African American teens face mental health crisis but are less likely than whites to get treatment
This article originally appeared on The Conversation.
Black youth in the U.S. experience more illness, poverty, and discrimination than their white counterparts. These issues put them at higher risk for depression and other mental health problems. Yet Black youth are less likely to seek treatment. About 9% of them reported an episode of major depression in the past year, but less than half of those – about 40% – received treatment. By comparison, about 46% of white youth who reported an episode were treated for depressive symptoms.
Instead, some turn to suicide, now the second leading cause of death among Black children ages 10 to 19. That rate is rising faster for them than any other racial or ethnic group. Data from the Centers for Disease Control and Prevention show the rate of suicide attempts for Black adolescents rose 73% from 1991 to 2017.
With schools nationwide grappling with how to offer instruction to students, principals and teachers need to be reminded that Black children have endured a distinctive kind of trauma since the pandemic began. They have had a different experience. The shootings of George Floyd and Ahmaud Arbery – and what happened afterwards – are just two examples.
As an expert in child and adolescent psychology, I know that a multitude of barriers keep Black children, and their families, from receiving that treatment. They need help to deal with the pervasive poverty and racism that surrounds them.
The ‘crazy’ label
Studies suggest Black youth and their families may be less likely to identify their own mental health symptoms. If they do receive referrals for care, they may follow up less often than whites. Delays in seeking care can lead to negative consequences, including emergency psychiatric hospitalizations and non-compliance with treatment recommendations. These youngsters may then become adults with mental health issues that remain unaddressed.
Parents and caregivers should encourage treatment. But interviews with them done as part of one study revealed they sometimes obstruct the process. Many feared their child would be labeled “crazy.” Those caregivers, sensitive to social stigma, also relied on others in the community when deciding to pursue treatment for their sons. Sometimes they would receive support from those they spoke with; other times, they would not.
Because of discrimination and abuse, Blacks have good reason to distrust the mental health system. Health care disparities exist there just as they do in other health care domains. Black adolescents are less likely than white teens to be treated with beneficial psychiatric medications, and more likely than white teens to be hospitalized involuntarily. Other reports suggest Black youth with psychiatric disorders are more likely to be referred to the juvenile justice system, while white youth are more often referred for mental health treatment.
That same study found that schools were also pivotal, in both positive and negative ways. Some parents and caregivers said school staff validated their concerns and provided support. Others felt forced to seek services only because they believed their son would be expelled.
Stigmatizing mental illness
Researchers have found that Black adults, exposed to a police killing of an unarmed black citizen through media or word of mouth, had worse mental health. This includes an increased fear of victimization, diminished social trust and a revisiting of prior trauma.
Much the same seems true for Black adolescents. When a group of them aged 11 to 19 viewed traumatic events online – including viral videos of police shootings – they had higher rates of depressive and post-traumatic stress symptoms, including re-experiencing, avoidance, numbing, and hyperarousal. Experts have suggested that police violence be viewed as a public health issue, because each killing impacts individuals and communities both physiologically and emotionally. Each incident reminds Black youth that, in this country, their lives have been devalued.
One might consider the impact from the case of Ahmaud Arbery, a 25-year-old Black man shot to death in Glynn County, Georgia, last February. Three white men are charged in the killing. An attorney for one of them attempted to cast doubt on the character of Arbery, who reportedly had a previously diagnosed mental illness. The lead investigator in the case testified that Arbery suffered from hallucinations, though he was not undergoing treatment on the day of his death.
Hallucinations are actually relatively common in children and adolescents. Up to 13% of youth experience them. If Arbery had hallucinations, it appears they had little bearing on his killing, but those with mental health issues were further stigmatized.
With protests sweeping the nation calling for racial justice and defunding the police, I believe more funding to address disparities in mental health care for Black youth is critical. But merely investing in treatment is not enough. To support them and their families, we as a society must deal with stigma, cultural mistrust, systemic inequities and social supports.
Assistant Professor, Department of Psychiatry and Behavioral Neurosciences, Wayne State University
This article originally appeared on The Conversation
How Adults Can Support the Mental Health of Black Children
Psychologist Riana Elyse Anderson explains how families can communicate about race and cope with racial stress and trauma.
