And how to discuss treatment options with cultural sensitivity

Photo by August de Richelieu on Pexels.com

Writer: Faith Wilkins

Clinical Experts: Rhonda Boyd, PhD , Jonathan Shepherd, MD , Robert Harris

What You'll Learn

- What is the historical context of Black parents' skepticism of medication treatment for their children?

- How can providers talk to skeptical parents about treatment options?

- How can Black parents advocate for their child when they disagree with the prescribed treatment?

- The history of overmedicating Black patients  

- How are Black children directly impacted?

- How can clinicians work with skeptical parents?

- How can parents advocate for their child?

“Iam deeply concerned that mental health services will rely too heavily on medication rather than seeking the root cause.”

This sentiment — expressed by a participant in a recent study that explores the views and experiences of Black families and young adults seeking mental health care — reflects a common concern within the Black community.

The study, conducted by the Child Mind Institute in partnership with The Steve Fund, included a nationally representative survey of 1,000 Black parents seeking mental health care for their children and 500 young adults seeking care for themselves. When asked about their concerns around mental health care, about half of the respondents (both parents and young adults) agreed that “mental health professionals are too quick to prescribe medication for mental health issues.”

This sense of mistrust around medication treatment is also reflected in other studies. For instance, a 2021 review of data on African American caregivers deciding whether or not to give children with ADHD medication, caregivers were less likely to trust the efficacy of the medication and were more concerned about side effects and addiction than white caregivers.

“I work in an integrated mental health system, which includes psychiatry. So, concerns about medication come up a lot,” says Rhonda Boyd, PhD, a mental health advisor for The Steve Fund, psychologist, and associate director of the Children’s Hospital of Philadelphia’s (CHOP) Child and Adolescent Mood Program. “Black families in particular want to start with therapy first and see how it works before considering medication if therapy is not working.”

One source of medication reluctance, Dr. Boyd says, is concern about side effects — will it stunt their child’s growth? But it also may come from feeling pressure from schools. “Schools oftentimes refer kids for treatment if the kid’s behavior is disruptive, which could be for a number of reasons. And that’s where the pressure comes in — you have to do this, or we can’t treat your child in a regular classroom. They may not even be able to be in this school.”

But concerns about medication run deeper, in no small part because of the historical use of psychiatric medication to silence and control Black people in the United States. 

The history of overmedicating Black patients  

Historically, the overmedication of Black patients in the mental health care system has been linked to their frequent misdiagnosis. The background of schizophrenia characterization and diagnosis is a clear example.

In the late 1950’s, as psychiatric hospital wards began to desegregate and the Civil Rights Movement gained momentum, the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) was published. Schizophrenia previously had been separated into subtypes, including “paranoid schizophrenia,” which was characterized by delusions and/or frequent auditory hallucinations. But in the DSM-II, researchers redefined characteristics of that subtype as a “masculinized belligerence” in which patients displayed violent delusions, hostility, and aggression. Based on racial bias, researchers and clinicians began to associate this type of schizophrenia with Black patients — specifically Black men. Schizophrenia diagnoses among Black individuals drastically increased, and by 1969, the National Institute of Mental Health found that Black patients had “a 65% higher rate of schizophrenia” than white patients.

As more Black people were diagnosed with schizophrenia, psychiatrists started to conflate civil unrest with the disorder’s “violent delusions” characteristic. Two prominent New York psychiatrists coined the term, “protest psychosis,” arguing that Black Liberation rhetoric and art caused hallucinations and acts of violence among Black men. In response, clinicians argued Black patients should be given higher doses of tranquilizing antipsychotic medication to quell these violent tendencies. For Black patients, medication transitioned from treatment to a form of control.

While the language in theDSM has since changed, recent studies have shown that Black Americans are still 2.4 times more likely to be diagnosed with schizophrenia than their white counterparts. Additionally, researchers have found that Black patients are more likely to receive higher doses of long-acting antipsychotic drugs — indicating a persistent belief among providers that Black patients not only need more medication than typically necessary but are also less likely to take it as prescribed.  

How are Black children directly impacted?

This idea that Black people are inherently more prone to violence and disruption continues to be perpetuated to this day. And in classrooms, Black children are much more likely to be viewed as disruptive or displaying behavioral challenges than their white counterparts.

“If Black and brown children display behavioral challenges like biting or hitting — things that you may see in the pre-K years or early childhood years where this type of behavior is developmentally appropriate — these children are seen as more aggressive, more forceful, and much more of a concern,” explains Robert Harris, an early childhood intervention supervisor for the D.C. Healthy Futures Program.

Worried about the disruption in learning, educators are quick to find a solution — and this most likely involves referring the child to a mental health professional. But according to Harris, “Even in the referral process and the description of the challenge, they tend to lean towards or hint at the use of medication to mitigate this issue that may exist. This is before parents have even spoken to a mental health professional.”

So, by the time parents are consulting a provider, they may already have their guard up, especially if that provider goes on to prescribe medication for their child’s mental health issues.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How can clinicians work with skeptical parents?

Clinicians worry that in some cases, reluctance towards medication treatment runs the risk of impeding a child’s quality of life. “Negative perceptions about medication can delay treatment longer than you want,” says Dr. Boyd. “If someone has severe depression, for instance, what is recommended is both therapy and medication at the same time to get the kid out of that episode. I understand exactly why parents have concerns, but it can be frustrating.”

To find the best solution for the child’s mental health challenges, the first critical step is to create a comfortable and collaborative environment, according to Jonathan Shepherd, MD, a child, adolescent, and adult psychiatrist who is chief clinical officer at DC Department of Behavioral Health. “For those initial appointments, I do my best to develop a form of trust where they feel comfortable enough with me,” he says.

And to do so, Dr. Shepherd suggests the following:   

- Educate yourself. Dr. Shepherd points out that when a mental health professional isn’t Black, it’s hard for Black patients to feel like the provider will understand where they’re coming from. Given the history of mistreatment of Black patients, there’s a hesitancy to even reach out to a provider. “You have to understand what that person may be going through or what environment they live in. It’s very difficult for people who don’t understand Black culture to be able to say, ‘I understand what it took for you to even come see the doctor.’” So, it’s important for non-Black providers, especially, to take that extra step and educate themselves on the history of mental health in the Black community.

