"They Call Them 'the Bad Kids' "

World Mental Health Day - 2020

Everyone who works with me knows that I sign up for every webinar relevant to our cause. This September 20th and 21st, I had the privilege of attending a summit hosted by the Global Youth Mental Health Association, or GYMHA. The title of the summit was "Global Stress Management Revolutions.” The first speaker, Dr. Berman Ahmed, re-iterated and expanded on what I have known for the last 20 years since working in-depth with disadvantaged youth in residential and school settings. I recently had a conversation with a colleague, who echoed the same sentiments.

Black, Indigenous, and Youth of Color with stress, anxiety, and depression often go undiagnosed and untreated. Dr. Ahmed stated correctly that the mental health of marginalized people is only getting worse over time. His thoughts were that we have a generational gap in mental health among young people and the generation before them, which causes crises in many cultures worldwide. For this article, however, I will focus on two of the marginalized cultures in the USA. Our Black and Indigenous young people.

​The World is Different
Your children's experiences are different than ours. There are new awarenesses and information barraging them from all angles. COVID-19 is a situation like none of us have experienced in 100 years. Racial tensions are worse than they've been in 50 years. And, children are seen by the color of their skin, worldwide. Youth are rightfully stressed out, anxious, and depressed. As people, adults, and peers, we are not taking adequate care of these children and young adults mentally or emotionally. Stress, anxiety, and depression are running rampant through the young people of the world.  And the world isn't helping them.

The truth is that human brains don't stop development until people reach their 20's or 30's. Under constant duress, and the necessity of producing more "feel good" hormones, such as serotonin, throughout younger years can overwork the brain to the point that it is in a constant state of anxiety and depression. Then, the person experiencing this chemical imbalance in their minds may need help via counseling, medicine, or both to feel like themselves.

Stress in Children and Young Adults

The stress our children, young friends, and peers experience is not the kind of tension or depression that we, as Counselors, Doctors, and Educators, refer to as situational. It doesn’t come as a result of an event that is quickly done and rectified. The body doesn’t immediately recover its balance.

Situational stress is an ancient and evolutionary response for the earliest people to keep themselves safe, fed, and clothed. This type of anxiety was purely situational and an essential method of coping. Other examples are when you have to give a speech or when someone you love is in immediate danger. That stress serves a purpose.

The stress I’m talking about is chronic, pervasive, and damaging to young brains and developing bodies. As one speaker put it, when the body is not in tune with the mind, all other systems shut down, including the immune system. 

Chronic stress happens when a young person experiences constant, unaddressed stress, and traumatic experiences that overwhelm them. Bullying, violence at home, watching news filled with hate and vitriol every day, and now COVID, all of these are causes of chronic anxiety and depression. The young people affected by these illnesses have a high risk of developing severe mental health and physical diseases.

How Youth With Chronic Stress Suffer
Chronic stress becomes a crisis when not addressed. Being in crisis, suffering from stress and depression is often marked by:

• emotional intensity - anger, sadness, lethargy, mania
• inability to focus
• confusion about what they should do
• changes in appetite or sleep
• isolation
• substance abuse
• risky behaviors

If Stress Isn't Addressed among Youth

• Addictions 
• Acts of Violence, 
• Personality disorders 
• schizophrenia and other psychoses 
• Risk of heart attack later in life
• Risk of Diabetes
• High Blood-Pressure
• Ulcers
• Institutionalization
• Imprisonment

​All of these are more likely to occur as traumatized young brains and bodies develop under extreme stress without treatment. This is no where near a comprehensive list, but the danger is clear. When the mind and spirit suffer, the body does too.

The Children Most at Risk

Barriers to Mental Health Treatment

​The barriers between brown and Black youth and mental health care go beyond the double stigma attached to their mental health. In truth, one of the blocks is probably one of the root causes of why Black and brown people don’t seek help for their mental health. 

It isn’t just parents, Elders, and adults in communities who underestimate the effects of handling stress within the self. It is school officials and counselors who don’t take cultural sensitivity seriously. Hundreds of years of self-reliance and independence have naturally turned into a social memory for the Black community. There are ways people in positions to help can learn diversity and inclusion, but it hasn’t ever been a priority.

A great majority of mental health professionals are white. They are white with little to no diversity training. For a child or young adult with black or brown skin to go to a white mental-health care provider who hasn't had any sensitivity training. This stranger doesn't understand the challenges, micro-aggressions, and flat-out aggressions youth of color face each day. This is unproductive and potentially more harmful to the psyche. 

This is happening more in populations with black or brown skin, who are less likely to acknowledge mental health as something that needs to be addressed and treated by a mental health care professional. As always, there are differences from culture to culture and city to city. But, seeking a source of help outside of the self or community is discouraged or looked down on in numerous non-white cultures.

