The Case for Focusing on Black Girls’ Mental Health
Black girls have serious unmet mental health needs—it has been called a mental health crisis “hiding in plain sight.” Between 1991 and 2017, suicide attempts by Black youth increased, while suicide attempts among youth across other race and ethnicities decreased. Actual suicide death rates for Black girls ages 13 to 19 increased by 182% from 2001 to 2017.
And, although little research examines mental health related issues specifically among Black girls who are impacted by the juvenile and criminal legal system—even though Black girls are much more likely to be incarcerated than white girls—we know that youth in juvenile detention are at higher risk for depression, and recent research does suggest that Black girls in juvenile detention are especially vulnerable to depression.
For youth in foster care—where there are a disproportionate number of Black youth—mental health issues are prevalent: Among teenagers, 42% had at least one mental health disorder; of these, nearly one-third had 2 disorders and one-fifth had 3 disorders.
And the COVID-19 pandemic has exacerbated this, and existing inequities in mental health services have nearly ensured these mental health needs continue to go unaddressed.
When mental health needs go unaddressed, it can lead to terrible outcomes: Mental health continues to decline, and the impact of not addressing adolescent mental health issues last long into adulthood. Unaddressed mental health issues can begin to manifest physically and make it difficult to cope with parts of daily life. This can ultimately lead to poor performance in school, job loss, homelessness, and more, and it can make people more vulnerable to victimization. All of this may worsen a person’s mental health, creating a continuous negative cycle.
This is why the National Black Women’s Justice Institute has partnered with The Children’s Partnership to create The Hope, Healing and Health Collective (H3 Collective). H3 is a youth-led collaborative (with support and thought partnership from adult allies within policy, research, direct service and government) that will develop a policy agenda to expand the availability and accessibility of culturally-competent and gender-responsive mental health and well-being services to Black girls and other youth of color who are experiencing historic, crisis-level rates of mental health needs and suicide risk.
This is critical because in general, 50% of all lifetime mental illness begins by age 14. Youth also engage with services differently than adults do, so addressing youth mental health needs to look different than addressing adult mental health. Similarly, we must also approach addressing the mental health of Black girls with a tailored approach. We need mental health services that recognize the specific experiences of Black girls and provide approaches that are both culturally specific and gender affirming. Currently, there is a lack of non-white mental health providers and providers who can provide culturally competent mental health services to Black girls.
Factors that impact Black girls mental health
In addition to challenges that youth face may face in general, many Black girls also have to contend with racism, adultifcation, sexual harassment and violence.
There is a correlation between experiences of racial discrimination and signs of depression among Black teens: Black teenagers can face an average of five racially discriminatory experiences every day. In addition, we know that youth of color experience both direct and indirect harms to their mental health and well-being from racism, including racialized police violence. Black girls who experience negative messages about Black women also experience more symptoms of depression. Racism—including racialized state violence—triggers a stress response in children and youth that accumulates over time, adding to existing social and cultural harms based on race and ethnicity. It becomes yet another adverse childhood experience that youth of color must overcome without the proper investment in community supports for their resilience and healing.
Black girls experience disproportionate levels of gender-based discipline in school such as being suspended or removed from class for dress code violations and being “disruptive”—all pointing to the “adultification” of Black girls. Black girls are six times as likely to be suspended and four times as likely to be arrested at school than white girls.
Black girls report higher rates of sexual harassment, both in school and out of school, than any other group. For girls, sexual harassment can lead to elevated risk of self-harm, suicidal thoughts, feeling unsafe at school, and more.
Other factors, such as poverty, can also play a role: Black people living below the poverty level—as compared to those over twice the poverty level—are twice as likely to report serious psychological distress.
Black girls may not engage with current mental health services—or services may not even be available
Overall, racial and ethnic minorities have less access to mental health services than whites, and when they receive care, it is more likely to be of poorer quality. For youth, nearly 50% of those with a mental health disorder did not receive needed treatment or counseling from a mental health professional.
Among Black youth, mental health issues such as depression may manifest differently than it does in adults—for example, young people with depression may exhibit interpersonal or behavioral problems, low self-esteem or pessimism. This may make it more likely that youth will be flagged as “problems” or “troublemakers” and punished rather than be understood as youth with depression or mental health issues and get the services they need.
When mental health services are available, youth of color may not engage in those services because of social stigma, misgivings about the efficacy of treatment, and distrust of providers. Or the approach and treatment itself may not address the causes and symptoms that are specific to Black girls. This is at least in part due to the lack of cultural competency that exists across most mental health providers: for example, only 4 percent of psychologists in the United States are Black.
What can be done to improve the quality and access of mental health services to better meet the mental health needs of Black Girls?
First, we need more research on Black girls’ mental health. There is not much research focused on the specific mental health needs and mental health outcomes of Black girls. We need to understand just how prevalent mental health issues are among Black girls, especially girls in the juvenile legal system. We need to understand what’s causing mental health issues among Black girls and better understand the consequences when those issues go unaddressed.
Broadly we must also better support and strengthen our Black communities. Focusing on eliminating systemic barriers such as poverty and racism and discrimination—which leads to and housing/homelessness, incarceration, unemployment and more—could get us a long way towards better mental health for our Black girls.
More immediately, the H3 Collective is an important intervention. It will serve as a driving force for change and as a model to demonstrate what meaningful mental health services for Black girls and other girls of color could look like.