- Listen to their concerns and answer every question. When encountering parents who are wary of treating their child with medication, Dr. Shepherd starts the conversation by saying, “You have every right to be skeptical and hesitant regarding care for your children. I get it. It is scary to think about providing a medication for your child, or your child having to take a pill and you don’t know what that pill may do. But that’s where the experts come in. Now, what I will not do is force my help on you, but I will work alongside you to guide you through the process.

- Be patient and meet them where they’re at. Dr. Shepherd acknowledges that after he explains why he’s prescribing the medication, describes the side effects, and answers every question, he still might face some resistance from a parent — and that’s okay. Instead of pushing, he schedules a follow-up appointment to continue the conversation at a different time. He also provides them with some helpful resources to gain more information about different treatment options. “You have to be very careful about the websites that people are going to, to seek out information. So, steer them in the right direction.”

How can parents advocate for their child?

When a school is pushing for a quick solution to a child’s disruptive behavior, such as medication treatment, parents may feel backed into a corner. Harris wants them to know that there’s still a choice. And if you feel uncomfortable with what you’re being told, you can say, “Yeah, when you said this, it really made me feel like I needed to go for medication.” This way, says Harris, educators might take a step back and re-evaluate how they approach the situation.

He also reiterates the importance of parents arming themselves with the knowledge of early signs to look for in their child, whether it’s a behavioral issue, mental health disorder, or learning challenge. “I think that’s why mental health consultation, particularly for infant and early childhood is paramount, because through education, we provide families as well as professionals with an understanding of what’s appropriate, what’s typical, what’s developmentally acceptable, and what you should expect.” For instance, it can be helpful for parents to know that there are several alternatives to medication treatment for disruptive behavior in a classroom, such as therapy, parent training,  specialized programs, and a change in classroom structure.

And in a clinical setting, Dr. Shepherd says, if you’re feeling skeptical about what your provider has prescribed for your child, you can start by making it clear to them that you don’t feel like they’re hearing you. “You can say, ‘I’m not sure if we’re hearing one another. I’m not sure that we are on the same page regarding what I’m saying I see in my child or what I think is necessary for my child at this point in time.’”

And that’s when it’s important to pay attention to the provider’s reaction, says Dr. Shepherd. Are they receptive to what you have to say? Are they open to answering questions or engaging in a dialogue about different treatment options? “Someone who does not allow you to ask questions or glosses over your questions, that’s a physician that you should run from.”

When parents and providers are able to have the tools and language they need to enter these types of conversations, it can make finding the solution to a child’s mental health challenges much easier.

Photo by August de Richelieu on Pexels.com https://standingabovethecrowd.com/?p=16549

James Donaldson on Mental Health - Why Are Black Parents Concerned About Medication Treatment?

And how to discuss treatment options with cultural sensitivity

Photo by August de Richelieu on Pexels.com

Writer: Faith Wilkins

Clinical Experts: Rhonda Boyd, PhD , Jonathan Shepherd, MD , Robert Harris

What You'll Learn

- What is the historical context of Black parents' skepticism of medication treatment for their children?
- How can providers talk to skeptical parents about treatment options?
- How can Black parents advocate for their child when they disagree with the prescribed treatment?
- The history of overmedicating Black patients  
- How are Black children directly impacted?
- How can clinicians work with skeptical parents?
- How can parents advocate for their child?

“Iam deeply concerned that mental health services will rely too heavily on medication rather than seeking the root cause.”

This sentiment — expressed by a participant in a recent study that explores the views and experiences of Black families and young adults seeking mental health care — reflects a common concern within the Black community.

The study, conducted by the Child Mind Institute in partnership with The Steve Fund, included a nationally representative survey of 1,000 Black parents seeking mental health care for their children and 500 young adults seeking care for themselves. When asked about their concerns around mental health care, about half of the respondents (both parents and young adults) agreed that “mental health professionals are too quick to prescribe medication for mental health issues.”

This sense of mistrust around medication treatment is also reflected in other studies. For instance, a 2021 review of data on African American caregivers deciding whether or not to give children with ADHD medication, caregivers were less likely to trust the efficacy of the medication and were more concerned about side effects and addiction than white caregivers.

“I work in an integrated mental health system, which includes psychiatry. So, concerns about medication come up a lot,” says Rhonda Boyd, PhD, a mental health advisor for The Steve Fund, psychologist, and associate director of the Children’s Hospital of Philadelphia’s (CHOP) Child and Adolescent Mood Program. “Black families in particular want to start with therapy first and see how it works before considering medication if therapy is not working.”

One source of medication reluctance, Dr. Boyd says, is concern about side effects — will it stunt their child’s growth? But it also may come from feeling pressure from schools. “Schools oftentimes refer kids for treatment if the kid’s behavior is disruptive, which could be for a number of reasons. And that’s where the pressure comes in — you have to do this, or we can’t treat your child in a regular classroom. They may not even be able to be in this school.”

But concerns about medication run deeper, in no small part because of the historical use of psychiatric medication to silence and control Black people in the United States. 

The history of overmedicating Black patients  

Historically, the overmedication of Black patients in the mental health care system has been linked to their frequent misdiagnosis. The background of schizophrenia characterization and diagnosis is a clear example.

In the late 1950’s, as psychiatric hospital wards began to desegregate and the Civil Rights Movement gained momentum, the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) was published. Schizophrenia previously had been separated into subtypes, including “paranoid schizophrenia,” which was characterized by delusions and/or frequent auditory hallucinations. But in the DSM-II, researchers redefined characteristics of that subtype as a “masculinized belligerence” in which patients displayed violent delusions, hostility, and aggression. Based on racial bias, researchers and clinicians began to associate this type of schizophrenia with Black patients — specifically Black men. Schizophrenia diagnoses among Black individuals drastically increased, and by 1969, the National Institute of Mental Health found that Black patients had “a 65% higher rate of schizophrenia” than white patients.

As more Black people were diagnosed with schizophrenia, psychiatrists started to conflate civil unrest with the disorder’s “violent delusions” characteristic. Two prominent New York psychiatrists coined the term, “protest psychosis,” arguing that Black Liberation rhetoric and art caused hallucinations and acts of violence among Black men. In response, clinicians argued Black patients should be given higher doses of tranquilizing antipsychotic medication to quell these violent tendencies. For Black patients, medication transitioned from treatment to a form of control.

While the language in theDSM has since changed, recent studies have shown that Black Americans are still 2.4 times more likely to be diagnosed with schizophrenia than their white counterparts. Additionally, researchers have found that Black patients are more likely to receive higher doses of long-acting antipsychotic drugs — indicating a persistent belief among providers that Black patients not only need more medication than typically necessary but are also less likely to take it as prescribed.  

