Are We Listening? Youth Mental Health Challenges are Rooted in Racism and Discrimination

By Isha Weerasinghe 

“But you just got to keep understanding that… being brown is different. Being white is really different. Having the privilege and having the access and not having the privilege and the access.” 

-Young adult focus group participant, Behind the Asterisk*, 2019 

In October 2023, I attended a workshop on how racial socialization can support the well-being of young people of color. At the beginning of the session, the presenter asked, “When was the first time you experienced racism?” For him, a Black man, his first experience was at a grocery store when he was four years old. Like the presenter, many young people of color experience racism and discrimination—implicit and explicit, individual and institutional—from a very young age. These experiences continue into young adulthood and beyond. They affect how young people perceive themselves, impacting their confidence and self-esteem, and therefore their well-being. Young people of color experiencing poverty have repeatedly noted how racism and discrimination are root causes and key traumas that adversely impact their mental health.  

Systemic and structural racism also impact the other major drivers of adverse mental health in youth: community violence and financial strain. When young people of color have multiple marginalized identities, such as being disabled or identifying as LGBTQIA+, they may experience various, layered forms of discrimination. Repeated instances of discrimination and the lack of accountability for racist actions can increase stress, leading to depression and anxiety 

“At my school, I was friends with this guy, Sammie, and he had to leave school because he would get in constant fights because people would be racist towards him. He wouldn’t put up with that. He would get in a fight. And he would just get in trouble. And like, the people committing that actions aren’t getting in trouble, but he’s getting in trouble for standing up for himself. And a lot of people from [town name] specifically, because they have a large like population that’s people of color. They, a lot of kids there, haven’t been going to school because of it, because they just can’t handle it, and even if they do something about it, they would get reprimanded for their actions.”  

-Rural young adult, from the Behind the Asterisk* report 

Structural racism persists in the environments that young people participate in daily, like schools and the workplace. Because of this, young people may not trust adults who use power in an authoritative and punitive way. Systemic racism in the health care system can deter youth of color from utilizing necessary mental or physical health services because of the lack of trust, even if young people have access to services. Beyond health coverage, barriers to care also include limited access to mental health providers who can relate to a young person and show cultural sensitivity.  

Although effective policy solutions for young people must center their voices, policy recommendations are often adult-driven. Youth have consistently recommended solutions that could improve and maintain their well-being, around recognizing and addressing the root causes of the mental health challenges they experience, rather than only focusing on improving clinical care. Federal, state, and local policymakers can implement system and policy changes to address racism and discrimination from a youth-development perspective. Solutions noted by young people include policies that directly address systemic racism, such as funding and supporting cultural education in schools; encouraging voter engagement; developing programs that affirm cultural and racial identities; reimbursing traditional and/or culturally-derived healing practices; banning the use of punitive measures in school environments (i.e., school resource officers); and reimbursing peer specialists and networks. Youth peer support specialists, for example, can support young people in ways adults cannot, using anti-racist practices that intentionally challenge the hierarchy of the provider-patient relationship, meeting young people where they are, and speaking from similar experiences and backgrounds.  

We cannot fully address systemic racism in health systems, the built environment, and people’s biases overnight. However, learning about interventions that work for young people will start to reduce racism and discrimination in the places youth work, live, and play, ultimately addressing some of their mental health concerns.  

“El de clima por razas, eso es no solamente el racismo, sino el discrimen que sufre la persona que está recibiendo el racismo. Estos, estos límites que se les ponen a la hora de buscar ayuda.”

“The thing about the racial climate, it’s not just racism, but also the discrimination that the person suffers when they’re experiencing racism. Those, those limits that they place on you at the time you look for help.”

-Young adult focus group participant, 2023