For too long, mental health struggles in Black children have been whispered about, dismissed as behavior, or treated like something families should handle privately. Knowing what to look for and getting help early can change a child’s life.

Originally by Tiffany Caesar
Updated by Successful Black Parenting Magazine

Let’s Name “It”

Why don’t we talk about it?

Sometimes there are signs in our children’s behavior. A teacher may mention that something seems different. A child who used to love being around friends begins spending more time alone. A teenager suddenly cannot sleep. A younger child complains of stomachaches every morning before school.

And sometimes, in Black families, we still hear phrases like, “That’s just how he acts,” “She’s being dramatic,” “You need to toughen up,” or “We don’t put our business in the street.”

But we need to name it plainly: Black children can experience anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), trauma-related disorders, eating disorders, mood disorders, and other mental health conditions just like children from every other community.

Silence does not make a mental health problem disappear. It can leave a child trying to understand frightening or confusing emotions alone.

The good news is that childhood mental health conditions can be evaluated and treated. According to the National Institute of Mental Health, recognizing concerns and beginning treatment earlier can help prevent problems from becoming more severe or lasting as children grow.

Signs Your Child May Be Struggling With Mental Health

Every bad day is not a mental health disorder. Children get angry. Teens withdraw occasionally. Kids worry about tests, friendships, sports, relationships, and growing up.

What parents should watch for is a change that lasts, causes significant distress, or starts interfering with everyday life.

The National Institute of Mental Health recommends talking with a health professional when concerning emotions or behaviors continue for weeks or longer, distress the child or family, or interfere with functioning at home, at school, or with friends.

One symptom does not automatically mean your child has a mental health disorder. Instead of trying to diagnose your child yourself, bring persistent concerns to your child’s pediatrician, family doctor, school mental health professional, psychologist, therapist, or another qualified health professional.

For more ways to recognize and support emotional struggles, read Supporting Your Child’s Mental Health: Overcoming Stress, Social Media, and Stigma in the Black Community.

Mental Health Screening Shouldn’t Begin With a Crisis

One major change since this article was first published is how children’s mental health screening is viewed.

Parents do not have to wait until a child is falling apart before bringing up mental health.

Current guidance from the American Academy of Pediatrics recommends annual mental, emotional, and behavioral screening after age 3 during preventive health visits. The AAP recommends screening for anxiety beginning at age 8 and expanding screening at age 12 to include depression and suicide risk when earlier screening is not indicated.

The U.S. Preventive Services Task Force also recommends anxiety screening for children and adolescents ages 8 through 18.

That means asking about emotional health during regular medical appointments should feel as normal as discussing growth, sleep, nutrition, or physical activity.

Why This Matters Specifically for Black Children

Black children’s mental health does not exist separately from the world they have to navigate.

A child may be managing ordinary childhood stress while also dealing with racial stereotypes, discrimination, microaggressions, online racism, harsher disciplinary responses, or the pressure to remain composed in environments where their emotions may be interpreted differently from those of other children.

Those experiences matter.

The CDC’s 2023 Youth Risk Behavior Survey found that almost one in five U.S. high school students reported experiencing unfair discipline at school. Black students were more likely than White and Hispanic students to report unfair discipline.

CDC researchers also found that Black students who reported experiencing racism at school had higher levels of poor mental health and suicide-related risk than Black students who said they had not experienced racism at school.

This is why parents should not automatically interpret every emotional or behavioral change as something being “wrong” inside the child.

Sometimes the right question is not only, “What is wrong?”

It is also, “What happened to you?”

Ask about the classroom. Ask about friendships. Ask about bullying. Ask whether your child feels respected by teachers. Ask what is happening online. Ask whether someone has said something about their hair, skin, body, culture, intelligence, or family.

If you need help starting those conversations, see What Black Parents Are Not Told About Talking to Kids About Racism Without Scaring Them.

When School Behavior May Be Telling You Something

Mental health concerns are sometimes first noticed at school because children spend so many waking hours there.

A student may suddenly stop completing assignments, struggle to concentrate, become disruptive, withdraw socially, miss school frequently, or appear exhausted.

But behavior should not automatically be treated as misconduct.

Black parents may need to ask whether adults are trying to understand why a behavior is occurring before punishing it.

