This year marked Virginia’s 2nd Racial Truth & Reconciliation Week (RTRW), a virtual week-long conference hosted by Voices for Virginia’s Children. It promotes the reckoning of Virginia’s past to reconcile our present and future.
In June 2020, Virginia’s trauma-informed community networks of color convened to address the disproportionate impact of COVID-19 on at-promised communities and the modern civil rights movement. They felt an innate urge to respond and react to two pandemics, COVID-19 and racism as a public health crisis. In response, there became a clear need to concentrate efforts on the impact of cultural, racial and historical trauma on marginalized communities.
RTRW was an awareness week launched in 2020 with a mission to empower marginalized communities to promote healing, reconciliation and social justice for children, youth and families across the commonwealth. Checkout Virginia’s 2nd Racial Truth & Reconciliation Week Opening Address led by Amy Strite, CEO of Voices for Virginia’s Children and Chlo’e Edwards, Racial Truth & Reconciliation Virginia Campaign Coordinator.
The four conference tracks concentrated in ‘policy, equity, and data analysis’, ‘advocacy and action’, ‘diversity, equity, and inclusion’ and ‘community-centered engagement’ provided an opportunity for all ages and demographics to engage in truth, reconciliation, healing, and repair. The community-centered track presented an opportunity for kids to engage through Exploring Patterns, Rhythm, Music, & Dance with the Children’s Museum of Richmond and the Richmond Performing Arts Alliance Wolf Trap program. Other tracks, such as the advocacy and action track, tackled issues like racism as a public health crisis and presented ways advocates could mobilize at the federal, state and local-level.
We want to raise awareness about the importance of having mental health professionals of color and why children in particular need clinicians who present and reflect their same racial and ethnic experiences. This post focuses on the recruitment of clinicians of color, barriers to recruitment and how you can be an advocate.
Intentional Recruitment of Clinicians of Color
As mentioned in the first part of this series, there is a shortage of Black and Brown mental health providers and those that do exist can be difficult to access, especially depending on where you live. So, in addition to raising awareness about the need for more mental health professionals of color, we have to speak to why there is a shortage. One of the reasons is recruitment and retention. The mental health arena consists of many types of job settings and positions and for a long time, the field has not been intentional about recruiting Black and Brown people. While better efforts have been made with the help of increased conversations about diversity, inclusion and equity, we still have some ways to go to close the gap.
Barriers to Recruiting and Retaining Mental Health Professionals of Color
The Reach of Job Postings
I have benefited from recruitment efforts that involved being personally referred for a job opening by an inside person. This is a common practice in the mental health field especially in the non-profit world. I don’t knock this kind of recruitment effort, however I do have a problem with it being providers’ primary or sole recruitment strategy especially if the organization or agency’s staff is predominately white and have little or no connections to other professionals of color. This will not help reach more clinicians of color. Intentional recruitment of clinicians of color requires diversifying the places/platforms where job opportunities are posted. Posting jobs in places that attract the same pool of applicants every time and then simply concluding that Black and Brown clinicians don’t apply for whatever biased reason is a barrier.
Fair and Equitable Pay
Traditionally, the mental health care field has been known to have low to average paying positions. Though we are beginning to see increases in pay, we still need to consider the equity implications for why White mental health clinicians generally would be more likely to accept a lower paying job than clinician of colors. Funding for Black and Brown mental health providers to start businesses of their own is also a barrier.
We cannot deny that workplace discrimination continues to occur and when it does, the discrimination is mostly based on race and sexual orientation, which is reflected in a 2017 Report from the Behavioral Health Workforce. This report highlights that discrimination against the client population also deters mental health clinicians of color from working with particular employers or is a factor that leads to them leaving their job.
Call to Action
What you can do? Mental health providers of color can connect with/join area chapters of organizations like the National Association of Black Social Workers, National Association of Black Psychologists, and National Association of Black Counselors. Membership benefits can include networking, educational opportunities, mentorship, greater access to job referrals/job postings, and other community resources, just to name a few. These associations often have directories and other resources that can help community members of color find Black and Brown mental health providers in their areas. Additionally, the aforementioned associations oftentimes have student chapters at various colleges and universities that allow students of color to get connected to strong professional networks which helps prepare them for the workforce post-graduation.