How are Black children directly impacted?

This idea that Black people are inherently more prone to violence and disruption continues to be perpetuated to this day. And in classrooms, Black children are much more likely to be viewed as disruptive or displaying behavioral challenges than their white counterparts.

“If Black and brown children display behavioral challenges like biting or hitting — things that you may see in the pre-K years or early childhood years where this type of behavior is developmentally appropriate — these children are seen as more aggressive, more forceful, and much more of a concern,” explains Robert Harris, an early childhood intervention supervisor for the D.C. Healthy Futures Program.

Worried about the disruption in learning, educators are quick to find a solution — and this most likely involves referring the child to a mental health professional. But according to Harris, “Even in the referral process and the description of the challenge, they tend to lean towards or hint at the use of medication to mitigate this issue that may exist. This is before parents have even spoken to a mental health professional.”

So, by the time parents are consulting a provider, they may already have their guard up, especially if that provider goes on to prescribe medication for their child’s mental health issues.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How can clinicians work with skeptical parents?

Clinicians worry that in some cases, reluctance towards medication treatment runs the risk of impeding a child’s quality of life. “Negative perceptions about medication can delay treatment longer than you want,” says Dr. Boyd. “If someone has severe depression, for instance, what is recommended is both therapy and medication at the same time to get the kid out of that episode. I understand exactly why parents have concerns, but it can be frustrating.”

To find the best solution for the child’s mental health challenges, the first critical step is to create a comfortable and collaborative environment, according to Jonathan Shepherd, MD, a child, adolescent, and adult psychiatrist who is chief clinical officer at DC Department of Behavioral Health. “For those initial appointments, I do my best to develop a form of trust where they feel comfortable enough with me,” he says.

And to do so, Dr. Shepherd suggests the following:   

- Educate yourself. Dr. Shepherd points out that when a mental health professional isn’t Black, it’s hard for Black patients to feel like the provider will understand where they’re coming from. Given the history of mistreatment of Black patients, there’s a hesitancy to even reach out to a provider. “You have to understand what that person may be going through or what environment they live in. It’s very difficult for people who don’t understand Black culture to be able to say, ‘I understand what it took for you to even come see the doctor.’” So, it’s important for non-Black providers, especially, to take that extra step and educate themselves on the history of mental health in the Black community.
- Listen to their concerns and answer every question. When encountering parents who are wary of treating their child with medication, Dr. Shepherd starts the conversation by saying, “You have every right to be skeptical and hesitant regarding care for your children. I get it. It is scary to think about providing a medication for your child, or your child having to take a pill and you don’t know what that pill may do. But that’s where the experts come in. Now, what I will not do is force my help on you, but I will work alongside you to guide you through the process.
- Be patient and meet them where they’re at. Dr. Shepherd acknowledges that after he explains why he’s prescribing the medication, describes the side effects, and answers every question, he still might face some resistance from a parent — and that’s okay. Instead of pushing, he schedules a follow-up appointment to continue the conversation at a different time. He also provides them with some helpful resources to gain more information about different treatment options. “You have to be very careful about the websites that people are going to, to seek out information. So, steer them in the right direction.”

How can parents advocate for their child?

When a school is pushing for a quick solution to a child’s disruptive behavior, such as medication treatment, parents may feel backed into a corner. Harris wants them to know that there’s still a choice. And if you feel uncomfortable with what you’re being told, you can say, “Yeah, when you said this, it really made me feel like I needed to go for medication.” This way, says Harris, educators might take a step back and re-evaluate how they approach the situation.

He also reiterates the importance of parents arming themselves with the knowledge of early signs to look for in their child, whether it’s a behavioral issue, mental health disorder, or learning challenge. “I think that’s why mental health consultation, particularly for infant and early childhood is paramount, because through education, we provide families as well as professionals with an understanding of what’s appropriate, what’s typical, what’s developmentally acceptable, and what you should expect.” For instance, it can be helpful for parents to know that there are several alternatives to medication treatment for disruptive behavior in a classroom, such as therapy, parent training,  specialized programs, and a change in classroom structure.

And in a clinical setting, Dr. Shepherd says, if you’re feeling skeptical about what your provider has prescribed for your child, you can start by making it clear to them that you don’t feel like they’re hearing you. “You can say, ‘I’m not sure if we’re hearing one another. I’m not sure that we are on the same page regarding what I’m saying I see in my child or what I think is necessary for my child at this point in time.’”

And that’s when it’s important to pay attention to the provider’s reaction, says Dr. Shepherd. Are they receptive to what you have to say? Are they open to answering questions or engaging in a dialogue about different treatment options? “Someone who does not allow you to ask questions or glosses over your questions, that’s a physician that you should run from.”

When parents and providers are able to have the tools and language they need to enter these types of conversations, it can make finding the solution to a child’s mental health challenges much easier.

Photo by August de Richelieu on Pexels.com https://standingabovethecrowd.com/james-donaldson-on-mental-health-why-are-black-parents-concerned-about-medication-treatment-3/

James Donaldson on Mental Health - Meeting the Mental Health Needs of Black Adolescent Boys

Why young Black males are less likely to seek professional support and how parents, faith leaders, and youth leaders can help them

Writer: Alexa Imani Spencer

Clinical Experts: Brandon Jones , Deborah Moon, PhD , Keith Pettus, PhD , Jonathan Shepherd, MD

- Barriers to care for young Black men
- The dangers of bias and misdiagnosis
- Why young Black males turn to church leaders for support
- How mental health providers can work with the church
- How can parents and mentors provide support?
- Some resources

“I’m only here because my grandma made me come here.”

When Brandon Jones was a public school counselor in Minneapolis, he heard those words regularly from a 12-year-old Black male student who wore a tough exterior amid a dysfunctional home life. But after three or four months of therapy sessions, Jones says, the young man stopped mentioning it.

“I remember I asked him, ‘Why are you still coming here? Because your grandma wants you to come here?’ He was like, ‘No, I come here because I like you,’” says Jones, who wears jeans and Jordan sneakers just like his young clients do.

Now the executive director of the Minnesota Association for Children’s Mental Health, Jones crossed paths with the student over a decade later. The former counselor sees how being “a voice of reason” and helping the student “see a future for himself” may have had a positive effect on him. A life that could have ended in incarceration or premature death transformed into one of service instead, as the student had become a basketball coach in the same school district where they’d met.