During my research, I had the honor of talking to one of my colleagues and friends, Chuyone McGuire-Ford, LPC-S, BC-TMH, a licensed professional counselor for a telehealth organization, and a Black woman. She confirmed the research I had done and some of the experiences I've had working within the system. She generously offered me some more insight into the challenges Black kids go through, and how deeply the denial of mental health goes in the Black community.

We discussed how this attitude is so pervasive that most Black men treat mental health as if it doesn't exist at all. The prevailing thought in the Black community is that a person should be able to handle stress, anxiety, and depression on their own, that strong people don't need to seek outside help. People who do get assistance are weak. We already know of the enormous stigma attached to mental illness by society in general. The thought that everyone ought to mentally care for themselves creates a double stigma. Youth know they should get help, yet feel incapable of reaching out.

Black and Brown Youth are Punished for Mental Illness

Unfortunately, AA children may be tabled as undisciplined or identified as ED (emotionally disturbed) and placed in special education. A lot of times because the parent may not have been able to recognize the symptoms, they do not bring the child to see a therapist for assistance with helping the child deal with their symptoms allowing for the child to have a chance to work through their issues, show improvement and avoid being placed in a program that may not necessarily be an appropriate placement.                                                                          
Chuyone McGuire-Ford, LPC-S, BC-TMH 

Examples of the Truth

​I knew a young teen girl who was ridiculed by her father regularly for her severe mental health status. He didn’t believe in it, so he thought she should be able to will herself to instantly "get over it.” All that accomplished was a worsening of her health. 

I took care of two very loving and generous young Black women. Their father had died, they had no one else, and they were angry. It makes sense. But the stigma of our world labeled them Emotionally Disturbed and put them in the residence where I worked. It only served to turn anger into violence. All they wanted was love.

I've seen hundreds of similar situations, but could never have summed it up like Chuyone did. These situations make me question how many Black children go through the same thing. I know most of the kids at my job were Black. I think of the disproportionate number of young Black men in jail and prison, and I know that most of them suffer from mental illness and subsequent institutionalization that began when they were young. It is more than discouraging. It’s heartbreaking.

A Different Kind of Stigma

II spoke at length with my fiance, a Native Blackfoot from Montana, and knowledgeable about numerous tribes and their customs. At different points in life, I discussed mental health with a few of our Native friends; one is Cree, the others are from the Lummi Nation and Dakota Sioux. 

I noticed that there are minuscule medical clinics and no counselors on the reservations I’ve visited. The population has to leave and go to the "white man’s" doctors for real treatment. This is to be avoided at all costs.

The care from white doctors near the reservations is as minute as the reservations’ mental health clinics. I have often seen the extreme sub-standard medical care given to Native Americans. Given the history and social memory of Native peoples, it is apparent why he and many of our friends only rely on each other, shunning outside help. 

My fiance quoted the adage, "it takes a village to raise a child" when explaining some of the reasons Tribes don’t utilize mental health care. Tribal Nations throughout the US have struggled to hang on to their cultures through centuries of white people forcing culture on Native Americans. He stated that all counselors want is to turn Natives into white people.

We spoke of how it had been in the past, with children would seek and accept help from Elders, something that doesn't happen much anymore. At ceremonies, the separation of Elders from Native youth is almost tangible. Addiction is commonplace. It is a rare young person that is clean and sober. Here again, is the generation gap of which Dr. Ahmed spoke. The Elders of now may be the last.

We HAVE to Talk

We Have to Talk

For any changes to happen, adults and youth alike need to talk about mental health. The message that it is not a sign of weakness to seek help must spread through communities. Taking care of and asking for guidance with a mental illness is bravery. It is strength. It is scary, but sometimes necessary to get help from outside the communities in which we live. That’s okay.

It is okay to need help with your feelings. It’s natural to get overwhelmed, especially right now. I know that asking for help is excruciating sometimes, literally painful. But necessary to stay sane and physically healthy. There is no shame in mental illness.  

A conversation about diversity and inclusion within the mental health professions is essential. Professionals must come from all different cultures. Just as important is having inclusive training for providers. Without that, children will just keep cycling in and out of mandatory treatment. Making change comes with gaining knowledge.

Parents, educators, counselors, and peers need education about mental health. They need to know how chronic stress, anxiety, and depression can affect children and young adults. Educating ourselves is the most incredible tool we can give.

According to Dr. Ahmed, it is essential to remember that each community has its specific problems. If these issues are not acknowledged and communicated, "children are the price to pay.” 

What a horrific price it would be, too.