Beyond the Numbers: Pediatric Mental Health

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There are significant disparities in suicide risk, mental health outcomes, and access to mental health care for racial and ethnic minority youth across the United States; these youth are more likely to receive lower quality and fewer mental health services compared to non-Hispanic White peers. According to the 2023 Youth Risk Behavior Survey (YRBS), 15.3% of Native Hawaiian or other Pacific Islander respondents, 11.5% of American Indian or Alaska Native respondents, 10.8% of Hispanic or Latino respondents, and 10.3% of Black or African American respondents reported they had previously attempted suicide compared to 8.3% of White respondents.  The suicide rate among Black youth has been found to be increasing faster than any other racial/ethnic group. The 2023 YRBS indicated that the experience of racism was two to three times more prevalent among students from all marginalized racial and ethnic groups compared to White students and that students who experienced racism had higher rates of poor mental health and suicide risk.  Factors that have been identified as perpetuating and contributing to these mental health disparities include socioeconomic status, exposure to adverse childhood experiences (ACEs), neighborhood-level stressors, family structure, as well as mental health practitioners’ implicit biases and limited cultural competence.

These disparities are also reflected in data from Arizona. The 2023 YRBS for Arizona showed 17.4% of Black or African American respondents and 10.4% of Hispanic or Latino respondents reported they had previously attempted suicide compared to 9% of White respondents (there was no data for American Indian or Alaska Native respondents).  The Arizona Adolescent Mental Health Report from October 2024 indicated that diagnoses of anxiety and depression were highest among those adolescents that identified as “Non-Hispanic Other” for racial/ethnic category.

What can we do to address these disparities as providers caring for ethnic and minority youth facing mental health concerns?

1. Practice cultural humility and commit to providing culturally competent care.
   • Helpful resources:
     • American Academy of Child and Adolescent Psychiatry Cultural Diversity Resource Center
     • APA Committee on Children, Youth and Families’ Resource List for Addressing Disparities in Youth Mental Health
     • Bright Futures Health Equity Resources for Health Care Professionals
        
2. Consider the child/teen's intersecting identities while providing care.
    
3. Creatively engage youth through motivational interviewing and a culturally sensitive therapeutic alliance.
    
4. Bolster protective factors including positive home and school environments, stable parental mental health, social support and religious and community involvement, and positive racial and ethnic identity.