Black Youth Face Unique Mental Health Challenges

Teen years are a difficult time of transition, changing bodies and changing rules. Young people today are also facing many other challenges, like fear over climate change, gun violence, racial inequities, online bullying and the lingering effects of the COVID-19 pandemic. 

Together, all these issues are severely impacting young people’s mental health. It’s so concerning that former U.S. Surgeon General Vivek H. Murthy issued a youth mental health advisory in 2021. Murthy wrote, “Since the pandemic began, rates of psychological distress among young people have increased. The pandemic is most heavily affecting those who were already vulnerable. This includes youth with disabilities, racial and ethnic minorities, LBGTQ+ youth and other marginalized communities."

But even before the pandemic, young people were struggling with their mental health, particularly young Black people. According to AP News, “Between 1991 and 2019, Black adolescents had the highest increase among any racial or ethnic group in prevalence of suicide attempts — a rise of nearly 80%.” While all young people in the U.S. are experiencing a mental health crisis, Black youth face additional challenges that uniquely impact their mental health. 

Black children’s behavior is more frequently punished
In the U.S., Black children are treated differently, even from a very young age. The Center for Law and Social Policy states, “Black children’s behavior is scrutinized and punished more than their peers, even typical child-like behavior. While Black children comprise 19 percent of the preschool population, they represent 47 percent of preschool suspensions. This punishment even begins in the earliest years, with 42 percent of infant/toddler care centers in a state reporting at least one expulsion in the past year.” For example, a Black preschooler who hits a peer or calls another child a bad name is much more likely to be suspended, rather than giving the child a time out or asking them to apologize. While some childcare workers and teachers may be unaware of their bias, the impact is clear. Young Black children learn from a young age that they are different and are treated differently. 

This is particularly problematic for Black children who have autism, mental health concerns or other developmental delays. Challenging behaviors can be a symptom of those issues. So, a child who has difficulty with language may have angry outbursts because they can’t explain their needs and wants. Or, a child who has sensory-processing differences may struggle to focus in their school classroom because the fluorescent lights hurt their eyes. But for Black children, these challenging behaviors are more likely to be treated only as misbehavior, and instead of being referred for a mental health or autism assessment, Black children are punished. 

Black teens are perceived as less innocent
The unequal treatment certainly doesn’t stop after elementary school. Black teens continue to face racism and criminalization of behavior. According to AP News, “Black teenagers report experiencing an average of five instances of racial discrimination per day. Young Black students are often perceived as less innocent and older than their age, leading to disproportionately harsher discipline in schools.” 

So, Black teens continue to face harsher consequences throughout junior high and high school. The Center for Law and Social Policy states, “Black children in the K-12 system are more likely to be disciplined than their peers for defiance or other common behaviors. And Black students are overrepresented in referrals to law enforcement, in-school and out-of-school suspensions, corporal punishment, and expulsions at every age level, even though white students are referred to the principal’s office more.” 

Again, Black teenagers are more likely to be punished for typical behavior, and again, when their “bad behavior” is caused by poor mental health, like depression or anxiety — instead of being referred to a counselor — they receive detention, expulsion or are sent to law enforcement. In addition to not being treated for their mental health, they’re punished for symptoms resulting from their mental illness.  

The criminalization of their behavior can have lifelong impacts. The Center for Law and Social Policy states, “Black students who are suspended or expelled are 3x more likely to have contact with the criminal legal system.” In other words, being treated like a criminal as a child or teen can lead to being treated as a criminal as an adult, and, therefore, they may become incarcerated adults. This is known as the school-to-prison pipeline. The American Civil Liberties Union states, “The ‘school-to-prison pipeline’ [is] a disturbing national trend wherein youth are funneled out of public schools and into the juvenile and criminal legal systems. Many of these youth are Black or Brown, have disabilities, or histories of poverty, abuse, or neglect, and would benefit from additional supports and resources.” 

Racism is incredibly prevalent, and it negatively impacts mental health 
Racism negatively affecting young Black people’s mental health should come as a surprise to none. However, there are many ways Black youth are impacted, and some are more particularly prevalent and damaging, due to the rise of social media. There are hate groups like the Proud Boys and other white supremacist groups, who deny the humanity and rights of Black people and other people of color and who plan attacks and commit acts of violence. There are microaggressions, which, according to Howard University, are “a comment or action that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group, such as a racial minority.” A microaggression can be something like touching a young Black woman’s hair without her permission or saying something like, “You speak so eloquently” to a young Black man. 

Black teens also routinely experience vicarious racism, which is “seeing people of color subjected to racist violence.” A young Black person can experience this by watching the video of the murder of George Floyd or reading about a young Black man being killed by police. 

