Status of Mental Health of Black Youth

african american man and white man shaking hands

Status of Mental Health of Black Children and Youth

Steering Committee

January 01, 2024

Given that we are due to observe the Martin Luther King, Jr. holiday and are heading into Black History Month observances, it is an appropriate time to look at the status of the mental health of black children and youth. The current state of the world can best be described as uncertain, and children and youth perhaps feel this more acutely than adults due to their immediate connection to each other through gaming and social media platforms. We have already established that youth in the United States (US) in general are experiencing a mental health crisis.1 The US and the world regularly provide example after example of how we continue to judge people by the color of their skin instead of the content of their character leading to a crisis within a crisis for Black youth in the US. Black youth are exhibiting the stress of carrying this burden in the state of their mental health. According to the US Surgeon General’s Advisory on Protecting Youth Mental Health, black youth younger than 13 are almost twice as likely to die by suicide.1 Black youth also exhibit higher rates of depression, anxiety, and other stress related mental health challenges.1 The news is full of examples of police violence against the Black community, instances of gun violence against the Black community, occurrences of everyday activities turning into incidents where Black folks are unjustly treated just for being Black while doing things like walking, shopping, house hunting, enjoying the outdoors, etc. This leads to high levels of chronic stress in Black individuals, and while we know this chronic stress has negative consequences for the physical and mental health of all individuals,2 the distinct contextualand psycho-social aspects, specifically the everyday and insidious exposure to racism and discrimination, creates an additional daily stressor for Black folks.3

Studies show that experiences of racial discrimination are frequent and prevalent among black youth.4 We know that racism leads to many negative outcomes for black adults so the likelihood that this pattern of frequent and persistent racial discrimination leads to negative mental and physical health outcomes for black youth is very high. The Adverse Childhood Experiences (ACE) research shows us that Black youth more likely to report multiple ACEs.5 The interactive and intergenerational nature of social and biological vulnerabilities position Black youth to be particularly susceptible to ACEs and the deleterious health consequences that follow. This disproportionate exposure may be why Black youth show a higher propensity to engage in risky behaviors (delinquent and/or intentional misbehavior, self-harm, substance use, etc.) and have greater mental health challenges than other youth. Although research shows that racial discrimination was significantly associated with diagnoses of depression, even after controlling for ACEs and other sociodemographic variables.6 What this tells us is that the consequences related to racism-related experiences and stressors for Black youth mirror the disruptions in neurodevelopment and mental and physical health outcomes the same way that ACEs have been determined to influence health outcomes for the population in general. This makes Black youth doubly vulnerable to negative mental and physical health outcomes.

If you add any intersectional variables to this mix, such as Black youth with special health care needs, special educational needs, gender, sexual orientation, and gender identity the higher the likelihood of these children and youth experiencing discrimination and other potentially traumatic events. For example, a recent study showed that Black, Indigenous, and other People of Color (BIPPOC) adolescents with special health care needs were almost twice as likely to experience discrimination and that Black youth with asthma or genetic disorders experienced higher rates of discrimination.7 Black youth who are also part of the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, plus (LGBTQIA+) community experience higher rates of discrimination and adverse mental and physical health outcomes.8

The structural systems that support the different treatment of Black individuals leads to Black children and youth being exposed to unequal treatment. We know that Black children are more often suspended or expelled from schools.9 Black youth are also more likely to be diagnosed with conduct disorders due to behaviors being misinterpreted as angry, aggressive, dangerous, etc., instead of being seen as a possible mood disorder. Getting a diagnosis of conduct disorder can lead to challenges in finding appropriate treatment and a clinician willing to work with the child or youth and is also linked to an increased risk of incarceration.10

It is important for schools to begin to address these disparities as research supports a strong correlation between a student feeling attached to their school and better mental health.11 This means that schools can have a strong impact on the mental health of Black students by adopting a more comprehensive view of mental health in designing interventions aimed at improving educational experiences. Schools are meant to provide safe spaces for children and youth, and we know that a positive school experience is a protective factor for children to counterbalance negative experiences.12 It is important to provide safe spaces and people for Black children to talk to regarding their negative experiences. It is imperative that staff be trained in culturally competent practices and strategies to build skills that address implicit bias and discriminatory habits. Staff must be ready to have difficult conversations and to look inward to meet the needs of Black children. Hiring and retaining Black staff so that children and youth can seek out adults to serve as role models who will be able to relate to their experiences is key. School staff can also assist Black youth in breaking the stigma of seeking help when needed and can help navigate those systems that have historical structural barriers to Black children seeking and receiving help for their mental health challenges. Black youth are struggling at rates much higher than their white counterparts – it is vital for us all to focus our efforts to meet that need.