Racism, children’s mental health, and anti-racist practice

Racism is a pervasive problem experienced by up to 60% of racially marginalised children in Australia. Experiences of racism harm people of all ages, including children, and have a profound negative impact on the physical health, mental health, development, and general wellbeing of children. By building racial literacy and adopting anti-racist practices service professionals can take steps toward:

• identifying and addressing the impacts of racism on children
• reducing children’s exposure to racism in service settings; and
• mitigating the mental health impacts of racism on children.

What is racism?

Racism includes the expression of prejudiced or discriminatory attitudes, behaviours and practices towards racially marginalised people. Racially marginalised people are individuals or groups that experience racism and the varying degrees of societal exclusion associated with it. Racism involves the maintenance of a racial hierarchy that places whiteness at the top (Alberta Civil Liberties Research Centre, n.d.). Racism continues to operate via imbalances in institutional power whereby those at the top of the hierarchy are afforded privileges that racially marginalised groups are not (Becares & Priest, 2015; NCCDH, 2022; Yared et al., 2020).

Types of racism

Racism occurs on various levels across society including:

• Interpersonal racism can occur directly (e.g. using a racial slur toward an individual or group), indirectly (e.g. through invalidation, microaggressions¹ and stereotyping) or vicariously (e.g. witnessing racism in person, online or via other media).
• Internalised racism occurs when individuals accept or adopt racist ideology about their racial group which subsequently perpetuates systems of oppression (e.g. a child disliking their skin colour because of white-centric beauty standards).
• Institutional racism occurs within organisations or systems (e.g. racist laws, policing, policies and practices).
• Systemic racism occurs across entire systems (e.g. education, employment, and health care). This results in the inequitable distribution of resources, services, and opportunities between racial groups based on the racial hierarchy.

(Sources: Heard-Garris et al., 2018; Priest et al., 2021; Solorzano et al., 2002; Trent, 2019).

Racism contributes to inequitable access to resources, opportunities and services across all sectors of society. Although estimates of the extent of racism vary, there is evidence that children from marginalised racial backgrounds in Australia experience racism regularly (Priest et al., 2021). According to a nationally representative prevalence study on racism experienced by school-age children, 50–67% of First Nations children and children from other racially marginalised backgrounds had experienced direct racial discrimination (Priest et al., 2021).

Racism occurs across many settings, but children commonly experience racism at school (Mansouri & Jenkins, 2010; Priest et al., 2019; Yared et al., 2020) and within service settings through microaggressions, colour-evasive approaches², inappropriate mental health assessment and intervention tools (Alvarez et al., 2022; Sue et al., 2007).

How does racism affect children’s mental health?

When children experience direct or vicarious racism, it can result in negative behavioural, emotional, and social outcomes. Experiences of racism can negatively impact mental health and are associated with increases in anxiety, depression, sleep difficulties, substance misuse and suicide (Priest et al., 2013; Shepherd et al., 2017). As children develop, they can become aware of racism in society, which may result in hypervigilance when navigating their environment (Priest et al., 2021). Children can also internalise racist ideology about themselves which affects their racial identity, self-esteem and sense of belonging (Gray et al., 2018; Priest et al., 2013; Trent et al., 2019). Children who experience racism report worrying about future encounters with racism and altering their behaviour to avoid racism (Yusuf et al., 2022).

Racism can have a cumulative impact that adds to adverse childhood experiences and impacts health outcomes later in life (Cave et al., 2020). For example, systemic racism can reduce the accessibility or quality of resources, services and opportunities for marginalised children and their families, which in turn can affect their ability to thrive (Alvarez et al., 2022).

How can practitioners begin to engage in anti-racist practice?

Because of the multifaceted impacts that racism has on children’s mental health, and the barriers that racially marginalised children face in accessing care, it is crucial that practitioners are competent in responding to racism and racial trauma. Many practitioners lack training or experience in addressing racism in children. This can lead to marginalised children feeling silenced or invalidated, which further perpetuates the racial trauma they have experienced.

