The Yale Child Study Center (YCSC) hosted the first event in its inaugural Black Youth Mental Health Clinical Case Conference Series on January 16.
The series, created by Amanda Calhoun, MD, MPH, PhD candidate in the Yale Investigative Medicine Program and Solnit Integrated child psychiatry fellow/chief resident at YCSC, is dedicated to the discussion of the growing mental health crisis among Black youth and the impacts of anti-Black medical racism. Each case conference features an anonymized story from institutions around the country and expert-led discussions.
Storytelling is a unique and integral feature of each event. Presenting each case as a narrative helps humanize the youth who far too often have been dehumanized by the medical community, Calhoun explains. This format also makes the conference accessible to a broad audience, not just those with a background in medicine.
“The current mental health system is not adequately equipped to optimally care for Black children,” she says. “The goal of the conference is to better understand the historical underpinnings of anti-Black racism in the medical system—how the history of this country and the history of medicine affect Black children today.”
Black youth are facing a mental health crisis
In October 2021, the American Academy of Pediatrics declared that the state of child and adolescent mental health is a national emergency. Black youth are especially at risk. Alarming data are revealing that suicide death rates among Black youth are on the rise and growing more quickly than for any other racial/ethnic group.
At the same time, Calhoun says, anti-Black racism remains prevalent among mental health professionals. Black children, for example, are more likely to be diagnosed with disruptive disorders such as oppositional defiant disorder, while white children are more likely to be diagnosed with attention-deficit/hyperactivity disorder (ADHD).
When you give a Black child a diagnosis like oppositional defiant disorder, you’re branding them as a ‘bad kid,’ not just to schools and their peers, but also within the medical field.
Amanda Calhoun, MD, MPH
The former is laden with stigma, says Calhoun, and there are limited interventions available for these conditions. ADHD, on the other hand, is a highly researched disorder with many available resources and treatment options. “When you give a Black child a diagnosis like oppositional defiant disorder, you’re branding them as a ‘bad kid,’ not just to schools and their peers, but also within the medical field,” says Calhoun.
As a clinician, Calhoun says she has witnessed firsthand the lack of empathy, and sometimes even incompetence, that Black children experience at the hands of their providers. She was a co-author of a 2021 JAMA Pediatrics paper that found that Black children are more likely to be physically restrained in emergency rooms than white children. The findings did not surprise her. “I myself often have to protect Black children and keep them from being restrained,” she says. “I kept seeing all these patterns of anti-Black racism across hospital systems, and I thought—we have to do something about this.”
Highlighting the prevalence of medical racism in psychiatry
To address these disparities, Calhoun wanted to create an event devoted entirely to Black youth and their mistreatment by mental health professionals. “A clinical case conference made sense to me because we could talk about actual cases of Black children and bring expert discussants to comment on them,” she says.
However, case conferences do not typically focus on racist behavior by health care personnel themselves. “One of the reasons why people don’t talk about the racist behavior of medical teams is because there is fear of retaliation,” Calhoun explains. “It’s essentially killing the messenger.”
Thus, Calhoun and her colleagues decided that Yale’s case conference would focus on heavily anonymized cases from around the country. This would allow for expert-led discussions on how to address real-life examples of medical racism while simultaneously protecting those who submitted the cases.
Another unique aspect of the conference is its emphasis on storytelling. Presenting the cases in a narrative form makes the event more accessible to non-mental health professionals, Calhoun explains. But even for psychiatrists, the use of storytelling can make discussions more powerful. “You can’t really know the patient just by that bland and sterile history that we typically use,” she says. “The narrative brings the patient alive in a way that the audience feels like it knows that child.”
Greater Yale community encouraged to attend
The case conference will continue monthly through June 12, and is open to the greater Yale community, as well as those outside of Yale. Calhoun strongly encourages those both with and without a background in mental health to attend. “Even though I’m a psychiatrist, psychiatry isn’t the only answer to addressing anti-Black racism,” she says. “We’re going to need a multi-disciplinary effort to think critically and creatively about how to make mental wellness something that targets the unique issues that Black youth are experiencing.”
Registration is required to attend all events in the series. Interested participants can register online here.
“If you’re interested in the mental well-being of Black youth, in understanding why Black youth continue to be in crisis, and why we continue as a country to inadequately respond to it, this conference is for you,” says Calhoun. “Similarly, if you love hearing stories and understanding people, this clinical case conference will be of interest.”