According to the study, “Vicarious Racism and Vigilance During the COVID-19 Pandemic: Mental Health Implications Among Asian and Black Americans,” “Neuroscience-based models suggest that experiences of racism directed at other individuals of the same racial group mirror the effects of social threats to the self and activate regions of the brain associated with direct experiences of ostracism, exclusion and rejection.” In other words, a young Black person watching a video of racial violence or bigotry may feel rejected for who they are fundamentally (since they can’t change the color of their skin). Or, they may feel like the violence was perpetrated directly against them.

With the proliferation of this content online, and on social media, particularly, young Black people are continually exposed to these images and instances of violence, bigotry and hate speech. It can seem like there is no escape.  

The U.S. has a complicated history of medical care for Black people 
Some in the Black community harbor a distrust of the medical establishment for numerous reasons. Black people are more often denied medical care or misdiagnosed. Black women die during childbirth at a rate of over double that of white women.  The CDC states, “In 2022, the maternal mortality rate for Black women was 49.5 deaths per 100,000 live births and was significantly higher than rates for white (19.0), Hispanic (16.9) and Asian (13.2) women.”  

Not to mention, the chilling history of “medical studies” which were perpetrated on people of color. You’ve likely heard of the Tuskegee Study, but may not know what actually happened. AP News states, “For 40 years, the U.S. Public Health Service…conducted a study in which human guinea pigs, denied proper medical treatment…died of syphilis and its side effects. The study was conducted to determine from autopsies what the disease does to the human body.” The “study” began in 1932 “with about 600 black men, mostly poor and uneducated, from Tuskegee, Ala., an area that had the highest syphilis rate in the nation at the time. One-third of the group was free of syphilis; two-thirds showed evidence of the disease. In the syphilitic group, half were given the best treatment known at the time, but the other half, about 200 men, received no treatment at all for syphilis, PHS officials say.”

The men were also offered incentives to enter the program, like “free transportation to and from hospitals, free hot lunches, free medicine for any disease other than syphilis and free burial after autopsies were performed.”  Further, after penicillin was discovered to be a cure for syphilis, the study participants were denied the drug, despite that “its use probably could have helped or saved a number of the experiment subjects.” 

The “study” ended in 1972, when a whistleblower at the U.S. Public Health Service contacted a reporter at The Associated Press. According to AP News, “A public outcry ensued, and nearly four months later, the ‘Tuskegee Study of Untreated Syphilis in the Negro Male’ came to an end.” The racist experiment denied Black men life-saving care for 40 years. 

Young Black people face multiple barriers to mental healthcare
Due to the problematic history with the medical establishment, young Black people, and their families, may not seek mental healthcare. Even when they do, there’s a shortage of Black therapists and those trained to deal with the unique mental health conditions Black people face. The Center for Law and Social Policy states, “Only 4% of psychologists are Black, according to the American Psychological Association. And 80% of mental health providers are not trained in treating race-based trauma.” 

In the U.S., there’s also a shortage of therapists and counselors, in general, which particularly impacts certain areas. Mental Health America offers an interactive map, which ranks each state by access to mental healthcare. Mental Health America states, “The access measures include access to insurance, access to treatment, quality and cost of insurance, access to special education, and mental health workforce availability. A high Access Ranking (1-13) indicates that a state provides relatively more access to insurance and mental health treatment.” On this map, Minnesota is ranked #6 in access among the states, but neighboring state Iowa is ranked at #18 and Nebraska at #33. While Texas, the 2nd largest geographic state in the country, is ranked last at #51. 

There’s also the cost of mental healthcare. It’s not always covered by insurance, the co-pay may be high and not all providers take insurance. The Center for Law and Social Policy states, “The cost of care — sometimes hundreds of dollars for a single therapy session if providers don’t take insurance, and many do not — can make services inaccessible.” 

But we can create change and better support Black youth’s mental health
Despite all these challenges, there are ways to better support the mental health of young Black people. One way is encouraging and supporting more people of color to become therapists, psychiatrists and school counselors. Mental healthcare organizations need to provide training in race-based trauma to therapists. Increasing access to mental healthcare at schools, like Fraser’s school-based mental wellness programs, will also help Black young people more easily access treatment. 

Of course, combatting racism and allowing Black children to be children is another incredibly important way to support their mental health. The Center for Law and Social Policy states, “Society must change that narrative at an individual level by acknowledging and recognizing implicit bias and combatting that through education and trainings. Additionally, we must address narrative change at a macro level through conversation, policy, and the media.”

Parents can share positive portrayals of Black people in books, films, TV and music with their children. They can also buy their children dolls with dark skin or Christmas decorations with a Black Santa. It’s also important to educate youth about the history of racism in the U.S., slavery and the Civil Rights movement and eventually teach them about historical wrongs like the Tuskegee Study. 

Educators and school administrators must examine those implicit biases and work to prevent themselves from acting out these biases on Black children. We can unlearn these biases through continued education and additional training. For schools, re-examining policies like expulsion and suspension may help prevent unfair treatment of Black teens. Removing law enforcement officers from schools can further help prevent the criminalization of Black children and combat the school-to-prison pipeline.