“I would just try to say, ‘Man, you have so much talent. You’re so smart. You don’t have to do these things,’” Jones recalls.

Despite having an overall positive attitude toward mental health care, many young Black males are resistant to professional care, according to the Mental Health Support for Black Families study conducted by the Child Mind Institute in partnership with The Steve Fund. The study — which surveyed 1,000 Black parents seeking mental health care for their children and 500 Black young adults seeking care for themselves — found that young male participants were less likely than their female counterparts to seek help from a mental health professional. Among survey participants, 44 percent of young Black males (compared to 31 percent of females) said they were more likely to turn to family members and friends for support, with 37 percent (compared to 24 percent of females) seeking out church leaders.

Barriers to care for young Black men

Results of the survey suggest that the hesitation of young Black males to seek professional mental health care could be due to stigma. While both parents and young people said they were concerned about stigma, young adults were more likely than parents to say that stigma prevented them from seeking care.

And lack of trust in mental health professionals may be a legacy that historians can trace back to slavery. In 1848, John Galt, the medical director of the Eastern Lunatic Asylum in Williamsburg, Virginia, said that “Blacks are immune to mental illness.” He also stated that enslaved Africans were “exempt” from mental illness because they didn’t own property, and that people who had the highest risk of psychiatric illness were those who were exposed to the “mental excitement” of a free life.

In spite of this false ideology, in 1868 the Freedmen’s Bureau negotiated with the Virginia legislature to open the Central Lunatic Asylum for Colored Insane — the first mental asylum for Black Americans. This was an important step towards acknowledging the mental health needs of Black people. But historians have noted that medical racism and implicit bias among clinicians contributed to high rates of admission and severe diagnoses.

In the late 1950s, when psychological hospitals began to desegregate and the Civil Rights Movement gained momentum in the United States, clinicians would use a schizophrenia diagnosis to categorize Black men as violent and unstable. They especially applied this label to those who spoke out against racial injustice. The rates of schizophrenia diagnoses remain disproportionately high among Black men to this day.

“Some studies have revealed that Black men see professional mental health-seeking as a sign of weakness,” says Annelle Primm, PhD, a licensed psychiatrist and senior medical director at The Steve Fund. “And with high rates of misdiagnosis of schizophrenia among Black males and involuntary inpatient hospitalization, help-seeking through informal sources may be seen by Black males as a safer alternative.”

The dangers of bias and misdiagnosis

Unfortunately, even after Black males overcome stigma and make it to a mental health professional’s office, more barriers exist. There, they may be met with continued bias.

“When a person sees a Black man who’s emotional, they see us as an angry being. They don’t see us as a person who may actually have a disorder,” says Jonathan Shepherd, MD, a psychiatrist and chief clinical officer at the D.C. Department of Behavioral Health.

A costly consequence of racial bias in a mental health setting is misdiagnosis, especially of mood disorders.

“You have to be with a skilled mental health professional who can tease out the difference between ADHD and a mood disorder, because some of the symptoms overlap,” Dr. Shepherd says. “A person who has depression has poor concentration.”

Research shows that Black kids are more likely to receive the wrong diagnosis when they show signs of a mood disorder. For example, a Black boy who is inattentive or fidgety in class may be diagnosed with ADHD or a conduct disorder, while his white classmate with the same symptoms may be diagnosed with depression.

“How you treat ADHD and how you treat depression are two totally different ways,” Dr. Shepherd says about the dangers of receiving improper treatment.

Additionally, reactions to trauma and adverse childhood experiences — such as living in a hostile neighborhood or having an incarcerated loved one — share the same symptoms of ADHD: agitation, restlessness, and volatility. Without the correct diagnosis, Black males don’t receive the proper care and risk remaining stuck in unhealthy cycles. 

For this reason, it comes as no surprise to Dr. Shepherd that young Black males are leaning on loved ones, mentors, and church leaders for support.

“It makes perfect sense. Men need to have safe, confidential, and peaceful areas to express themselves.”

Why young Black males turn to church leaders for support

As a significant percentage of young Black males in the Mental Health Support for Black Families study said they were more likely to reach out to a church leader than a mental health professional for support, experts suggested that it would be beneficial to work with churches to encourage these young men to seek mental health care.

Pastoral counseling is an important part of the faith experience. In a study that included interviews from nearly 100 Black pastors, the respondents averaged more than six hours of counseling work per week, in which they often addressed serious problems similar to those seen by mental health professionals.

Keith Pettus, PhD, serves as lead pastor at Truth Center on Long Island, outside New York City. In the four decades that he’s worked as a minister, he’s counseled many Black boys and men navigating life’s issues.

“Pastoring gives you a front row seat to the darkest moments of people’s lives and the brightest ones,” Dr. Pettus reflects. “We are with people from the cradle to the grave.”

He agrees that one of the main reasons why Black males avoid mental health providers is due to a general distrust in medical professionals.

“The challenge with Black boys is they become Black young men, and they become Black adult men who don’t go to doctors,” says Dr. Pettus, who encouraged the men in his congregation to get check-ups after he survived prostate cancer last year.

Because therapists may be viewed as just “another doctor,” he believes it’s easier for his congregants to seek him out for support. Two of the main reasons why young Black males come to him is for low self-esteem and anxiety about the future.

How mental health providers can work with the church

As a former school counselor, Jones appreciates when faith leaders are involved in resolving the mental health needs of community members. He hopes to see more innovation and collaboration between the two groups in the future.

“It’d be amazing if there were therapists that were housed inside churches,” he suggests. “A lot of church buildings are not active after Sunday…. They could be mental health centers at this point. Or they could have therapists in there working.”

Historically, the church has functioned as a social service hub for Black Americans, providing information and resources that might otherwise be inaccessible. Church members also use it as an emotional outlet. With that in mind, researchers and organizations are utilizing the institutions to find new ways to address mental health needs.

In 2019, the University of Pittsburgh’s School of Social Work launched CHURCH (Congregations as Healers Uniting to Restore Community Health), a research initiative that seeks to develop evidence-based training to build more capacity for African American faith leaders to provide mental health support to their congregation members.

For the past four years Deborah Moon, PhD, a mental health therapist and assistant professor in the School of Social Work at the University of Pittsburgh and the CHURCH project team, has worked alongside local Black pastors to develop a training that would equip local Black pastors with the knowledge and skills in cognitive behavioral therapy (CBT), a form of talk therapy that helps people change negative thought patterns and behaviors.

