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BIPOC Children’s Mental Health Challenges During COVID-19

BIPOC children often face additional mental health difficulties during COVID.

Key points

  • BIPOC children often have worse mental health outcomes and more difficulty accessing treatment.
  • These families have also been disproportionately affected by COVID-19.
  • Potential solutions include increasing telehealth access, improving mental health assessment, and optimizing parental supports.

This post was co-authored by Brad Eardley, LMFT. Eardley is the program director of Outpatient and Children Behavioral Health Initiative (CBHI) Services in Haverhill at the Beth Israel Lahey Health Behavioral Services, overseeing multiple home- and community-based mental health programs in Northeast Massachusetts.

Black, Indigenous, and People of Color (BIPOC) children often have worse mental health outcomes and more difficulty accessing mental health treatments. According to the Centers for Disease Control and Prevention (CDC), suicide is the leading cause of death for youths, and the rates of suicidal attempts have been highest among BIPOC youths. The COVID pandemic has increased the prevalence and severity of childhood mental health difficulties while concurrently interrupted access and care delivery. The disproportionate prevalence and severity of mental health problems in BIPOC children are compounded by the already strained and limited school-based mental health resources. For many youths, schools often serve as the primary and only providers of mental health intervention. Strong collaborations between mental health agencies, incorporating trained external providers (EPs), and school systems may effectively address the limited resources and access to mental health care for vulnerable children.

 Agung Pandit Wiguna/Pexels
Children learning remotely.
Source: Agung Pandit Wiguna/Pexels

Access to telehealth infrastructure

During COVID, many schools have shifted to the virtual platform for learning, which has also revealed incompatibilities with certain telehealth platforms. For many BIPOC families with limited resources and income, BIPOC children may only have access to school-provided computers. A study showed that schools serving lower socioeconomic communities were much less likely to be able to provide students with a laptop. The Pew Research Center suggested that only half of low-income families can access internet speeds necessary for telehealth. During a time where mental health care is especially needed, BIPOC children are at a higher risk of losing access and discontinuing care.

Exposure to COVID and pandemic sequelae

BIPOC families have been disproportionately affected by COVID—both directly via the rates of infection and mortality and indirectly via socioeconomic factors. Due to economic downturns, BIPOC families are disproportionately more likely to lose employment—thus, health insurance, leading to additional difficulties for their children to access the already limited mental health resources. Pre-COVID, children with limited resources may access mental health care from school systems; however, due to the closures of schools and intermittent disruption of learning schedules, the disengagement and discontinuation of treatment portend worse mental health outcomes, especially for BIPOC children. Additionally, BIPOC workers are more likely to have service-related and in-person jobs, which concurrently removes parental supervision and increases risk of COVID exposure for the entire family.

Adult support at home

The COVID pandemic has forced many families to work and learn from home; however, BIPOC families are less likely to have a quiet and contained environment. As previously mentioned, BIPOC workers are less likely to be able to work remotely and thus less likely to facilitate the optimal environment for remote schooling and telehealth treatment for their children. BIPOC children are significantly more likely to be raised by a single parent, which may lead to less availability for direct engagement in health care. Furthermore, some studies have suggested that BIPOC parents are less likely to have flexible work schedules, which may further exacerbate the needs of supervising their children who struggle academically during the pandemic.

Potential solutions

Increasing telehealth access:

  • School systems need to deepen relationships with community mental health agencies that provide EPs. Best practice entails providing EPs flexible access to students and clear workflows that integrate mental health care with the didactic curriculum.
  • Mental health agencies may serve as integral consultants to ensure the compatibility of school-based hardware and software with telehealth platforms to avoid disruption in treatments.
  • EPs can assist schools in identifying at-risk students and advocate for relevant accommodations to address access challenges, such as lack of broadband internet, or unavailability of parental involvement.

Improving mental health assessment and engagement:

  • Mental health agencies may assist school stakeholders in utilizing appropriate mental health surveys to better assess student needs.
  • EPs can collaborate with school stakeholders to develop tailored roadmaps for school-based treatments, ranging from the identification of specific problems to specific service referrals.
  • Schools and mental health agencies can help develop a treatment plan schedule to address students’ mental health needs without jeopardizing their school attendance.

Optimizing parental supports:

  • Through the school system, mental health agencies develop better communication channels for the occupied parents, such as, via the teachers and the adjustment counselors in addition to the EPs.
  • Mental health agencies can also assist schools in identifying the mental health needs of the parents/guardians.
  • EPs can provide coaching to parents to better optimize the mental health treatments in the home.

The COVID pandemic has laid bare the infrastructural vulnerabilities that perpetuate and exacerbate mental health inequities facing BIPOC communities. School-based mental health treatments, albeit not the panacea, can serve as invaluable additional resources to mitigate the worsening mental health inequities for vulnerable children. By integrating mental health services into school settings, assessing current needs, and increasing parental support, the collaboration between EPs and schools can prevent both short- and long-term social, educational, and psychological consequences for minoritized and under-resourced BIPOC children.

References

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Hoagwood K, Erwin HD. Effectiveness of school-based mental health services for children: a 10 year research review. J Child Fam Stud. 1997; 6:435–451

Catron T, Weiss B. The Vanderbilt School-Based Counseling Program: an interagency, primary-care model of mental health services. J Emot Behav Disord. 1994; 2:247–253

Sanchez et al. The effectiveness of school-based mental health services for elementary-aged children: A meta-analysis. 2018; 57(3): 153-165.

Giano Z., Wheeler D.L. & Hubach R.D. The frequencies and disparities of adverse childhood experiences in the U.S. BMC Public Health 2020 20, 1327

Kazdin AE, Holland L, Crowley M. Family experience of barriers to treatment and premature termination from child therapy. J Consult Clin Psychol. 1997;65:453–463

Herold, B. The disparities in remote learning under Coronavirus (in charts) Education Week. 2020; April 10.

Hanscombe et al. Chaotic homes and school achievement: a twin study. J Child Psychology & Psychiatry. 2011 Nov; 52(11): 1212–1220.

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