We can create pipeline structures for future mental health professionals of color by increasing exposure about employment opportunities in the mental health field to Black and Brown youth as early as possible. Increased positive experiences between Black and Brown clients and mental health providers who reflect their ethnicity and cultural norms can lead to increased interest and desire for people of color to enter the field. White providers working toward intentional recruitment of clinicians of color can reach out to local Historically Black Colleges and Universities and connect with their Department of Field Education and Career Centers to share job/internship opportunities. Go to these places and participate in their job fairs, build relationships with the Schools of Psychology, Social Work, Counseling, etc.
Last, but not least, keep addressing systemic racism and its impacts on Black and Brown people. Invest in more trainings for administrators and employees that address biases, structural racism and other barriers to achieving equity, inclusion and diversity in the workplace. Advocate for more equitable funders/funding sources so Black and Brown mental health providers don’t have to continue struggling to effectively meet the needs of their communities.
As the world faced stay-at-home orders in March 2020, communities across the country witnessed expanded attention that was called to what is essentially dual pandemics, the COVID-19 pandemic and racism as a public health crisis. Inequities that contribute to the social determinants of health were already present, but the pandemic further widened disparities that continue to contribute to poor social and health outcomes in marginalized communities.
While great awareness has been raised around trauma-informed policy and practice over the past few years, we must acknowledge that this approach is incomplete. Today, communities across the state are raising their voices on behalf of much needed acknowledgment of the systemic inequities that perpetuate toxic systems and policy, and practices that reinforce the root cause of trauma and cause harm.Equality gives everyone the same exact resources. Equity acknowledges the disparities affiliated with oppression and inequality and, therefore, distributes resources based off of the needs of the recipients so that everyone can achieve their full potential in life regardless of race, ethnicity or the community in which they live.
While the COVID-19 pandemic presents economic challenges, Virginia is poised to reconcile hundreds of years of exacerbated inequities in order to correct the disparities that are further heightened today. Our talking points for the 2021 legislative session will focus on these themes:
Create systemic interventions that address the root cause of trauma.
Ensure Virginia’s public entities prioritize the needs of children.
Connect parents to supports that foster resiliency and positive health outcomes.
Ease the impact of trauma and victimization that children and families experience.
Promote financial stability and resilience for families through community-level supports.
Address unintended consequences and biases that can lead to additional trauma for children
Creating Systemic Interventions for Trauma
According to a 2019 Pew Research survey, roughly eight in ten people who identify as Black with some college experience (81 percent) reported that they have experienced some form of racial discrimination from time to time with 17 percent reporting that this happens to them regularly. The American Public Health Association defines racism as a social system with multiple complex dimensions, including internalized or interpersonal individual racism, institutional or structural systemic racism, which unfairly disadvantages some individuals and communities and unfairly advantages other individuals and communities. It ultimately decreases the strength of our whole society through investments that do not address the root cause of trauma, which further contributes to multi-disciplinary disparities.
Racism As A Public Health Crisis:Delegate Aird introduced a resolution during special session to declare racism as a public health crisis. It included numerous steps that Virginia can take to address systemic racism and its impact on public health, including the examination of racial inequity in Virginia law, implicit bias training for public employees and officials, a glossary of terms specific to racism and health equity and engagement with communities most impacted.
Prioritizing The Needs Of Children
A prolonged activation of an individual’s stress response system in the body and brain without buffering can cause toxic stress to a child’s brain, which can disrupt the immune system, the ability to learn, and even the way DNA is read and transcribed. This is referred to as trauma. In addition, racial trauma refers to the ongoing impact of racism, racist bias, and the exposure to racist abuse. This can impact a person’s ability to develop authentic relationships, feel safe, and even live a long and healthy life.
According to the KIDS COUNT Data Center’s indicators, which include socioeconomic hardship, family violence, neighborhood violence and racist bias, 19 percent of Virginia’s children experience two or more adverse childhood experiences (ACEs). However, in 2017 to 2018, 37 percent of Black children experienced two or more ACEs, which is almost double the rate of trauma that all children experienced. ACEs can contribute to toxic stress in the brain, which is known as trauma. According to the CDC-Kaiser Permanent Adverse Childhood Experiences (ACE) Study, trauma is connected to long-term negative physical, social and emotional health outcomes.
Governor’s Children’s Cabinet: The Governor’s Children’s Cabinet, which is chaired by First Lady Pamela Northam has made great strides in promoting wraparound services that children need, including food insecurity, trauma-informed systems and school readiness. Virginia should make the Governor’s Children’s Cabinet permanent and create a position for a Chief Advisor in order to continue this momentum in ensuring children and families have access to the services they need to thrive.
