Over 500 school-based mental health professionals joined this webinar to hear this much-needed conversation about Breaking the Stigma around mental health in black communities so that Black youth can get the mental health support they need. Black youth are at higher risk of experiencing mental health challenges due to discrimination, trauma, poverty, and more. The suicide rate among 13- to 30-year-olds is growing fastest in the Black community, rising over 50 percent between 2010 and 2019. 

For me, as a person of color who spent my entire professional career working in the Boston Public Schools—a district that serves a majority of minority students—this topic is of paramount importance to me. In Boston, I worked incredibly hard to create strong and meaningful connections with students, families and community members to create a foundation of trust that would allow for more open conversations around access to mental health support for our students.  

We were incredibly lucky to have had two school and mental health experts, who both focus on creating access within the Black community, with us for this discussion:

Dr. Wenimo Okoya, Ed.D, MPH, has brought equity-focused mental health programming to K12 schools. In her prior role at the JED Foundation, she worked with schools, organizations, and individuals to enhance their adoption of anti-racist, trauma sensitive cultures. Using her experience in K12 schools, Dr. Okoya founded the Healing Schools Project, which brings thoughtfully designed programs to support teacher mental health and wellbeing in an effort to retain educators, especially educators of color.

Granville T. Freeman, LPC, CPCS, BC-TMH has over a decade of experience working with students as a school-based mental health professional. In addition to his own private practice, Granville works for Metro RESA in the Atlanta metro area as a coach, helping schools to become Community Schools. He facilitates and develops mental health training and support for schools in Metro Atlanta. 

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UNDERSTANDING THE ROOT CAUSES‍

It’s important to first understand the root causes of why these stigmas around mental health exist in black communities.

‍Driven by a Culture of Resilience

If we look at the historical context and what Black people have experienced with regard to clinical institutions, they have been pushed to “survive” not thrive. They have been expected to “push through” and be resilient. Dr. Okoya pointed out that “black resilience is an important thing to celebrate but it has led to this kind of phenomenon where it's normal to operate in a certain way”. The stigma is rooted in this culture of overcoming and pushing through and has created a dynamic that makes it incredibly difficult for Black people to ask for help when they need it. As a result, there is a lack of culturally competent or responsive services in communities to meet the needs of Black families and their youth.

Granville pointed out that “the system wasn’t made for people of color.” It is a system that was created specifically for wealthy white men which has created a general distrust of the healthcare system. 

The Power of Religion

The Black community is the most religious of any racial group in the United States. 

Religiosity can be a great, powerful, and spiritual tool for resilience. However, when people are experiencing mental health issues that they “can't pray away,” their community continues to reinforce that those feelings aren’t normal. We need to normalize that it is “okay to not be okay” and partner with churches and train pastors and other religious leaders to normalize mental health challenges and understand when someone should get professional mental health support.

These spiritual leaders can help their community understand that it isn’t about someone else trying to “fix you,” rather someone is there for you that you can rely on to help support you through this journey. The right therapist will respect your religious and spiritual connection that ground you as a person, which is another reason why having culturally competent clinicians is a must in the Black community.

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BREAKING THE STIGMA IN OUR SCHOOLS

Both panelists agreed that schools are where this mental health work needs to be happening. Children spend the majority of their young lives in the school building and they are legally mandated to be there until they are 16 years old. Kids are probably in their school building interacting with their school community more than they are interacting with their own families.

Dr. Okoya referenced the “Stages of Change” Model where people need to be in “pre-contemplation” mode before they can begin to take action. As it relates to mental health, people first need to see it as an issue or challenge. In Black families in particular, there may not be a culture of talking about mental health or one’s feelings. 

Schools should start exposing students and families to language around health, wellbeing and mental health to make it normal for people to talk about it. As a tier 1 intervention, teachers should have permission to talk about well-being in the classroom and help to build a culture around asking for help. By consistently exposing students to language around well-being and mental health, we are able to push folks into the “contemplation phase” of asking for—or seeking—support.

Dr. Okoya shared that the majority of young people who have attempted suicide had asked a friend for help before they tried anything. Oftentimes that friend doesn’t know what to do. Schools have the opportunity to create a culture of asking for help and training young people on what to say, what to do, and how to get necessary support. 

Teachers can model this behavior to their young students. They can show that it’s okay to say, “I had a rough weekend and am working through some things today. But, I’m proud of myself for being here.” Or, “It’s not just you. Mr. Freeman also has a really hard day from time to time.” It is important to let kids know what it looks like and what it takes to manage those feelings or emotions. There are so many non-clinical interventions that can be leveraged to start to create that culture change. One of the attendees shared that “oftentimes we have to teach the teachers so they can model it for the kids.”

As Dr. Okoya said, “regulated adults can regulate young people.” We must make space for the adults in our schools to get the support they need as well. We should model this culture in staff meetings by providing empathy, support and compassion for one another and provide mental health support systems for school staff. 

