CU Anschutz researchers' findings highlight a need for more tailored school intervention and adult support
Knowing that multiple studies provide strong evidence that links racism to poor mental health, researchers at the University of Colorado Anschutz wanted to know what types of racist incidents young people are experiencing in schools and if repeated events were more harmful to their mental health.
"What we've been seeing in those who identify as Black or African American is increases in suicide since about 2018 nationally," said Erin Kelly, DrPH, MA, assistant professor in the Colorado School of Public Health's Injury & Violence Prevention Center (IVPC). This is despite suicide rates among all other groups of adolescents beginning to stabilize or drop from post-pandemic peaks.
So Kelly and IVPC Director Ashley Brooks-Russell, PhD, MPH, used the 2023 Healthy Kids Colorado Survey (HKCS) that they conduct and assess in partnership with the state, to examine whether multiple experiences of racism have a cumulative effect on mental health outcomes such as depression and suicidal thoughts among high schoolers who identify as non-white.
"Suicide is a leading cause of death among youth, and mental health issues driven by stress and depression are at critical levels," Brooks-Russell said.
Recent allegations of blatant racism at two Denver-area high school football games serve as reminders that racism exists, even amid the bleachers and hallways of our high schools, and underscore the importance of work like theirs, said Brooks-Russell, also an associate professor in the Department of Community and Behavioral Health along with Kelly.
"Suicide is a leading cause of death among youth, and mental health issues driven by stress and depression are at critical levels." - Ashley Brooks-Russell
How do experiences of racism differ among racial and ethnic groups?
The survey asked students whether they had experienced the following forms of racism or discrimination: treated unfairly; followed by security in a store; assumed less intelligent; or family treated unfairly.
Of Black respondents, 40% noted experiencing one or more forms of racism compared with 4% of white students.
Rather than combining all youth of color into one category, the researchers separated all racial and ethnic identities. "This study demonstrates that each of those groups have very different cultural and societal experiences because of the color of their skin or their access to differing resources," Kelly said.
For instance, Black students reported the highest prevalence of experiencing these forms of racism: assumed less intelligent (21.3%); followed by security (20.1%); and treated unfairly (12.7%). Asian American students had the highest prevalence of reporting their family as being treated unfairly (23.4%).
The nuances are important, as the IVPC partners with the Colorado Department of Public Health & Environment to help schools and communities use HKCS data to inform prevention and health promotion efforts.
"So the survey tells them that interventions need to be individually focused," Kelly said. "What has that racism looked like for you? How can we address this? How can we support you in this? And how is it showing up for you in your mental health? Those are really key questions that I think need to happen.
Racism's associated cumulative effect on suicidal thoughts
In a recent study, Colorado high school students reporting three or more types of experiences with racism had significantly higher odds of adverse mental health outcomes across the three groups studied.
The adjusted odds of a suicide-related outcome among students reporting multiple racism experiences, compared with those reporting none were:
7.8 times higher for Asian American students
4.9 times higher for Hispanic/Latino students
4.1 times higher for Black students
How does persistent racism affect teen mental health?
The survey was administered in 2023, amid ongoing pandemic-related racism targeting Asian American and Pacific Islander communities and widespread news coverage of police brutality affecting Black communities.
"There were lots of stories that were out at that point in time that were horrific, frankly. And so I think these (results) align quite a bit (with the social climate)," Kelly said.
"For all groups, students reporting multiple experiences of racism were also more likely to report depression and suicidal thoughts," Brooks-Russell said.
"The Asian American group showed the strongest link between having three or more of these discrimination or racism experiences and having considered suicide and feeling depressed," she said.
Kelly used an analogy to explain the cumulative effect of stress on these youth.
"Say someone hands you a weight and tells you to hold it. And then they hand you another weight and say hold it, too. And then they hand you another weight, and so on. At some point, your body can no longer handle that extra weight. That is physically what is happening to these young people when they experience these things."
"Adding the psychological stressors of racism on top of the stressors today's high schoolers are already under pushes those teenagers beyond their limit, and they collapse under the weight," Kelly said.
"They're dealing with this additional stress that most white youth have never experienced as a comparison. And all while they are emotionally and mentally developing at this age."
What role should adults play in supporting youth experiencing racism?
"So it's just horrific to hear about these incidents, especially these explicit acts of racism," Kelly said, detailing the alleged racial taunts and slurs at two Lutheran High School football games - social events that are meant to foster school spirit and feelings of belonging.
The Colorado High School Activities Association put the school's athletic department on probation for at least a year with the possibility of suspension.
The school said their investigation into the alleged incidents - including racial slurs, monkey sounds, verbal harassment, whipping belts, and blocking paths - is ongoing, and no disciplinary action has been taken.
"In these cases," Brooks-Russell said, "youth need to be able to look to adults to set norms and expectations. If they do not, whether they are administrators, teachers, coaches or parents, they are failing youth," she said.
"We know that's a really important protective factor for youth, is having someone you can trust, that you can talk to about your mental health, or just about anything going on in your life. That's really critical," she said.
"For all groups, students reporting multiple experiences of racism were also more likely to report depression and suicidal thoughts." - Ashley Brooks-Russell
How can schools better support students experiencing racism?
"Colorado has strong mental health services in place for the most part for schools," Kelly said. "But as far as we're aware, there aren't any explicit resources around screening for having experienced racism, asking about how that might be showing up for that young person if they have experienced it, and then really tailoring the services and support to that experience and directly addressing that," Kelly said.
Staff and student training focused on implicit bias and societal stigma are also recommended. "All of these things would help people create a more inclusive and equitable environment for all students," Kelly said.
"There's a social reckoning that needs to be happening," she said. "These things should not have happened. They should not continue to happen. Here's how we're going to move forward to address these things so that they don't happen for the next generation."
Researcher has hope for tomorrow's youth
Kelly has a child who is part of that next generation, and he recently gave his mother a glimmer of hope. The day after the news of the Lutheran High School incidents broke, her 4-year-old came home from preschool using a phrase that he's now happily repeating.
"Whenever something happens that is different, he says: "It's OK, Mommy. Everybody's different."
Kelly said it was a bright moment at a dark time. It showed that teachers at her neighborhood preschool want to set the stage for change. "And it's coming. We just need to keep pushing. I have to be hopeful."
Key Points:
- Researchers using the 2023 Healthy Kids Colorado Survey found associations between experiences with racism and poor mental health among high school students.
- 40% of Black students reported at least one racism-related experience compared to 4% of white respondents.
- Types of experiences with racism varied across racial and ethnic groups, underscoring the importance of tailored support.
- Students reporting multiple experiences of racism were more likely to report depression and suicidal thoughts.
- Researchers emphasized the need for caring adults, school-based interventions, and culturally-responsive mental health supports.
