating back to enslavementand largely contributes to the fact that black children are not only criminalized, but also hypersexualized at an earlier age than their white peers. A 2020 Georgetown The study found that black girls ages 5 to 19 were considered more sexually competent and less in need of attention and protection than their white counterparts. This can lead to black children receiving less emotional support than white children, which in turn can increase the risk of depression, stress and suicidal tendencies.
As Black children reach adolescence, like all children, their social and cognitive abilities increase, including abstract reasoning. This development allows them to be more and more listening to experiences of anti-Black racism – which they report on average experience five times a day. But even preteen children, ages 9 to 12, report increased suicidal tendency with experiences of anti-Black racism and more experiences of racism in general than non-Black youth. Among young adults, ages 18 to 25, experiences of anti-Black racism continue to be predictive of depressive symptoms And suicidal thoughts.
THE racist, multigenerational wealth gap also continues to harm Black youth and their families, playing an undeniable role in the decline of Black youth mental health. (This is related to suicidality, also.) But poverty is not everything. Higher socioeconomic status was associated with more depressed symptoms in black children living in predominantly white neighborhoods compared to those living in predominantly black areas. For White youth, greater parental education was associated with fewer depressive symptoms. Among black youth, however, the opposite is true; a 2015 study found that black youth with highly educated parents had higher rates of depression and higher scores on the perceived discrimination scale over their lifetime. These results suggest that experiences of racism outweigh the protective effects of parental education.
Anti-Black racism is a driver of the mental health crisis for Black youth, regardless of socioeconomic status, and solutions are urgently needed to scale mental health treatment for Black youth. Research funding is needed to continue studies examining the impact of anti-Black racism on children’s mental health across development. The subject remains understudied and underfunded, particularly for very young children. We also need more funding for anti-Black and racism-aware mental health treatments tailored to Black youth and delivered by mental health clinicians with expertise in providing targeted anti-Black racism care. Some organizations already exist, as AAKOMA ProjectTherapy for Black Girls and the National Black Child Development Institute, but there aren’t enough of them.
Standardized medical training does not teach the effects of anti-Black racism on mental health, so traditionally trained psychiatrists are ill-prepared to help Black children navigate these harmful complexities. Curricula for psychiatrists that specifically address anti-Black racism are very limited, with only one little published in the litterature. I had the chance to study with one of them, the Social justice Health Equity Studies Program at the Yale Department of Psychiatry. The landscape is gradually changing, with increasing number medical schools that strive to educate students and residents about the impacts of racism. For example, an anti-racism program adapted to child psychiatry, the known for the first time of its kind, was tested at UCLA in 2021.
But education is only the beginning; accountability is also necessary. Mental health clinicians cannot provide anti-racist care to Black children if they themselves engage in racist behaviors. Leaders in mental health settings, like hospitals and clinics, must take an active role in ensuring that when Black children seek help, their mental health is not further impacted by racism in medical care. Black children are more likely than white children to be diagnosed with laden with stigma disruptive mood disorders and physically restrained In emergency services, it is therefore crucial that leaders ensure that anti-racist hiring practices and reporting systems are in place to recruit and retain staff. When racist behavior occurs, leaders must hold mental health staff accountable, even if it means penalizing highly valued colleagues or close friends.
The youth mental health crisis will only end when the mental health of all children stabilizes. I refuse to let Black children be left behind – and that means confronting anti-Black racism head on.