In the classroom, teachers can have morning meetings/check-ins, show students how to regulate themselves when they are having a bad day (i.e. breathing techniques), have calming corners, etc. By teaching these practices and having these conversations with kids at a young age, they will grow up and have the ability to understand how to communicate and regulate their feelings, how to get help for their friend in need, and what to do in a crisis. Our schools are a microcosm of our communities and we need to start having these conversations and give them the permission to talk about these emotions.

QUALITY MENTAL HEALTH CARE FOR BLACK YOUTH

The Importance of Teletherapy

The discussion then turned to the importance of making mental health supports equitable and accessible to all students. Since the Black community has historically had a negative stigma associated with mental health support, teletherapy allows them to participate in a therapeutic relationship in a way that is easily accessible and most comfortable for them. They can do their sessions from the comfort of their own homes or schools without feeling like they are in a sterile office environment. And, because it is virtual, it doesn’t require time away from school or work to get to and from these appointments which can be costly.

Teletherapy also gives students access to a more diverse clinical base. It is incredibly important for Black students to meet with a therapist that looks like them. A shared cultural background allows for more authenticity in creating a judgment free connection and ultimately more positive clinical outcomes.

Schools can provide these services to students, at no cost to families, with teletherapy providers like Daybreak Health. 

Connectedness and Belonging‍

When it comes to Black students in particular, Dr. Okoya shared that “it's really important that young people feel like they belong in the school not despite their identity, but because of their identity. We see you, we accept you, and we want you here. You belong.”

Schools must focus on how to create strong relationships with their students. This begins with creating a sense of connectedness within the school community. Dr. Okoya recommended that schools focus on strength-based outcomes versus deficit-based ones. We often look at students with a deficit lens, this is why we often tier students rather than tiering our supports. If we focus on connectedness and create tiers that focus on the desired outcome, we will naturally create a culture that is strength based.

Dr. Okoya shared an example that she has seen work well in schools. They put every student on an index card and the staff marked (with a dot) every student with whom adults in the building had a connection with. Every young person who didn't have one or two dots became priority students. They were the ones the school staff needed to make connections with. Oftentimes, particularly in a white school, those are going to be the Black students or other students of color.

Black students and students of color tend to have the highest metrics around disciplinary data, attendance issues, etc. If we can look at those metrics and overlay that with connectedness, we would see the trend moving in another direction. Using connectedness and belonging starts to flip the narrative on its head around what we are doing to ensure that students feel connected and a sense of belonging in school. We need to be addressing the root causes of the problem, not the manifestations of the problem. 

Dr. Okoya shared, “the fact of the matter is that schools were not designed for Black students to be successful.” So we need to be really intentional about making space so that their identities are accepted. All students, regardless of which tier they map into, need to feel like they're connected, that they belong in school, and that their identity matters.

Engaging with Families‍

Dr. Okoya shared that oftentimes when she is working with districts that predominantly serve white students, the staff can struggle around ways in which to deeply engage the Black students and families. To combat this, it is essential to include the voice of those families in the conversation. We need to ensure that we are creating a place at the decision making table for their voice. We have to have open dialogue with people rather than creating solutions for them. Without doing so, we will continue to perpetuate harm and be unable to create a sense of belonging, connectedness, and trust in the institution for our Black families. 

Schools need to re-think and ask themselves, “are the partnerships we HAVE actually the partnerships we NEED?” By listening to parents, children, and staff you can start to see what the themes are and what is actually needed in your schools. But, it was called out that you must follow-up and create action or else it will continue to perpetuate mistrust in the system and will make it even harder to build those authentic relationships.

AN UPSTREAM APPROACH TO MENTAL HEALTH

It was acknowledged that districts across the country are facing serious budget limitations due to the ESSER cliff. This discussion reinforced that school-based mental health support should be a core investment. 

The panelists discussed the importance of mental health being an “upstream investment”. An analogy was made where there was a river and people kept seeing babies come down the river that they had to rescue and save. Someone called out, “what if we go further up the river and figure out why these babies are here at all?” By doing that, they saved more babies from getting into the river in the first place. 

With regard to mental health in schools, we need to approach this in an upstream manner. We must look at the environment that is creating these downstream issues like chronic absenteeism, declining test scores, an increase in behavioral issues, and go upstream. We need to understand the trauma that young people are experiencing. For Black youths, many feel like they don’t belong in school. They don’t believe they have access to people who care about them and who they can talk to. If we invested in upstream support, we wouldn’t be spending so much time and money “catching babies” downstream in the river. 

Although it might feel like a big investment to put more clinicians in schools, partner with teletherapy providers, and invest in teacher well-being, we are actually saving more time and money in the end. It will be an investment in dealing with fewer crises, getting more instructional time in the classrooms, and creating an environment where both students and families are engaged. 

We are in an urgent moment where we feel like we have to solve all of the problems that are rising to the surface. But, if we look up, we’ll see that mental health is one of the biggest issues that needs to be addressed, invested in, and prioritized.