“There’s lots of evidence that CBT works,” Dr. Moon says. “But then , we try to highlight that those same principles that are proven by science are already in the Bible.”

She and her team compiled a day-long workshop as the final curriculum. The program was separated into four sessions that covered the relevance of mental health topics in Black churches and the various levels of human cognition that are targeted in CBT. All sessions integrated core CBT principles and skills with spiritual teachings in Black churches. The workshop also included a music therapy element within the faith-based praise and worship. Their main goals were to change attitudes toward evidence-based mental health treatment, raise confidence in providing informal mental health support, and increase the knowledge of CBT concepts and skills among faith leaders in culturally sensitive ways through spiritual integration.

“We saw significant improvement in all of those areas in a recent pilot,” Dr. Moon says. The team is planning to conduct larger studies with a sufficient number of participants to more rigorously test the training effects. Like the participants of CHURCH, Jones recommends that all pastors who respond to mental health needs take up some form of CBT education. Dr. Pettus, the pastor at Truth Center, agrees but also sees the limits of what spiritual advisors can do. If he feels that a matter requires clinical services, he refers congregation members to therapists in the area.

“I’m not the last step. I have people above me that can take them even deeper.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How can parents and mentors provide support?

Jones offers the following tips to parents and mentors who seek to support young Black males:

Parents:

- Keep an open space for your child to talk to you. If your children are coming to you, that’s a big plus. A lot of times when kids are avoiding talking to their parents, Jones has found, it’s because the parents are part of the problem
- Model healthy habits and behaviors. Your children are watching what you do. If they come to you for help and you’re not utilizing the advice you’re giving them, they’re not going to believe what you say. They’ll revert to poor habits
- Find ways to engage in healthy activities. Talking is great, but actions are also important. Without activities, children may fall into an idle mindset, where they’re entertained and informed by the world or whatever they can get access to. Playing games, helping them with homework, and going for walks are all therapeutic opportunities

Mentors/youth workers:

- Understand that you have an opportunity to build a level of trust that youth may not have with their parents. You may be able to get through to the child or young adult a little easier than a parent or caregiver. Utilize that
- Similar to parents, model healthy behaviors and be active.
- Keep the mentor-to-mentee power dynamic in play. Many mentors and youth workers slip into friendships with the young people they work with. This isn’t inherently a bad thing, but it can become challenging if you become stuck as a friend instead of an authority figure. This, in turn, hinders the help that the young person can receive. Make sure to let them know, “Hey, I’m an adult, and I’m here to listen and be helpful to you”

Some resources

For pastors:

- Soul Shop for Black Churches is a one-day workshop designed for clergy, staff, lay pastors, and faith-based clinicians in Black churches. https://standingabovethecrowd.com/james-donaldson-on-mental-health-meeting-the-mental-health-needs-of-black-adolescent-boys-3/

Why young Black males are less likely to seek professional support and how parents, faith leaders, and youth leaders can help them

Writer: Alexa Imani Spencer

Clinical Experts: Brandon Jones , Deborah Moon, PhD , Keith Pettus, PhD , Jonathan Shepherd, MD

- Barriers to care for young Black men

- The dangers of bias and misdiagnosis

- Why young Black males turn to church leaders for support

- How mental health providers can work with the church

- How can parents and mentors provide support?

- Some resources

“I’m only here because my grandma made me come here.”

When Brandon Jones was a public school counselor in Minneapolis, he heard those words regularly from a 12-year-old Black male student who wore a tough exterior amid a dysfunctional home life. But after three or four months of therapy sessions, Jones says, the young man stopped mentioning it.

“I remember I asked him, ‘Why are you still coming here? Because your grandma wants you to come here?’ He was like, ‘No, I come here because I like you,’” says Jones, who wears jeans and Jordan sneakers just like his young clients do.

Now the executive director of the Minnesota Association for Children’s Mental Health, Jones crossed paths with the student over a decade later. The former counselor sees how being “a voice of reason” and helping the student “see a future for himself” may have had a positive effect on him. A life that could have ended in incarceration or premature death transformed into one of service instead, as the student had become a basketball coach in the same school district where they’d met.

“I would just try to say, ‘Man, you have so much talent. You’re so smart. You don’t have to do these things,’” Jones recalls.

Despite having an overall positive attitude toward mental health care, many young Black males are resistant to professional care, according to the Mental Health Support for Black Families study conducted by the Child Mind Institute in partnership with The Steve Fund. The study — which surveyed 1,000 Black parents seeking mental health care for their children and 500 Black young adults seeking care for themselves — found that young male participants were less likely than their female counterparts to seek help from a mental health professional. Among survey participants, 44 percent of young Black males (compared to 31 percent of females) said they were more likely to turn to family members and friends for support, with 37 percent (compared to 24 percent of females) seeking out church leaders.

Barriers to care for young Black men

Results of the survey suggest that the hesitation of young Black males to seek professional mental health care could be due to stigma. While both parents and young people said they were concerned about stigma, young adults were more likely than parents to say that stigma prevented them from seeking care.

And lack of trust in mental health professionals may be a legacy that historians can trace back to slavery. In 1848, John Galt, the medical director of the Eastern Lunatic Asylum in Williamsburg, Virginia, said that “Blacks are immune to mental illness.” He also stated that enslaved Africans were “exempt” from mental illness because they didn’t own property, and that people who had the highest risk of psychiatric illness were those who were exposed to the “mental excitement” of a free life.

In spite of this false ideology, in 1868 the Freedmen’s Bureau negotiated with the Virginia legislature to open the Central Lunatic Asylum for Colored Insane — the first mental asylum for Black Americans. This was an important step towards acknowledging the mental health needs of Black people. But historians have noted that medical racism and implicit bias among clinicians contributed to high rates of admission and severe diagnoses.

In the late 1950s, when psychological hospitals began to desegregate and the Civil Rights Movement gained momentum in the United States, clinicians would use a schizophrenia diagnosis to categorize Black men as violent and unstable. They especially applied this label to those who spoke out against racial injustice. The rates of schizophrenia diagnoses remain disproportionately high among Black men to this day.

“Some studies have revealed that Black men see professional mental health-seeking as a sign of weakness,” says Annelle Primm, PhD, a licensed psychiatrist and senior medical director at The Steve Fund. “And with high rates of misdiagnosis of schizophrenia among Black males and involuntary inpatient hospitalization, help-seeking through informal sources may be seen by Black males as a safer alternative.”

