As America works to adapt its health services and public policy to the needs of children suffering from the current mental health epidemic, it is important that history does not repeat itself – with black children left behind.
The stakes are higher than ever. Suicide rates among black children have risen faster than any other racial or ethnic group over the past two decades. Many Black children’s earliest experiences with our modern healthcare system were marked by racism, microaggression, a lack of cultural understanding, limited trauma-informed care resources, and fear, particularly after the death of George Floyd on May 25, 2020. These experiences are compounded by historical inequalities in healthcare have put black children at higher risk for depression, anxiety and stress.
There is a lifeline for black children: access to mental health services is one of the top predictors of suicide risk, according to the World Health Organization. But a multitude of barriers stand between black children and the care they desperately need. These barriers include poverty, food insecurity and discrimination against families seeking quality and equitable care. Additional factors that stand in the way are travel expenses or other restrictions, such as. B. the inability of a parent or caregiver to miss work for their child’s appointments.
In addition, telemedicine has proven to be another factor of discrimination. Celebrated today for its easy access and reach, telemedicine is widely used in mental health care. However, recent research shows that rural families are less likely to use telemedicine for behavioral health needs. In many cases, large black populations live in rural areas where broadband service is unavailable and low-income families often cannot afford internet service.
As Chief Equity and Inclusion Officer at Children’s Mercy Kansas City, I am intimately familiar with the barriers many children and their families face in our community. Missouri has a higher rural population than most of the country, with about a third of the state’s residents living in rural areas.
I am also aware that our local care experience is a microcosm of the national one. Over the past two years, we have begun to break down these barriers through health equity-focused initiatives based on research and an understanding of our organization’s culture and systems. An example is the cross-cultural medical assessment of physicians and providers presented to our physicians and allied healthcare providers such as social workers, psychologists and advanced practice nurses. The assessment assessed the extent of our providers’ formal training in cross-cultural medicine, their opinions on health differences, and their self-assessed willingness to treat a variety of people – such as: Patients with limited English skills, deaf and hearing-impaired patients, and patients whose health preferences may be at odds with Western culture, potentially affecting treatment decisions. The assessment has helped us uncover areas in our healthcare system that need improvement, which will ultimately lead to better healthcare outcomes for our diverse patient population.
As physicians and institutions alike organize to address a mental health crisis we have never seen before as providers, it is critical to continue with the context of how history, modern society structures and COVID have impacted black children in particular -19 Pandemic. We must not be afraid to look into our own systems to assess and identify equity gaps so we can get to the root of problems. Only then can we prepare to drive enterprise-wide change in our own institutions as well as in our communities. Together we have the opportunity, but above all the responsibility, to serve and protect our Black children.