Equity in Mental Health Month: A Q&A With Dr. Khadijah Booth Watkins

July is known as BIPOC Mental Health Month, National Minority Mental Health Awareness Month, and at JED, Equity in Mental Health Month. Regardless of title, it’s important to collectively recognize that young adults from communities of color often face unique challenges that negatively impact their mental health. 

Here, JED Advisory Board Member Khadijah Booth Watkins, MD, MPH, shares her insights about the barriers that young people of color currently face and what can be done to shift these circumstances and promote equity in mental health.

1. What are some unique barriers to mental health support and/or resources for young people of color?

Barriers that are unique to Black and Indigenous youth, as well as those from other communities of color, include stigma. The stigma surrounding mental illness can be pretty significant within these populations, often delaying or even preventing people from seeking the help they need. 

There’s also the issue of not enough mental health providers of diverse cultural and ethnic backgrounds in the field to provide care to those communities. There are also longstanding and deep-rooted issues that are systemic, which have resulted in profound inequities and disparities as they relate to health care and access to care for those in these communities. 

Lastly, although this is not an exhaustive list, there is a lack of time, effort, and resources allocated to research that is directed at better understanding these populations and communities. Fully regarding the impact of the individual’s experiences on their mental health is another glaring omission, especially knowing the hefty toll this has on the well-being of our young people in these communities. The uniqueness of Black youth and other youth of color have not been considered, and as a result, the impact of their experiences has been excluded, and as such, the resources do not adequately address their needs.

2. A 2020 study from the Journal of Applied Developmental Psychology found that Black Americans experience an average of 5.21 incidents of racial discrimination a day. The study also found that these incidents correlated with depressive symptoms. What are your thoughts about the impact this has on the mental health of Black youth? 

Racism, discrimination, living in communities with greater incidents of violence, food deserts, and lacking safe and clean spaces to enjoy nature: This is all very STRESSFUL. 

While stress is natural, and meant to protect us from threats and danger, it is a widely known fact that high levels of chronic stress are unhealthy for our bodies, leading to high blood pressure, heart disease, and digestive issues. It also takes an immense emotional toll on our youth, leading to problems with sleep, anxiety, depression, and other mental health conditions.

3. As a result of climate change, issues of police brutality, and many other sociopolitical issues, young adults are experiencing heightened anxiety and hopelessness. How can young adults of color help themselves and each other process their thoughts and emotions about the general unrest in our country?

Things have felt quite tenuous for most young people, and we are amid a National State of Emergency related to youth mental health. It was also noted that the worsening in child and adolescent mental health is “inextricably” tied to the stress brought on by COVID-19 and the ongoing struggle for racial justice. Watching images of others resembling you being discriminated against and being the victim of violence is demoralizing, stressful, and scary. We cannot disregard their experiences and the impact on their health and overall well-being. There are many ways in which young people of color can support themselves and one another.

Those include:

• Meet with other students and young adults of color for support. Knowing that you are not alone in your feelings of uncertainty, sadness, frustration, and so forth, can be extremely validating and supportive. Isolation is stressful and can leave us vulnerable. Having the sense that you alone are having an experience, or one that no one else can relate to, can feel extremely lonely, which is why it is imperative to connect with others.  
• Engage in activism. This can force a shift by challenging feelings of helplessness and hopelessness. It can be a powerful tool for fostering agency and a sense of purpose. It also serves as another platform for connection and community.
• Engage in self-care. Doing things that please you allows you to recharge and promotes physical and mental well-being. Actively work on building resilience by meeting your basic needs. Exercising, eating a healthy diet, and getting enough sleep is essential. Maintaining connections to friends and family and engaging in activities like mindfulness and gratitude also foster resilience. As a result, you will be better able to recover from the challenging emotional stressors and traumatic experiences.

4. What are some ways communities and institutions can support BIPOC mental health this month?

Teachers, parents, coaches, and mental health professionals who engage regularly with young people of color need to be educated as to the uniqueness of these communities: their risk factors, protective factors, how they talk about and exhibit depression or anxiety (for example, showing irritability instead of sadness or focusing on physical symptoms), etc.

There needs to be a deliberate effort to recruit and retain mental health providers of diverse cultural and ethnic backgrounds, who are culturally competent. These providers need to be accessible in schools, community centers, primary care offices, and places of worship.

There also needs to be a concerted and deliberate effort to provide education regarding mental health, with the ultimate goal of eradicating the stigma associated with it. Proper education must be at the core and the primary tool to dispel many of the widely held beliefs and misconceptions regarding mental illness and treatment. Educational materials and resources must be available in multiple languages; these also need to be accessible. Using various platforms to disseminate information, such as pamphlets, videos, blogs, podcasts, and more, creates more opportunities to engage. 

Khadijah Booth Watkins, MD, MPH, is the Associate Director of the Child and Adolescent Psychiatry Residency Training Program of Massachusetts General Hospital (MGH) and McLean Hospital, as well as the Associate Director of the Clay Center for Healthy Young Minds at MGH. She specializes in the evaluation, diagnosis, and treatment of psychiatric disorders in children, adolescents, and adults, having earned her MD from the University of Tennessee Health Science Center and her MPH from Columbia University. She is a member of the JED Advisory Board.