This article originally appeared on Greater Good, the online magazine of the Greater Good Science Center at UC Berkeley.
With his last breaths, George Floyd called out, “Momma!” before he was killed in Minneapolis. He was one of nearly 1,300 black people who have been killed by police in the last five years. They are two times more likely to be killed by police than white Americans.
Facing destructive policies and attitudes in the United States, mothers and fathers try to safeguard their black children from racism. This often takes the form of preparing them for bias and communicating the real threats to their lives from a history of othering that continues today. But it also involves highlighting how to draw from a well of strengths that black culture and black families—immediate, extended, and historical—possess.
To better understand this process, we interviewed Dr. Riana Elyse Anderson, clinical and community psychologist and professor of public health at the University of Michigan. Anderson developed Engaging, Managing, and Bonding through Race (EMBRace), a program to help families communicate about race, cope with racial stress and trauma, and build strong relationships and well-being. Below, she explains how black parents can support their children’s mental health, and their own.
Maryam Abdullah: Your research focuses on how black families use racial socialization to protect their children in the face of pervasive racial stress and trauma. What is racial socialization?
Riana Elyse Anderson: Socialization, generally, is the statements that parents are making to their children about how to think or behave in the world. Some common examples of that might be “Look both ways before you cross the street,” or “Don’t touch that iron. It’s hot.” For gender socialization, we’re familiar with suggestions of which sports to play between girls and boys, as a crude example.
Racial socialization is the behaviors and the attitudes being passed down from parent to child with respect to race in particular. Some of those might be wearing certain kente cloth if you’re going to celebrate Kwanzaa or if you’re going to the National African American Museum in Washington, D.C., to celebrate your culture. Those are some of the more positive ones. Unfortunately, we also have to think about “Keep your hands on 10 and 2,” “You can’t wear your hoodie in the store,” or “You have to work twice as hard to get half as far” as some of those elements that are part of “the talk,” the racial socialization talk.
MA: How does racial socialization help black children cope with racial stress?
REA: We’re talking to our children about what it is that mommy or daddy experienced or what they see in the world. We’re able to have that conversation between parent and child, rather than the children not really having a space to ask what’s going on and why so many people are upset or frustrated—or seeing people like them on the news either being snuffed out or arrested for uprising, and then wondering or just keeping it to themselves. That opens up lines of communication, and it doesn’t stop there.
After that line of communication opens up, we get to practice and talk through what it is that we would want to do as a parent or as a child—a series of coping strategies. Do I want to sit here on the couch? (which is totally fine if I want to do that). Do I want to go out and protest? Do I want to write a letter to someone? Do I want to not support a certain business? Now I have options of the things that I want to do, and I feel more efficacious in my ability to execute any of them because I’ve talked with my family about that.
Talking to our family, thinking about strategies, and supporting our children in their ability to execute those strategies is how racial socialization works.
MA: In EMBRace, children and parents work together on a variety of practices. Can you share one?
REA: We use a family tree exercise. Before we even meet with the family about their family tree, we ask them to do some digging. Tell us a bit about who your family members are, who your support system is, then go ahead and put that on this family tree.
Then, demonstrate on this family tree how big and resourceful your community, your garden, your village is. Now you’re seeing, OK, my grandma is with me, my aunts are with me—especially as a child, I can rely on all these people.
And even though I don’t know Michelle Obama, she feels like an auntie to me, so I’m going to put her on my [family] tree. We have a space for greater community influences. OK, Rosa Parks passed away before I was here, but I know that there are streets named after her in Detroit and she’s given a lot of support to black people like me, so I’m going to put her [on].
You start to understand there are people who have come before you and who will come after you who will continue this really rich tradition of who we are and how wonderful our people are. You’re now demonstrating and seeing that I have a whole community who has my back in a time where George Floyd’s life was taken from us in the most violent and visible way. To know that there are millions of people, who now count him as our brother and that he now has as his family, continuing on his legacy, speaks to what it is that we’re trying to do here within EMBRace. We have a whole group of people who are going to support you should you need us. You don’t have to take this racist event by yourself. You can come to your family and that family is an extended family.
MA: What’s important for parents to know about when and how to speak to their young children about racism?