The first step in addressing this is to build racial literacy through self-education and by learning how to implement anti-racist practices (Williams et al., 2022). Anti-racist practice goes further than culturally inclusive/responsive practice because it explicitly recognises racism and actively seeks to dismantle systems of oppression. Practitioners can begin to consolidate their racial literacy skills and incorporate anti-racism into their practice by considering the following:

• Critical self-reflection. Do you have a good understanding of racism, privilege, power dynamics, your own prejudices, and how these elements impact therapeutic processes?
• Learn to regulate your emotions and reactions. Are you able to engage in discussions about race, racism, and whiteness with children and their parents comfortably and safely, even when it requires acknowledging your own prejudice, privilege or racism?
• Engage in continuous anti-racism learning. Are you competent in understanding how racism, racial trauma and whiteness impact children’s mental health and development? Are you committed to ongoing learning?
• Think about your physical space. Does your therapy room, waiting room, website and the staff within your workplace reflect a culturally safe, diverse, welcoming and anti-racist setting?

(Sources: Svetaz, 2020; Trent et al., 2019; Williams et al., 2022)

Racism can impact children’s mental health from an early age and can progressively impact mental health as they grow up. It is important for practitioners to understand how racism can be experienced, the effects on child mental health and how they can support children who are experiencing racism. Initial steps in recognising, reducing exposure to and addressing the pervasive impacts of racism on child mental health are to build racial literacy and adopt anti-racist practice.

Practitioners can continue to grow their knowledge and skills by exploring the following resources.

Further reading and related resources

Emerging Minds resources

• What are adverse childhood experiences (ACEs)?
• Prejudice-motivated bullying and its impact on child mental health and wellbeing

Resources for practitioners to build racial literacy and anti-racist practice

Build your racial literacy by hearing the stories of people’s experiences of racial trauma.

• Becoming anti-racist diagram, by McGill University
• Living while black: The essential guide to overcoming racial trauma by Guilaine Kinouani
• My grandmother’s hands: Racialised trauma and the pathway to mending our hearts and bodies by Resmaa Menakem
• Educating Australian social workers in the post-apology era: The potential offered by a whiteness lens by Susan Young and Joanna Zubrzycki
• Internalised racism resources, by Racial Equity Tools
• Whiteness, by the Alberta Civil Liberties Research Centre

Resources on the experiences of racism in Australia

• Racism, racial discrimination and child and youth health (VicHealth)
  This report focuses on Australian data collected over five years (2016–2020) on racism, racial discrimination and health. It underscores the high prevalence of racial discrimination experienced by children and young people from Aboriginal and Torres Strait Islander backgrounds, and from some ethnic groups. It also focuses on what works in interventions to reduce the impacts of racism on health.
• Reimagining young people’s futures without racism (VicHealth)
  This webinar discusses the impact of racism on young people through emerging research and the voices of lived experience.
• Strength in my roots (headspace)
  This website explores experiences of multicultural young people in Australia and provides resources to support young people’s mental health.
• Racism and its links to the health of children and young people
  This fact sheet summarises key findings from studies examining racism and health and wellbeing in children and young people, in particular the research led by Dr Naomi Priest who was supported through a VicHealth grant.

Resources on racism in schools

• No Way: Anti-racism education for Australian schools (NSW Department of Education)
  This website provides resources to support the delivery of anti-racism education in the classroom. The resources may assist students to engage positively with other peoples and cultures and to better understand Australia’s cultural diversity and history.
• Busting myths and changing perspectives on racism in schools (Monash University)
  This article describes common myths about racism in schools and what teachers can do to change their teaching practice.

General resources on racism and mental health

• All Together Now is a non-for-profit organisation delivering evidence-based projects that promote racial equity and provide Australians with information about racism’s impacts and ways in which we can effectively challenge racism. Visit the All Together Now website.
• Racism. It stops with me is a national Australian Human Rights Commission campaign that provides tools and resources to help people and organisations learn about racism and take action to create change. Visit the Racism. It Stops With Me website.
• The Australian Human Rights Commission is also developing a National Anti-Racism Framework concept paper.
• To build awareness of the link between racism and mental health Beyond Blue provides a range of resources, including Educate yourself about racism.