The dangers of bias and misdiagnosis

Unfortunately, even after Black males overcome stigma and make it to a mental health professional’s office, more barriers exist. There, they may be met with continued bias.

“When a person sees a Black man who’s emotional, they see us as an angry being. They don’t see us as a person who may actually have a disorder,” says Jonathan Shepherd, MD, a psychiatrist and chief clinical officer at the D.C. Department of Behavioral Health.

A costly consequence of racial bias in a mental health setting is misdiagnosis, especially of mood disorders.

“You have to be with a skilled mental health professional who can tease out the difference between ADHD and a mood disorder, because some of the symptoms overlap,” Dr. Shepherd says. “A person who has depression has poor concentration.”

Research shows that Black kids are more likely to receive the wrong diagnosis when they show signs of a mood disorder. For example, a Black boy who is inattentive or fidgety in class may be diagnosed with ADHD or a conduct disorder, while his white classmate with the same symptoms may be diagnosed with depression.

“How you treat ADHD and how you treat depression are two totally different ways,” Dr. Shepherd says about the dangers of receiving improper treatment.

Additionally, reactions to trauma and adverse childhood experiences — such as living in a hostile neighborhood or having an incarcerated loved one — share the same symptoms of ADHD: agitation, restlessness, and volatility. Without the correct diagnosis, Black males don’t receive the proper care and risk remaining stuck in unhealthy cycles. 

For this reason, it comes as no surprise to Dr. Shepherd that young Black males are leaning on loved ones, mentors, and church leaders for support.

“It makes perfect sense. Men need to have safe, confidential, and peaceful areas to express themselves.”

Why young Black males turn to church leaders for support

As a significant percentage of young Black males in the Mental Health Support for Black Families study said they were more likely to reach out to a church leader than a mental health professional for support, experts suggested that it would be beneficial to work with churches to encourage these young men to seek mental health care.

Pastoral counseling is an important part of the faith experience. In a study that included interviews from nearly 100 Black pastors, the respondents averaged more than six hours of counseling work per week, in which they often addressed serious problems similar to those seen by mental health professionals.

Keith Pettus, PhD, serves as lead pastor at Truth Center on Long Island, outside New York City. In the four decades that he’s worked as a minister, he’s counseled many Black boys and men navigating life’s issues.

“Pastoring gives you a front row seat to the darkest moments of people’s lives and the brightest ones,” Dr. Pettus reflects. “We are with people from the cradle to the grave.”

He agrees that one of the main reasons why Black males avoid mental health providers is due to a general distrust in medical professionals.

“The challenge with Black boys is they become Black young men, and they become Black adult men who don’t go to doctors,” says Dr. Pettus, who encouraged the men in his congregation to get check-ups after he survived prostate cancer last year.

Because therapists may be viewed as just “another doctor,” he believes it’s easier for his congregants to seek him out for support. Two of the main reasons why young Black males come to him is for low self-esteem and anxiety about the future.

How mental health providers can work with the church

As a former school counselor, Jones appreciates when faith leaders are involved in resolving the mental health needs of community members. He hopes to see more innovation and collaboration between the two groups in the future.

“It’d be amazing if there were therapists that were housed inside churches,” he suggests. “A lot of church buildings are not active after Sunday…. They could be mental health centers at this point. Or they could have therapists in there working.”

Historically, the church has functioned as a social service hub for Black Americans, providing information and resources that might otherwise be inaccessible. Church members also use it as an emotional outlet. With that in mind, researchers and organizations are utilizing the institutions to find new ways to address mental health needs.

In 2019, the University of Pittsburgh’s School of Social Work launched CHURCH (Congregations as Healers Uniting to Restore Community Health), a research initiative that seeks to develop evidence-based training to build more capacity for African American faith leaders to provide mental health support to their congregation members.

For the past four years Deborah Moon, PhD, a mental health therapist and assistant professor in the School of Social Work at the University of Pittsburgh and the CHURCH project team, has worked alongside local Black pastors to develop a training that would equip local Black pastors with the knowledge and skills in cognitive behavioral therapy (CBT), a form of talk therapy that helps people change negative thought patterns and behaviors.

“There’s lots of evidence that CBT works,” Dr. Moon says. “But then , we try to highlight that those same principles that are proven by science are already in the Bible.”

She and her team compiled a day-long workshop as the final curriculum. The program was separated into four sessions that covered the relevance of mental health topics in Black churches and the various levels of human cognition that are targeted in CBT. All sessions integrated core CBT principles and skills with spiritual teachings in Black churches. The workshop also included a music therapy element within the faith-based praise and worship. Their main goals were to change attitudes toward evidence-based mental health treatment, raise confidence in providing informal mental health support, and increase the knowledge of CBT concepts and skills among faith leaders in culturally sensitive ways through spiritual integration.

“We saw significant improvement in all of those areas in a recent pilot,” Dr. Moon says. The team is planning to conduct larger studies with a sufficient number of participants to more rigorously test the training effects. Like the participants of CHURCH, Jones recommends that all pastors who respond to mental health needs take up some form of CBT education. Dr. Pettus, the pastor at Truth Center, agrees but also sees the limits of what spiritual advisors can do. If he feels that a matter requires clinical services, he refers congregation members to therapists in the area.

“I’m not the last step. I have people above me that can take them even deeper.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How can parents and mentors provide support?

Jones offers the following tips to parents and mentors who seek to support young Black males:

Parents:

- Keep an open space for your child to talk to you. If your children are coming to you, that’s a big plus. A lot of times when kids are avoiding talking to their parents, Jones has found, it’s because the parents are part of the problem

- Model healthy habits and behaviors. Your children are watching what you do. If they come to you for help and you’re not utilizing the advice you’re giving them, they’re not going to believe what you say. They’ll revert to poor habits

- Find ways to engage in healthy activities. Talking is great, but actions are also important. Without activities, children may fall into an idle mindset, where they’re entertained and informed by the world or whatever they can get access to. Playing games, helping them with homework, and going for walks are all therapeutic opportunities

Mentors/youth workers:

- Understand that you have an opportunity to build a level of trust that youth may not have with their parents. You may be able to get through to the child or young adult a little easier than a parent or caregiver. Utilize that

- Similar to parents, model healthy behaviors and be active.