Connecting Parents To Supports
In 2019, Virginia Mercury reported that Black women in Virginia were three times more likely to die after giving birth than a white women, a disparity that Governor Northam made a goal to eliminate by 2025. Home visiting is a voluntary, evidence-based program that supports low-income pregnant women and parents of children birth age to five to access the resources needed to raise children who are healthy and ready to learn. Governor Northam’s 2021 budget proposal includes $2.4 million to increase access to doula care for pregnant women, which also reduces racial disparities in maternal health. What the COVID-19 pandemic has proven is that racial and ethnic disparities already contribute to poor health outcomes. Investing in these supports is a step in the right direction to shorten that gap.
Foster Positive Health Outcomes: Virginia is poised to support the Governor’s budget proposal to increase access to doula care for pregnant women through Medicaid. In addition, Virginia can take additional steps to liaise the gap in maternal and infant health disparities by fostering familial resiliency through Medicaid reimbursement for home visiting services.
Easing The Impact of Trauma And Victimization
The Virginia Heals goal is to bring healthcare, child welfare, justice and other systems together to coordinate and align efforts to ensure a timely and seamless response to young victims, their families, and caregivers regardless of the system that they may engage with or enter. The program offers a number of services, including resource mapping, screening for trauma, referral and response, agency assessments, family engagement, grant development and more, including COVID-19 interventions.
The Governor’s budget proposal includes $517,553 in FY22 to provide general fund support to the Virginia Helping Everyone Access Services (HEALS) program.
Support Early Identification and Intervention: We know that our communities and public entities are facing challenges in adjusting to the hardships of the COVID-19 pandemic. Now, more than ever, our systems of care should be cohesive and easy to navigate for those who need them. Virginia can adopt and support early identification and intervention as it relates to easing the trauma and victimization that community members may experience.
Promoting Financial Stability And Family Resilience
The Family and Children’s Trust (FACT) Fund is the only public/private entity that addresses trauma across a lifespan and the only organization that provides funding to Virginia’s 27 trauma-informed community networks across the state. These are multi-disciplinary networks that convene professionals in order to develop community-level trauma-informed approaches to services and best practices. Trauma is caused by an acute event or a combination of events. Virginia’s history includes historical, cultural, and intergenerational trauma that is passed down through generations, including the arrival of the first enslaved Africans to Old Point Comfort, now Ft. Monroe in Hampton, Virginia.
Today, communities face compound trauma in the wake of the pandemic as a trauma, economic trauma and more. Epigenetics is the study of how one’s behavior and environment can cause changes that affect the way their genes work, which can further impact a child’s stress response system and contribute to challenges, such as anxiety and stress. However, a loving, healthy and safe environment can promote intervention. Community networks have played an imperative role in fostering family economic security through COVID-19 interventions, including educational programming to foster community resilience, in addition to facilitating referral and response programs to help families meet their basic needs through emergency grant funds and services.
Fund Community Partnerships:While funding for community-based networks occurred during the 2020 General Assembly through approval for five communities to decide to allow casinos through a voter referendum, this funding will not be seen immediately and instead in about four to five years. However, Virginia is poised to promote the urgent financial stability communities need nowthroughinvestments in FACT funding for community partnerships, which will include technical assistance to community networks and funding for COVID-19 interventions through referral and response resources to combat economic challenges and break cycles of intergenerational trauma.
Address Unintentional Consequences And Biasess
In 2019, when accounting for the population of children that were chronically absent from school in the 4th grade, of that population 9 percent are Asian and Pacific Islander, 30 percent are Black, 31 percent are Hispanic or Latinx, 23 percent are Non-Hispanic white, and 28 percent are two or more races. Several factors contribute to chronic absenteeism, including chronic illness, poor transportation, a lack of access to mental health services, involvement in juvenile justice systems, negative school experiences, a lack of engagement and misconceptions that absences are only a problem if they are unexcused. Contributing to community-level prevention and wraparound resources that increase family engagement will contribute to an authentic solution rather than punitive policy and zero tolerance interventions.
Address unintentional biases that can lead to additional trauma for children: As our systems seek solutions to liaise disruptions in educational settings that lead to chronic absenteeism, such as housing and other supports, we must ensure these interventions do not inadvertently widen cultural, racial and ethnic disparities. We need to ensure policy responses do not contribute to unintended consequences, such as the school-to-prison pipeline.