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Structural Racism in Behavioral Health Presentation and Management.

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Structural racism and adultification bias negatively impact Black youth in healthcare and education systems. This case study reveals how these biases contribute to misdiagnosis and the school-to-prison pipeline, necessitating systemic changes.

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Area of Science:

  • Pediatric mental health
  • Social determinants of health
  • Health equity

Background:

  • Structural racism significantly impacts child welfare and healthcare access.
  • Adultification bias disproportionately affects Black youth, leading to misinterpretation of behavior.
  • Adverse childhood experiences (ACEs) are often overlooked in favor of behavioral diagnoses.

Purpose of the Study:

  • To define racism and its systemic manifestations in healthcare, education, and judicial systems.
  • To examine the impact of adultification bias on Black youth's mental health.
  • To delineate racial disparities in behavioral health, school discipline, and the school-to-prison pipeline.

Main Methods:

  • Case study analysis of a Black first-grade student experiencing psychiatric emergencies.
  • Review of systemic factors including structural, institutional, and interpersonal racism.
  • Examination of diagnostic and management disparities in pediatric behavioral health.

Main Results:

  • The case illustrates how structural racism and adultification bias lead to mislabeling of Black youth's reactions to trauma.
  • Racial disparities are evident in behavioral health diagnoses, school exclusion, and healthcare's role in the school-to-prison pipeline.
  • Involuntary interventions and restraints were used, highlighting systemic failures.

Conclusions:

  • Mitigating the impact of racism on pediatric mental health requires addressing systemic biases.
  • Interventions must recognize normative reactions to trauma and ACEs in Black youth.
  • Systemic changes are needed to promote health equity and prevent the school-to-prison pipeline.