- Keep the mentor-to-mentee power dynamic in play. Many mentors and youth workers slip into friendships with the young people they work with. This isn’t inherently a bad thing, but it can become challenging if you become stuck as a friend instead of an authority figure. This, in turn, hinders the help that the young person can receive. Make sure to let them know, “Hey, I’m an adult, and I’m here to listen and be helpful to you”

Some resources

For pastors:

- Soul Shop for Black Churches is a one-day workshop designed for clergy, staff, lay pastors, and faith-based clinicians in Black churches. The training was developed by the American Foundation for Suicide Prevention to address the rates of suicide within the Black community

- The American Psychiatric Association offers “Mental Health: A Guide for Faith Leaders,” a free resource guide for faith leaders who work with congregation members facing mental health challenges

- Learn more about religious CBT via this training video from the Center for Spirituality, Theology, and Health at Duke University

For parents and mentors/youth workers:

If you or someone you know needs help now, call 988 to reach the Suicide and Crisis Lifeline. The lifeline is available 24 hours a day, seven days a week, and is staffed by trained counselors.

The National Alliance on Mental Illness (NAMI) is a national grassroots organization that supports people and families affected by mental illness. The organization provides free mental health support, educational programming, and a helpline via its state and local chapters.

The Black Emotional and Mental Health Collective (BEAM) connects Black people to Black therapists and provides microgrants to Black and marginalized parents living with mental illness or supporting children living with mental illness.

Black Men Heal is on a mission to remove stigma and eliminate cost to care by connecting Black men with therapists and providing eight free sessions. The nonprofit organization also hosts a virtual weekly meetup to discuss male depression, anxiety, anger management, self-care, and more. https://standingabovethecrowd.com/?p=16542

Healthy Child and Adolescent Growth

https://www.youtube.com/watch?v=yLnT8dN9czA

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog https://standingabovethecrowd.com/?p=16538

James Donaldson on Mental Health - How can I help my child or teen build positive, healthy friendships?

Healthy Child and Adolescent Growth

https://www.youtube.com/watch?v=yLnT8dN9czA

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-can-i-help-my-child-or-teen-build-positive-healthy-friendships/

James Donaldson on Mental Health - How to Help Kids Who Are Lonely

What parents can say to kids who are struggling socially and how they can help

Writer: Rachel Ehmke

Clinical Experts: Lauren Allerhand, PsyD , Bethany Vibert, PsyD

What You'll Learn

- What are some reasons why kids might be struggling socially?
- How can you find out if your child is lonely?
- How can parents help kids who are struggling?
- Quick Read
- Full Article
- Why kids might be struggling socially
- How to tell if your child is lonely
- What to say (and what not to say)
- How to help kids who are struggling socially
- How to evaluate screen time

If your child is struggling to make friends, there are ways to help. First, try to figure out why. Some kids need help with social skills. This is common for kids who are immature or have ADHD, autism or non-verbal learning disorder. Other kids are anxious. They may feel overwhelmed in new social situations or big groups. Kids who are depressed often want to stay in their rooms. They may interpret things negatively and doubt others want to see them. Finally, some kids may have a hard time fitting in because they have different interests.

If you think your child is lonely, ask them. Start by describing a time when you have felt lonely. If they don’t want to talk, try again in a few days. Don’t push them.

If your child says they are lonely, try to be a good listener. Show that you’re listening by reflecting back what they’re saying: “It sounds like you’re having a hard time.” You can also say supportive things like: “That sounds tough. Would you tell me more about that?”

Once you know more, you can try to help. For kids who need practice with social skills, you can break things down into small steps. Then you can role play them with your child. For kids who have a hard time putting themselves out there, acknowledge how they feel. Then remind them that they’ll probably have a good time once they’ve made the effort. Give them lots of support and praise for doing something tough.

Some kids tend to misunderstand interactions. You can give a reality check: “What makes you think he’s mad? Are there other explanations?” For kids who interpret things negatively a lot, pointing it out each time can help break the pattern.

Finally, help kids find a group or activity that is interesting to them. Many kids find success online, where there are lots of virtual groups for kids with specific interests. Getting excited about something will help them feel more confident, too.

We all want our children to be socially successful. While they don’t need to be the most popular kid in the class, we do hope that they will have friends.

Friendships are one of the biggest sources of fun in a kid’s life, which is reason enough to value them. But they are also critical to development. They lay the groundwork for lifelong skills like listening to others, solving problems and self-expression. They are also an important source of confidence. As kids get older their friendships start playing an even bigger role in their emotional and personal lives.

When kids don’t have these relationships, it can have a serious impact on their mood, confidence and functioning. Going to school every day can be a trial. Using social media can be depressing. Kids who are lonely often feel rejected, invisible or like something is wrong with them. And parents watching from the sidelines wonder what they can do to help.

Why kids might be struggling socially

It hurts when you see that your child isn’t making friends, and you can’t figure out why — or how to help. Here are some potential reasons why a child may be striking out on connecting with other kids:

They don’t understand how to socialize. The rules of social interaction might seem obvious to you, but they do need to be learned. And while most kids pick up social cues and patterns so easily it seems automatic, some don’t, and need more support — and practice. This is particularly true for kids with ADHD, autism and non-verbal learning disorder. When one child isn’t understanding their peers’ expectations about how to decide what to play, how to share, when to talk and how to show that they’re listening, they’re going to find it harder to make friends.

They’re anxious. It is common for kids — and adults — to feel anxiety when they come into a new social situation or join a group. This shows up in young kids who can’t join in activities on the playground, or at birthday parties that are supposed to be fun but are actually overwhelming. Social anxiety gets more common as kids get older. Some kids with severe social anxiety may be paralyzed with worry that others are judging them. They might weigh every word in a text message and worry so much about how they look or what they say that they stop hanging out with friends. They may be so self-conscious they even stop eating in the school cafeteria.

They’re depressed. A major symptom of depression is a tendency to withdraw from others. While they might have fun with friends once they’re hanging out, a kid with depression will first need to be compelled to leave their room. Kids who are depressed are also more likely to interpret things negatively and assume other people don’t want to see them.

They don’t “fit in.” For some children, the problem is more environmental. “Something we talk about with some kids is the idea of being a rose in a tulip garden,” says Lauren Allerhand, PsyD, a clinical psychologist at the Child Mind Institute. “So maybe it’s not a lack of skills, but you’re just in an environment where people don’t have the same ideas or interests as you, and you’re just having a real challenge finding your group of people.”

