Young people in America are experiencing a collective mental health crisis exacerbated by the COVID-19 pandemic, but Black children specifically have been at a higher risk of struggling with mental health conditions for decades — and their crisis is less publicized than that of their white peers. Amanda Calhoun, M.D., M.P.H., Chief Resident of the Yale School of Medicine’s Albert J. Solnit Integrated Adult/Child Psychiatry Program, has dedicated her career to changing the narrative around the mental health and psychiatric care of African American children. The American Psychiatric Association Foundation (APA Foundation) sat down with Dr. Calhoun to discuss the Black Youth Mental Health Clinical Case Conference Series designed by Dr. Calhoun and sponsored by the APA Foundation.
Using stories from the field, the Black Youth Mental Health Clinical Case Conference Series engages and empowers psychiatrists, social workers, and healthcare professionals to undo the harmful patterns of dehumanization that follow African American youth in psychiatric treatment. Dr. Calhoun opens each conference with a patient’s story because, she says, “I want the audience to feel who the kids are. How can you discuss the intricacies of psychiatric care – so much of that is their mental health, the way they present, the way they interact – when you don’t even know who the patient is as a person? That’s why I wanted to bring this to life with narrative, and the narrative is what makes this conference series stand out.”
The power of narrative to provoke empathy and equity is needed. African American children are disproportionately diagnosed with ODD (Oppositional Defiant Disorder) and DMDD (Disruptive Mood Dysregulation Disorder). Dr. Calhoun does not use the ODD diagnosis with any of her patients of any race. “I’ve seen a real lack of compassion and empathy towards Black children. You see a lot of these anti-Black mindsets and statements about the inferiority of Black children – them being more violent, not being able to feel pain.” Dr. Calhoun is leading the charge towards a future where Black children and their family caregivers can anticipate receiving culturally competent psychiatric care.
“My vision includes mental health professionals that are caring for Black children really being compassionate, committed, and competent. I think we need to get a group of professionals who are trained in the care of Black children in a compassionate way, and they need to understand how medical racism shows up at an institutional level – and at a one-on-one level, which is what my focus is. Make sure you are taking time to sit down and conceptualize the child, to see them as a child, to not jump to negative stereotypes and conclusions about the child being ‘bad’ or oppositional, and instead to wonder ‘Why is this child responding with so much feeling? What must be going on at an internal level?’”
Dr. Calhoun’s call to action for child psychiatrists to lead with curiosity rather than judgment represents a tectonic shift in the culture of medicine. “You don’t have to know everything,” she said, “but you need to have a certain mindset, an openness, and the desire to be anti-racist. Medicine is changing, times are changing, and children are changing – we need to change, too.”
In addition to co-sponsoring the Black Youth Mental Health Clinical Case Conference Series at Yale University, the APA Foundation is hosting a series of events for Black History Month: an Executive Leadership Forum for the My Brother’s Keeper initiative on February 7, 2024, a conversation with the HOPE Center Harlem about Men and Mental Health on February 8, 2024, CCNA Community Stakeholders Breakfast on February 13, 2024, S.M.I.L.E. (Smart Men in Leadership Excellence) Foundation Black History Month Awards Dinner on February 24, 2024, and an APA Diversity at Work presentation, featuring Victor Armstrong, M.S.W., Vice President & Engagement for the American Foundation for Suicide Prevention, on February 27, 2024. Read the last installment of this blog series to learn more about the APA Foundation’s efforts to address social determinants of mental health.