Shining a Light on Sources of Systemic Racism and Discrimination in Behavioral Healthcare

Systems of care must recognize that discrimination and disproportionality exist in “most if not all helping systems and institutions” (James, 2020). Specifically, youth who are minorities are often treated differently than their white counterparts. Examples include failing to engage minority families in the treatment process (Hackworth et al., 2018), harmful or stereotypical language used to refer to youth of color (Goddu et al., 2018), and inferior quality medical care (Institute of Medicine, 2015). These differences often lead to reduced youth engagement and poor service outcomes.

To eliminate discrimination in behavioral healthcare, we must first identify significant sources of disproportionality in our own interconnected systems to respond effectively. In this presentation, we share preliminary results of an ongoing study exploring different sources of systemic racism and discrimination within the child welfare system. To identify these sources, we engaged relevant stakeholders including providers and youth receiving services in residential and community care. Data include youth and staff interviews, surveys, and detailed record reviews of treatment using tracer methodology.

Preliminary data analyses revealed several sources of bias or differential treatment. In the presentation, we share summary data alongside case examples heightened by youth testimonials. We will discuss implications of the identified sources of discrimination, as well as potential solutions including cross-systems collaboration and provider professional development.