By Dr. Christina Guillen
I remember when my visits with my patient Brittney a straight-A high school student aspiring to become a lawyer, were filled with lively conversations about what she was doing with her friends and her summer vacation plans.
In the summer of 2020, I met a very different Brittney sitting in the room with tears rolling down her face into her mask, telling me, “Dr. G., I’m so scared I don’t want to get COVID. I miss my friends, I feel so alone, I’m so scared. When is it going to end?”
The COVID-19 pandemic has been one of the most significant global public health crises of the past century that disproportionately impacted Black and Hispanic communities in the United States. The pandemic spared children and adolescents from the unimaginable death toll it took on adults; however, lying beneath the pandemic was brewing the mental health crisis that would soon take a toll on our youth.
The COVID-19 pandemic and shelter-in-place policies caused significant disruption to youths’ academic progress and milestones, mental health, physical health, and social relationships. Family dynamics were affected by financial stress, loss of loved ones, and caregiver job loss.
Having social connections, a sense of identity, and belonging are the most important factors during adolescent development. Adolescents are resilient when they are in an environment that provides support and access to the resources that they need. Due to the systemic poor resourcing in low-income communities, there are few accessible, affordable, and high-quality mental health support services available to our Black and Hispanic youth.
During the pandemic, I found myself spending the majority of the time listening to my adolescent patients express their feelings of despair, I would have never expected to have these conversations with teenagers who have promising lives ahead of them.
When schools re-opened in 2021, I had a visit with Brittney only to find out that her depression had worsened and she was having thoughts of suicide. Mental health resources were overburden, I contacted ten mental health clinics before I found one could be able to see her. There are barriers to Black youth getting mental health services that range from feeling stigmatized by their community, not trusting mental health providers, and a lack of mental health providers that are black with whom they can relate to.
We thought things would improve when schools re-opened, but we were wrong. We underestimated the negative impact of 18 months of isolation, fear and mental trauma on our youth. For those who had an underlying mental illness, there had been an increase self-injurious behavior like cutting and suicide attempts. The Centers for Disease Control (CDC) confirmed that suicide rates for Black youths rose significantly from 2018 to 2021. Between April and October 2020, the proportion of emergency room visits increased by 31% for adolescents aged 12 to 17 years. There were times during the pandemic when no beds were available in the NYC Child and Adolescent Psychiatric hospitals.
The only way to bring about change is through structural reform, which will take time, but in the meantime, we need to take the first step by improving access to culturally competent mental health care. The focus must be switched to our schools to provide suicide intervention programs and strong support systems. There is a demand on policymakers and funders to prioritize our underserved communities to order for equitable change to happen.
Although the pandemic is behind us, we are left with a population of youth just like Brittney who will have to navigate a very different world with deeper scars than we think.
Editor’s Note: Christina Guillen, MD, is an attending physician and MPH student at SUNY Medical Center in NYC. A proud member of Sigma Gamma Rho Sorority, Inc.’s Eta Nu Sigma (Brooklyn alumnae chapter), she was recently featured as a model in a Macy’s campaign for the popular Kasper D9 collection aimed at celebrating the four Divine 9 sororities: Alpha Kappa Alpha, Delta Sigma Theta, Zeta Phi Beta, and Sigma Gamma Rho.