Mental health concerns for children of color
As July’s Minority Mental Health Month comes to a close, the concerns of many in the Black community about emotional and psychological well-being are a continuing problem year-round. The annual designation by the U.S. Centers for Disease Control (CDC) serves as a reminder that while one in five Americans experience a mental health disorder, racial and ethnic minority groups are far less likely to receive diagnoses for their behavioral health issues and have less access to mental health services.
“Those with the highest need for support are the least likely to access it. Our data shows a significant amount of our health is influenced by where we live. Your zip code has more influence on your health than your genetics,” said Dr. Rhonda Randall, chief medical officer for UnitedHealthcare.
“We saw increases in rates of anxiety, depression, substance use disorder and suicide predating the pandemic. The pandemic put an accelerant on it and disproportionately impacted people of color,” she added.
A 2021 study by the U.S. Dept of Health and Human Services estimated that 39 percent of Black adults and 36 percent of Hispanic/Latino adults with any mental illness were treated, compared to 52 percent of White adults.
That troubling gap is also in evidence with mental health care for children and adolescents of color. Lack of access to health insurance and transportation is partly to blame for the discrepancy. The shortage of mental health professionals of color presents another obstacle to treatment.
“It’s challenging to find providers who mirror us, who are connected, and who understand us. Our mental health system was designed by White people for White people,” noted Sara Gonzalez, pediatric psychologist at Children’s Minnesota.
“We are doing good work. But the reality is, across Minnesota 80-plus percent of professionals working in mental health, from psychiatrists to social workers, are White.”
Dr. Gonzalez noted that Children’s Minnesota is taking steps to build trust with its young patients and their families. She said that screening for mental health is now woven into appointments with providers.
“A big push in our nine primary care clinics is to understand that mental health is health. In addition to seeing a pediatrician and a nurse, we offer access to social workers and therapists in routine checkups,” she said. “We’re aware of that mind-body connection. Children come in with headaches and stomach aches and that may be a byproduct of stress.”
Coming out of the pandemic, the entire mental health system is still swamped, with many people experiencing waits to see a counselor or therapist. Again, this backlog is more pronounced for families of color with children experiencing symptoms of anxiety, depression, or other mental health conditions.
According to data from the federal Youth Risk Behavior Surveillance Survey, children whose parents were frontline workers as Covid-19 arrived experienced higher levels of stress, and statistically, more people of color were employed as frontline workers.
“There has always been some cultural pride in resisting help,” says Brandon Jones, a psychotherapist, executive director of the Minnesota Association for Children’s Mental Health, and host of the “It’s Not Your Fault” podcast on the SHElettaMakesMeLaugh.com podcasting platform.
“In my clinical career, I have noticed that in communities of color, parents and caregivers often wait too long to get services for their kids. They are so resilient. They have dealt with so much adversity that by the time they do reach out to get help, the problem is significant.”
Jones believes that delays in getting help are especially problematic for youth with symptoms of bipolar disorder, eating disorders, or obsessive-compulsive disorder conditions. These mental health issues, he says, “require treatment beyond talk therapy.”
He urges parents and caregivers to be “proactive, not reactive,” in helping children and teens develop communications tools and skills to manage adversity in a constructive way. As the father of three daughters, aged two, seven and ten, Jones practices what he preaches.
“At our family dinner every night, we play a game called high-low. What was the high point and low point of the day,” he said. “We do this strategically, so that our kids know they can talk about their problems and identify their feelings from the day and have a safe space for these conversations.”
UnitedHealthcare has responded to the changing mental health landscape by using influencers and targeting social media to young people. Their campaigns raise awareness, stress the importance of mental well-being, and educate people on how to access care. They also detail how to support loved ones who might be experiencing mental health dilemmas.
Dr. Randall notes that today’s adolescents are making strides in breaking the stigma for addressing mental health. Many are willing, even eager, to share conversations connected to what were formerly taboo topics. She credits the power of peers for even saving lives.
“Teens are likely to confide in each other. We are using social media campaigns to raise awareness for youth to understand when to keep conversations with friends confidential and to know when to bring in an adult to prevent a serious consequence,” she says.
She also sees the rapid advancement of online therapy and telehealth appointments as a real positive prompted by the pandemic. “Virtual care in behavioral health has an ease of use and a quickness in which someone can get access to care in the comfort of their own home,” Dr. Randall said.
“This can even out some issues in under-resourced communities. With online appointments, it doesn’t matter what your zip code is.”