References

Alberta Civil Liberties Research Centre (n.d.). Whiteness.

Alvarez, K., Cervantes, P. E., Nelson, K. L., Seag, B. A., Horwitz, S. M., & Hoagwood, K. M. (2022). Review: Structural racism, children’s mental health service systems, and recommendations for policy and practice change. Journal of the American Academy of Child & Adolescent Psychiatry, 61(9), 1087–1105.

Becares, L., & Priest, N. (2015). Understanding the influence of race/ethnicity, gender, and class . PLoS ONE, 10(10).

Cave, L., Cooper, M. N., Zubrick, S. R., & Shepherd, C. C. (2020). Racial discrimination and child and adolescent health in longitudinal studies: A systematic review. Social Science & Medicine, 250, 112864.

Gray, D. L., Hope, E. C., & Matthews, J. S. (2018). Black and belonging at school: A case for interpersonal, instructional, and institutional opportunity structures. Educational Psychologist, 53(2), 97–113.

Heard-Garris, N. J., Cale, N., Camaj, L., Hamati, M. C., & Dominguez, T. P. (2018). Transmitting trauma: A systematic review of vicarious racism and child health. Social Science & Medicine, 199, 230–240.

National Collaborating Centre for Determinants of Health (NCCDH). (2022). Glossary of Essential Health Equity Terms.

Neville, H. A., Awad, G. H., Brooks, J. E., Flores, M. P., & Bluemel, J. (2013). Color-blind racial ideology: Theory, training, and measurement implications in psychology. American Psychologist, 68(6), 455–466.

Mansouri, F., & Jenkins, L. (2010). Schools as sites of race relations and intercultural tension. Australian Journal of Teacher Education, 35(7), 93–108.

Priest, N., Chong, S., Truong, M., Sharif, M., Dunn, K., Paradies, Y., Nelson, J., Alam, O., & Kavanagh, A. M. (2019). Findings from the 2017 Speak Out Against Racism (SOAR) student and staff surveys. CSRM Working Paper, No. 3/2019. Acton: Centre for Social Research & Methods, Australian National University.

Priest, N., Guo, J., Doery, K., Perry, R., Thurber, K., & Jones, R. (2021). Racism, racial discrimination and child and youth health: A rapid evidence synthesis. Melbourne: VicHealth.

Priest, N., Paradies, Y., Trenerry, B., Truong, M., Karlsen, S., Kelly, Y. (2013). A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people. Social Science & Medicine, 95, 115–127.

Shepherd, C., Li, J., Cooper, M. N., Hopkins, K. D., & Farrant, B. M. (2017). The impact of racial discrimination on the health of Australian Indigenous children aged 5–10 years: Analysis of national longitudinal data. International Journal for Equity in Health, 16(1), 1–12.

Solorzano, D., Allen, W. R., & Carrol, G. (2002). Keeping race in place: Racial microaggressions and campus racial climate at the University of California, Berkeley. Chicana/o Latina/o Law Review, 23(1).

Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271–286.

Svetaz, M. V., Barral, R., Kelley, M. A., Simpson, T., Chulani, V., Raymond-Flesch, M., Coyne-Beasley, T., Trent, M., Ginsburg, K., & Kanbur, N. (2020). Inaction is not an option: Using antiracism approaches to address health inequities and racism and respond to current challenges affecting youth. Journal of Adolescent Health, 67(3), 323–325.

Trent, M., Dooley, D. G., Dougé, J., Cavanaugh, R. M., Lacroix, A. E., Fanburg, J., Wallace, S. B. (2019). The impact of racism on child and adolescent health. Pediatrics, 144(2), e20191765.

Williams, M. T., Faber, S. C., & Duniya, C. (2022). Being an anti-racist clinician. The Cognitive Behaviour Therapist, 15, E19.

Yared, H., Grove, C., & Chapman, D. (2020). How does race play out in schools? A scoping review and thematic analysis of racial issues in Australian schools. Social Psychology of Education, 23, 1505–1538.