At the 66th Annual meeting of the American Academy of Child & Adolescent Psychiatry, Lorio Forensics Consultant and Child & Adolescent Psychiatrist Dr. Courtney McMickens was a presenter in the workshop Recognizing and Addressing Structural Factors Influencing Mental Health of Black American Youth. Dr. McMickens provided a lecture and fielded a variety of questions from audience members present at the well-attended session.
It has been increasingly recognized that understanding the role of culture and societal structures is also imperative to fully assessing and treating emotional and behavioral disorders in children and adolescents. Black American children are disproportionately affected by poverty, involvement in the carceral state, and limited educational opportunities which are inextricably linked to structural factors of racism, structural violence, and other social structures.
Integrating public health and cultural competency perspective, “structural competency” is a framework developed by psychiatrists, Jonathan Metzl and Helena Hansen for clinicians to better “recognize how social, economic, and political condition produce health inequalities”. In her lecture, Dr. McMickens drew from literature on structural factors that mediate and perpetuate violence against people of color and how that influences mental health and illness. She concluded that child psychiatrists and other clinicians can take practical steps to address structural violence and structural vulnerability through efforts on interpersonal, policy, community, and clinic levels.
Cultural exploration is important in understanding socially normative beliefs and practices of a patient (that may different from the dominant Eurocentric culture) but we have to go further in exploring the structural factors (policies and vulnerabilities) that may influence black children’s mental health outcomes because of their race, gender, or other aspects of their identity.
— – COURTNEY MCMICKENS, MD, MPH, CHILD & ADOLESCENT PSYCHIATRIST