REA: I want you to think about this concept of racial literacy that psychologist Dr. Howard C. Stevenson talks about. Racial literacy pretty much means you’re not going to give a Shakespearean novel to a three year old. You’re going to give an age-appropriate reading book or coloring book to that child, and you all are going to work up gradually to the understanding of what literacy means for their age. We don’t ask you to go beyond your child’s level.
When we’re saying we’re afraid to talk to our children about race, it’s not for them; it’s because we are afraid, if we’re being honest. We don’t know how to talk about it and we’re concerned. What we encourage in EMBRace is to think about your competency, rather than your content—to focus first on building your own skills, confidence, and resilience to stress in these conversations before talking with children.
Skills: Becoming more skillful at these kinds of interactions might involve preparation for and practice using inquiries or questions to ask our kids: “What did you notice?” or “How did that make you feel?”
Confidence: Confidence comes from practicing it more. Maybe that means you practice with yourself in the mirror like you do when you go to your job interview. Maybe you practice it with your loved one. You’re unpacking for yourself first.
Stress: If you go into it without having spoken about it, without thinking about what it means for yourself, you’re going to be highly stressed the entire time you talk to your child. But you can focus on “What are the things that are within my control when I talk to my child? Maybe I can’t change the entire police system, but I can help my child to navigate that one specific thing that they have going on. What can I do today?” That will reduce stress in that moment, along with practice and with inquiry-based questions.
Your child is never too young to have any discussion about it, but you don’t want them to have the most stressful and the most strenuous conversations. You’re the expert, you’re the parent, you already know what [the right level of conversation] is. It’s time for you to take your fear away from your child being the best that they can be.
MA: What further advice do you have for parents right now as they help their children cope with the trauma of current events?
REA: We’re thinking about this idea of “the talk.” Sometimes people have it once and they say, “Done. Great. Did my job.” Then they walk away.
If you think about how frequently you have to tell your child to pick up toys, buckle their safety belt, and clean up after themselves, we understand that having the racial talk once is not sufficient. So, yes, these events are current and, yes, it feels so imminent and so important that we have this conversation right now. There’s a lot going on in the media. There’s a lot going on that your children are hearing or experiencing and they have access to it in ways that years ago children would not have.
At this moment, you should be having conversations with your child. And next week when the protests have died down, you should continue having conversations with your child. And the month after that, you should continue. And weeks after that. At this point, the amount of content in books or media that is around you makes it possible to create a consistent environment. If that practice becomes consistent enough where you are bringing it up and you are letting them know this is an expectation you have for conversation, they will feel comfortable enough bringing it to you: “Mom, I noticed this.”
Use things in the environment, use things in your media, use things in books to ask your child what is it that they’re seeing, how can you support them through this, how do they feel about it?
MA: How can parents take care of their own well-being so they’re in the best position to help their kids?
REA: Our own well-being is compromised right now. We know that anxiety and depression are up three times the amount that they were in January. We are not doing well as a nation right now. If you need time as a parent to step away from this media and these types of conversations, remember that you are a human being, first and foremost—you’re not daddy or mommy first. You really are a human being who needs rest, restoration, self-care, love. There are tasks that parents have that are beyond description. You’re being asked to provide in ways that just defy the amount of energy you might have most days, especially in a stay-at-home-order situation where you are the go-to principal, teacher, nurse, etc.
Unless your child is so young that you cannot step away at all and it would be a physical danger for your child to be alone, if you need a moment to walk around the block or close a door, or to do something for yourself to engage in self-care, by all means, take it. As we’re starting to open up the community a bit more, if you need to create a small cluster of families with whom your child spends some time so that you can find some space and time on your own, by all means safely create that space. It is a cardinal and critical component of your child being well that you are well.
We’ve all heard the mask analogy. We’ve all experienced times where our behaviors can impact those of our children. We know that. It’s not just a saying; we really need you to be well, first and foremost. The practice I would really recommend is just to find time for yourself to carve out your wellness so that you can be the best parent that you can be for your child.
Developmental psychologist, Parenting Program Director of the Greater Good Science Center
This article originally appeared on Greater Good, the online magazine of the Greater Good Science Center at UC Berkeley.