by Jean Rhodes
In a special issue of the Journal of Clinical Child & Adolescent Psychology, mentoring experts Noelle M. Hurd and Andrea S. Young, address the problem of racial injustice in the field of clinical child and adolescent psychology and more broadly. The collection of articles focus on the disparities faced by racially and ethnically marginalized youth in the United States, who are less likely to initiate treatment, remain in treatment, and receive evidence-based care compared to their White peers. Implications for mentoring programs abound. As Hurd and Young note, disparities in mental health care stem from a range of factors, including treatment preferences, stigma, and a lack of understanding about mental illness. However, these are not the only factors. Disparities also stem from providers’ biases, which influence their decision-making. They note that, unlike Black providers, many White providers hold common implicit racial preference for White Americans over Black American.
The articles call for major shifts in the field to address and mitigate these racial inequities in mental health access and treatment. For starters, training must better assess how structural oppression and racial trauma shapes youth mental health, and adopt models that meet the needs of low-income communities where marginalized youth are overrepresented.
This includes the deployment of well-trained paraprofessionals (including mentors), who may share key social identities, languages, and cultures with marginalized families, facilitating connection and culturally responsive care. Within this context teletherapy can be effective and may help eliminate some barriers to access.
Taken together, this is a call to action for mental health providers, teachers, mentors, researchers, and gatekeepers to take into account the systemic and structural barriers that contribute to racial disparities and to find ways to make the field of clinical child and adolescent psychology more racially just.
Implications for mentor training and programs.
Focus on Systemic Barriers: Mentors, particularly those working across racial and cultural divides, should be made aware of the systemic and structural barriers that contribute to racial disparities in mental health care. Training should include historical and societal contexts of racism and its impact on youth mental health. Helpers should recognize racial trauma and, in some cases, engage in activism that supports anti-racist reforms.
Diversify the Field: Training programs (and mentoring programs) should actively recruit and support helpers from racially and ethnically marginalized backgrounds. This would help to reduce provider bias. As the editors note “Providers from racially and ethnically marginalized groups may be less likely to evidence racial and ethnic bias in clinical decision-making; however, American Indian, Alaska Native, Native Hawaiian, Black, and Latinx providers are underrepresented in the psychology [and volunteer mentoring] workforce.”
Provide Culturally Responsive Care: Training must emphasize culturally responsive care to build trust and connection with mentees from diverse backgrounds. Mentors should be equipped to understand and respect the cultural backgrounds of the individuals they mentor. This includes efforts to provide better training on racial bias awareness and cultural humility.
Deploy Paraprofessionals and Lay Health Workers: Mentors and other paraprofessionls should be trained and deployed to deliver or support evidence-based care that can extend mental health services to underserved communities and close gaps in effective care.
Embrace technology-delivered interventions: As teletherapy becomes more common, mentors need training on best practices for virtual service provision. Programs need to train their mentors in supportive accountability and to ensure equitable access to teletherapy across all racial and ethnic groups.
Offer Opportunities for Continuous Learning and Adaptation: Mentor training programs should be dynamic, incorporating ongoing research and emerging best practices related to racial justice. They should encourage a mindset of lifelong learning and adaptation to new information and societal changes.
Although the focus in on professional training, the editors’ recommendations and strategies have implications for mentoring programs. As they note these strategies should include “strengths-based approaches that capitalize on the resilience and rich legacy of racial/ethnic socialization among racially and ethnically marginalized families. .. ignoring these opportunities for action makes us complicit with systems of oppression. The time is now for us to more fully center anti-racism, racial justice, and equity in our clinical and empirical pursuits.”