If your child is repeatedly being disciplined, ask questions. Request documentation. Talk with the teacher, counselor, school psychologist, or administrator. If your child has a disability or an identified educational need, ask what services, accommodations, or evaluations may be appropriate.

Bullying also deserves immediate attention. A child should not be expected to simply “toughen up” while being harassed at school or online.

For children whose anxiety increases around the school year, you may also want to read Back-to-School Anxiety in Black Children: How to Break the Cycle of Fear, Racism & Mental Health Struggles.

Parents, Your Mental Health Matters Too

Parents influence the emotional environment of a home, but that does not mean a child’s mental illness is the parent’s fault.

Mental health conditions can be influenced by many factors, including biology, genetics, development, stressful experiences, relationships, environment, trauma, and other circumstances.

Still, children learn a great deal by watching how the adults around them respond to stress.

If every difficult emotion is hidden, dismissed, prayed away without further support, or treated as weakness, children may conclude that their own feelings should be hidden too.

Parents can model something different.

If racial stress is weighing on your family, read Parents, Managing Your Own Racial Stress Teaches Your Kids Healthy Coping.

Medical Mistrust Is Real, But Our Children Still Deserve Care

There are legitimate reasons some Black families approach medical systems cautiously.

American medicine has a documented history of exploiting Black people, and Black patients still report experiences of bias, dismissal, unequal treatment, and not being heard.

Recognizing that history does not mean avoiding care. It means becoming an informed consumer and advocate.

Ask a potential therapist or provider whether they have experience working with Black children and families. Ask how they approach racial stress and cultural identity. Ask how parents are included in treatment. Ask your child whether they feel comfortable and respected.

If the relationship does not feel right, when circumstances allow, look for another qualified provider.

A therapist does not have to share your child’s racial identity to provide excellent care, but they should be willing and able to understand that race, culture, family, and community can influence a child’s experiences.

Talk to Your Child Before Something Is Wrong

One of the most powerful things parents can do is make mental health an ordinary conversation instead of a crisis conversation.

Don’t wait until your teenager is in distress to say, “You can talk to me.”

Start while things are going well.

Ask questions that require more than “yes” or “no.”

The goal is not to interrogate children. It is to create enough emotional safety that they know they can tell you the truth.

For more conversation strategies, see 5 Ways to Discuss Mental Health With Your Children. Parents of older children can also read How to Normalize Teen Mental Health Conversations in Black Families.

When Professional Help Is Needed

Professional mental health care can take different forms depending on the child and the concern.

According to the National Institute of Mental Health, treatment may include psychotherapy, parent involvement, family counseling, medication when appropriate, school support, or a combination of approaches.

Exercise, supportive relationships, adequate sleep, cultural connection, faith, spirituality, recreation, and time with family can also support emotional well-being. But these supports should not be treated as substitutes for appropriate professional care when a child has a mental health condition requiring treatment.

If something feels wrong, you do not need to know the diagnosis before asking for help.

The Numbers Tell Us We Still Have Work to Do

The conversation about Black youth and suicide has changed substantially since this article was first published.

According to the CDC’s 2023 Youth Risk Behavior Survey, 10.3% of Black high school students reported attempting suicide during the previous year, compared with 8.3% of White students.

The same research found that Black students were less likely than White students to report poor mental health overall, yet more likely to report attempting suicide.

That apparent contradiction is one reason parents, schools, health professionals, and communities cannot rely solely on whether a Black child looks distressed.

• Our children can be strong and still need help.
• They can laugh and still need help.
• They can earn good grades and still need help.
• They can pray and still need help.
• They can come from loving homes and still need help.

Mental illness is not evidence of weak parenting, weak faith, weak character, or a weak family.

Final Word: We Don’t Have to Silence “It” Anymore

Years ago, families were often expected to keep mental health struggles behind closed doors. We know better now. Black children deserve families, schools, doctors, communities, and mental health professionals who take their emotional health seriously.

• They deserve to know that asking for help does not make them weak.
• They deserve to know that therapy is not something to be ashamed of.
• They deserve adults who will listen when something hurts, even when the pain cannot be seen.
• And they deserve something perhaps even more important: the knowledge that they do not have to carry everything alone.
• Let’s stop whispering about it.

Let’s call it mental health, talk about it openly, and give our children the support they deserve.

This article is for educational purposes and is not a substitute for medical diagnosis or individualized care from a qualified health professional.