Visibility is a hard thing to have to fight for as a teenager. The pressures of social hierarchy are thrust on their radar at an increasingly young age. A young Black teenager, fighting the varying messages trying to grab her attention, is also subject to a different set of rules compared to her white or Latinx classmates. She’s got a lot to think about. But if she grows up in a culture that prioritizes strength over health, she can suffer at the hands of the village that is supposed to raise her. Young Black men are no stranger to stereotypes and labels, either.
Teen suicide rates increase at an average of nine percent per year, and suicide has officially replaced homicide as the second leading cause of death for Black teens age 15-24, according to the Department of HHS Office of Minority Health. What can healthcare providers and parents of Black teens do to meet adolescents halfway and support them in taking care of their mental health?
Experts say the stereotypes surrounding Black life and stigmas attached to mental health care are at the root of the problem.
Change how you speak about mental health
While validation may not be a problem for everyone, teens need confirmation that their behaviors and experiences are normal and can be addressed. Alisha Woodall, a licensed professional counselor from Finding the Foundation in Dallas, tells SheKnows that many adolescents aren’t brought in for mental health treatment unless there is a drastic behavioral change.
“You’re going to have different demographics that use therapy more than others, just because of the perception of what that means,” Woodall says. “It really depends on perspective —and I think that is why certain communities are more frequent with treatment than others.”
Woodall treats mostly Black women ages 25 to 40 — but, nationally, the percentage of Black adults who receive mental health services in the last year was just 8.7 percent. Black teens are looking up to a generation that may not have prioritized their own mental health.
“The largest piece of this is changing the narrative and the way that we see mental health, because then it doesn’t seem alarming when someone seeks mental health service or therapy,” Woodall says. “If somebody is sick, it’s not a second thought to go to the doctor. It’s instantaneous.”
Even today, there is growing evidence that health care providers see Black people as more tolerant of pain. Mental health problems though do not discriminate. Recent surveys from the Office of Minority Health show that no one race experiences more mental health issues than another, but cost and community factors influence each person’s choice to seek help.
That’s why Woodall says that parents should be open to bringing up and discussing the “self” (inner thoughts, feelings, emotional processing) with their young ones. “Being open to it early on — not just being open to therapy — but just being open to what mental health really is,” she says can make a difference. Woodall adds that a simple “how was your day?” is not enough — it’s about digging into their inner self and understanding what your child is really feeling during their day.
Of course this might be contrary to messaging older generations may have received that encouraged pushing through and getting over it, but it’s essential. According to the National Institute of Mental Health (NIMH), mental disorders increase as teens go from 13 to 18, most drastically between the ages of 17 and 18 — which provides a short window to begin opening a productive, shame-free dialogue. If they need to seek help in the future, it can be difficult to know where to look if they associate seeking help with shame.
Attitudes toward mental health, Woodall says, will ultimately depend on the level of education, exposure and experience an individual has had with it: “Even in the past five years, there’s been a dramatic change in the way that people perceive therapy. But older generations would have been whispering.”
Understand the Black experience & respect each child’s individual experience
Black people are not a monolith. While the realities of absent fathers and attitude problems are still prevalent, tip-toeing around these stereotypes will not make teens more comfortable to speak about their issues. How we discuss the Black experience, whether we’re part of the community or not, is crucial.
Lorenzo P. Lewis is the founder of The Confess Project, a nonprofit dedicated to fighting mental health stigma for Black boys and men. Through his work with Black teens in juvenile detention centers, he has focused on the statuses that act as a barrier between providers and those they serve.
“Think about the dehumanizing of social media and the lack of social connectedness leading to Black teens feeling more isolated. Then there’s also the family dynamics,” Lewis told SheKnows. “Poverty is an issue in communities of color, and poverty ties directly into childhood trauma. If they may have been abused or received extensive discipline (spankings), they may be more likely to experience issues around ADHD or suicidal ideation.”
All of this, tied in with faith-based values (like believing God is the only source of healing) or Black hyper-masculinity (which treats mental illness as weakness) creates specific language around the Black experience. Lewis also mentions a distrust of the medical community in general, and historical trauma that Black Americans experience because of slavery and discrimination.
The Black experience is nuanced and personal, and there is no way for non-Black providers to fully understand it, as Lewis notes: “We need folks that really can show up and give a true narrative by being realistic and humanizing the experiences that we do go through, and letting the people that you serve know that.”
If you’re not Black, you can’t connect on a racial level, but you can connect on a personal level by setting aside your privileges and removing the status that society has assigned to Black people. Lewis suggests validating the teen where they are at, rather than bringing them to your level: “It’s about them,” he says. “It’s not about us.”
Black teens are not special cases or troubling stories. At the end of the day, they are just teens who deserve individual care for their individual journey. The Black experience attached to their journey is just a critical part to acknowledge.
If you are in crisis or in need of support, text “START” to 741-741 to speak to a trained counselor at Crisis Text Line.
A version of this story was published February 2020.