They’re immature. Kids may struggle to fit in when they are younger than their classmates or just slower to mature. They might not have developed the same social skills as their peers yet, or they might just have different interests. As kids get older they tend to catch up, but in the meantime they may be feeling confused and lonely.

How to tell if your child is lonely

When kids spend a lot of time alone, you might suspect they are lonely. But unless they complain that they don’t have friends or are obviously unhappy, parents can be left to wonder how much it’s upsetting them.

Kids might not volunteer to discuss it with you. This is particularly the case with teenagers, but kids of all ages might feel some reluctance about admitting how they feel. It can help if you start the conversation by talking about times in your life when you have felt lonely, says Dr. Allerhand. “Sharing a little bit can open the door for kids to express some of what they’re feeling. But I wouldn’t push too hard. If they don’t want to tell you, give it a try again in the next day or two.”

Other kids, especially very young children and kids on the spectrum, might not know how to explain what they’re feeling. “For individuals with autism, sometimes communicating their own experiences can be quite challenging. They often can have a hard time linking what they’re feeling and what their experience is with a specific word that others may use for that experience,” says Bethany Vibert, PsyD, a clinical psychologist. When asked point blank if they are lonely an autistic child might say no, but if you probed a little deeper you might find that they do actually wish they had friends.

For kids who are younger or struggle with emotion identification, first teaching what loneliness is can help. Sharing your own experience of feeling lonely is also a good strategy here. Dr. Vibert recommends that you might say something simple like, “When I haven’t been around people for a while, sometimes I want to spend time with somebody. That means I’m feeling lonely.” Dr. Vibert also suggests asking kids what they’d want to do if they could be doing anything. What they have to say could give you clues about what they might be missing out on.

What to say (and what not to say)

As parents we often want to immediately jump into problem solving mode whenever our child is having an issue. But it’s a better idea to slow down and just listen to what your kid has to say, first. Giving kids the space to open up and feel heard lets them know that it’s okay to talk about emotions — and that you’re a good person to turn to whenever they need help. For kids who might be feeling rejected or invisible, showing that you care will also be particularly meaningful to them. Waiting to hear more will help you be more supportive later, too. “If we don’t give them space to just talk, we might be coming up with a solution that’s not really a good fit for the actual problem,” points out Dr. Vibert.

Here are some strategies for a good conversation:

Ask open-ended questions. For example, if your child says they miss spending time with someone they used to see a lot, you can ask questions about that. “What did you really like doing with her? What do you miss the most about seeing her?”

Make observations. Sometimes comments are a good alternative to questions. So, if you notice that your child isn’t spending time with people as much as they used to, you might point that out. Then leave space for them to talk.

Validate their experiences. Showing genuine interest goes a long way. Do your best to listen without judgment (or visible panic) to whatever they have to say. Try also to avoid overreacting with too much sympathy or emotion, since that might make them feel even worse. You can show that you’re listening by reflecting back what they’re saying (“It sounds like you’re having a hard time”), or saying supportive things like “That sounds tough. Would you tell me more about that?”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How to help kids who are struggling socially

Make a plan. When something is confusing or intimidating it is often helpful to break it into smaller steps. So if your child is struggling to ask someone if they want to hang out, for example, you can work with them to come up with a plan for how to do it. Dr. Vibert recommends having a plan A and a plan B just in case. “If the child is already feeling lonely and then they’re putting themselves in a vulnerable position to reach out to somebody, I think it’s helpful for a parent to have them work through what to do if it doesn’t work out.” Having a plan B can help kids feel more confident going in, too.

Practice social skills. For kids who are struggling with their social skills, try to give them plenty of opportunity to practice at their own pace in a supportive environment. Coach your child on the things they find challenging — maybe settling conflict, taking turns or noticing when someone is losing interest in an activity — and try role playing to give them experience. Relatives and family friends can also help so they get practice with multiple people.

Give encouragement. Kids who are feeling anxious or depressed are less inclined to put themselves out there. “When kids say they want to stay home, it’s a challenge to figure out how much to push,” acknowledges Michelle Kaplan, LCSW, a licensed social worker. “But generally, kids are able to reflect afterward that ‘Oh, that was a little less awkward than I thought,’ or ‘I had more fun than I thought I was going to.’” Validate how kids are feeling by acknowledging that going to see people might be difficult for them. Then remind them that they’re probably going to have a good time once they’re there and offer lots of support and praise for doing something challenging.

Give a reality check. Kids can sometimes struggle socially because they are prone to misunderstanding situations. This is especially easy to do with text messages, big group chats, and social media. Kids who are depressed are also more prone to interpreting things negatively even when it isn’t warranted. Dr. Allerhand has worked with teens on maintaining relationships and says that helping kids “check the facts” on a situation is important. “I think a lot of teenagers are self-focused, so they think if a relationship has fallen off, it’s because of something they’ve done. But maybe there are other interpretations.” Dr. Allerhand recommends talking it through: “‘Okay, so you haven’t spoken with Jimmy in a while. Do you have any evidence that he’s mad at you? Could there be any other reasons why you haven’t talked?’”

For kids who tend to interpret things negatively a lot, helping them notice that tendency, and reminding them when they’re doing it, can help them break the pattern.

Look elsewhere for friendships. When kids just aren’t fitting in, they might be looking in the wrong places. “Maybe they’ve done a lot of sports groups before, but they’re not actually into sports,” points out Kaplan. Try to find a group or activity that is more interesting to them. Getting involved in something they genuinely find exciting will also likely improve their confidence and sense of self-worth.

Many kids also find success turning to the internet to explore niche interests or just connect with a larger pool of kids. “One positive thing to come out of the pandemic is there are more and more virtual groups for kids to come online and meet with other kids that have similar interests to them,” says Kaplan.

But if your child does turn to the internet, make sure they stay safe. “Children with autism and developmental disabilities may have more difficulty determining if a situation is dangerous,” notes Dr. Vibert. “It’s very important that parents be not only involved, but proactive in providing education to their child about safety and danger online.”

How to evaluate screen time

If you’re worried that all your child seems to want to do is stare at a screen, keep in mind that screens have become a major way that kids interact with each other. While they don’t make up for in-person socializing, your child may be socializing more than you realize. Thanks to social media kids are often in closer communication with their peers than parents realize. Video games can also be a lot more social than they may initially seem.

“I often suggest that parents sit by kids while they’re playing games and try to gauge how much they’re connecting with peers,” Kaplan explains. “Don’t ask a ton of questions, but maybe you can ask things like: Is there anyone else you’re playing with?

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