To Address the Youth Mental Health Crisis, Policymakers Must Advance Racial Equity

By Julia Collins

Young people are experiencing a mental health crisis that’s disparately affecting young people of color. To equitably address this crisis, federal and state policymakers must transform our mental health system into one that is culturally and socially responsive. Pouring money into the existing infrastructure will not fix this broken system. Instead, the solution is a mental health system that’s accessible to and meets the needs of Black, Indigenous, and youth of color.  

Both the U.S. Surgeon General and the American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry (AACAP), and Children’s Hospital Association (CHA) released advisories on the severity of mental illness in young people. However, the AAP-AACAP-CHA report doesn’t mention how racism hurts young people’s mental health. In another report, the AAP names racism as a social determinant of health, yet leaves this out of its State of Emergency statement.  Omitting the effects of racism means that the full story of young adult mental health isn’t being told. However, the Surgeon General reports that hate and harassment can have a negative effect on “racial and ethnic minority youth” mental health. Young people of color have specific mental health needs that require an inclusive system tailored to their multifaceted perspectives. 

What makes it difficult to reach youth of color?

  • Mental health providers and services are not spread equitably across the United States, making it hard for youth to find support in their area; 
  • When services are available, costs of mental health services are often too high; and
  • A history of discrimination in the medical field has led to a distrust of white institutions. 

Though more funding seems like a simple answer, current inequities would only be exacerbated unless decisionmakers invest those funds in a more deliberate and thoughtful manner. Youth of color shouldn’t be expected to assimilate their experiences into a system that wasn’t created for them. Policymakers can put into place policies and practices that better support youth of color. 

First, services must be culturally responsive. Culturally responsive supports recognize historical and cultural trauma; embrace racial and cultural identities; and may include “non-Western” modalities and Indigenous healing practices.  Policies that support culturally responsive care include:

  • Hiring diverse providers who can relate to patients; 
  • Providing care in-language (patients and providers speaking the same language);
  • Funding for peer support specialists and community-based care; and
  • Reimbursing for non-Western and Indigenous practices.

Second, services must focus on social needs. Social determinants of health, such as racism, economic stability, or access to health care, all play a part in wellness. Addressing social needs can lessen negative mental health outcomes and promote wellness for whole communities. Additionally, social determinants of health can negatively contribute to Adverse Childhood Experiences (ACEs), which are traumatic childhood events. Policies that address social needs include: 

  • Encouraging cross-sector collaboration to support mental health needs in workforce development programs, education programs, schools, and in other youth spaces;
  • Expanding access to mental health screenings and early treatment to prevent long-term effects of ACEs; and
  • Improving public mental health literacy to spread awareness of the impacts of mental illness and available services. 

It is vital to create culturally responsive and trauma-informed practices that meet youth where they are and will affirm their cultural identities in treatment. Policymakers must adequately fund these practices and policies and make them reimbursable for providers.

As policymakers work to address the youth mental health crisis, they must create policies and systems that’ll support the mental health needs of young people of color. It’s not enough to address the needs of only some young people or to pour money into a system that isn’t serving all young people. Young people deserve a mental health system that meets their needs.