Centering Black Youth, Rewriting the System: Toward Equitable School Mental Health Futures

• In Event: Centering Liberatory Health Equity Lenses in Interdisciplinary Approaches to the Promotion of Youth Well-Being

Abstract

Objective/Purpose
Guided by Bronfenbrenner’s Ecological Systems Theory, this two-part qualitative study explored systemic factors influencing Black youth’s access to and utilization of school mental health (SMH) services. Study 1 examined district and school-level policies and practices (exosystem and microsystem), identifying seven key components critical to access. Study 2 explored peer relationships and the feasibility of a culturally relevant peer-to-peer mental health intervention. Black youth and SMH providers emphasized the importance of trust, mentorship, and safe spaces while identifying systemic and interpersonal barriers.

Theoretical Framework/Perspectives
Bronfenbrenner’s Ecological Systems Theory framed both studies, as it places the child at the center of complex, interacting systems, ideal for examining the layered barriers and facilitators impacting SMH access and utilization.

Methods
Two qualitative studies were conducted with focus groups of 6th–8th grade students and interviews with school mental health providers. A researcher-developed 10-item self-report measure assessed student knowledge and awareness of available SMH services and providers. The Strengths and Difficulties Questionnaire (SDQ; Bourdon et al., 2005) was used as a behavioral screening tool.

Data Analysis
Data includes transcriptions from focus groups and interviews. Focus group and interview transcripts were thematically analyzed (Braun & Clarke, 2006).

Results - Study 1
Students and providers described access as a multilayered, bi-directional process, emphasizing that availability ≠ access. Key components of access included:
Student understanding of services and language to express need
Trusting teacher-student relationships
Universal mental health screening
Timely referrals and accurate care identification
On-site services and physical space for delivery
Facilitators included trusting adult-student relationships, proactive behavior, and ongoing training. Barriers included infrequent teacher referrals, systemic reliance on externalizing behaviors for identification, lack of staff training, and minimal integration of community mental health providers in school-based decision-making.
Results - Study 2
Black youth expressed a desire to codesign school-based mental health intervention and identified a disconnect between student needs and institutional responses. Youth emphasized that interventions should be youth-led and culturally relevant.
Students reported supportive peer relationships but were cautious about sharing mental health challenges. They valued anonymity and trust in peer interventions, identified family as key supporters, and expressed concern about stigma and burdening friends.
Providers and students stressed the need for school and administrative buy-in for any peer-to-peer model to succeed.

Scholarly Significance
This study contributes to the limited body of research that centers Black middle school youth in conversations about SMH services. It highlights systemic failures, the importance of relational trust, and the promise of youth-driven solutions. These findings support treating Black youth mental health as a public health priority and call for reimagined, equity-centered SMH systems.

Author

• Shlon A. Smith, Stepping Stone Therapy