What impacts the mental health of young people from Black, Asian and Latin American communities?

1. Young people from Black, Asian and Latin American communities have good knowledge of mental health and wellbeing and take positive action to stay well. This can include creative activities, making time for themselves, finding strength in their faith, and drawing on the wisdom of older generations.
2. Children and young people from Black, Asian, and Latin American backgrounds may share similar experiences which impact their mental health, but there are also significant differences between communities. For example, migration history, language barriers, gender stereotypes, and socioeconomic background etc.  
3. Experiences of racism such as microaggressions and stereotyping in conjunction with structural barriers significantly influences their emotional wellbeing and mental health. Young people affected by these experiences are aware of the stereotypical views ingrained in the mental models held by others (, creating barriers to access.
4. The stereotypes held by others can lead to support being delayed or denied for young people from Black, Asian, and Latin American communities. Poor treatment can lead to them reducing their engagement with services. As the result of direct and indirect racism from public services – including education, social care, housing, mental health services and the police – they miss out on support to reduce their vulnerability and on opportunities to flourish.
5. Despite the expectation that schools serve as a protective environment, they can, become sources of harm. Young people may experience racism, bullying and harassment from both peers and staff. They recalled facing exclusion based on racist practices, contending with undue academic pressure, or insufficient support from teachers.
6. School exclusions affect their confidence and self-esteem and can negatively impact their mental health and emotional wellbeing and cause increased stress levels and tensions at home.
7. Counselling services frequently fail to acknowledge the underlying causes of challenges faced by children and young people from Black, Asian, and Latin American backgrounds. They may hesitate to share their experiences of oppression, as therapists may lack insight into their unique racialised experience.
8. Unemployment and structural barriers to accessing and keeping good jobs have a direct impact on their mental wellbeing and are compounded by intersections of gender, migration history and disability.
9. Racial profiling and the stop and search practices of the police can trigger feelings of anxiety and depression in young people.
10. The family environment can serve as a sanctuary of safety, support, and comfort for children and young people from Black, Asian and Latin American backgrounds. Parents, carers, and siblings play a crucial role in safeguarding their mental wellbeing, relying on their families for mental health support. The value placed on intergenerational wisdom extends beyond tradition, offering a source of hope, strength and resilience.
11. The expectations set by elders and intergenerational trauma within the family and community context can act as barriers, deterring young people from seeking help. They may perceive their challenges as less significant compared to the adversities endured by their elders, leading them to believe their struggles don’t warrant assistance. Additionally, concerns about being perceived as weak can also be a barrier to accessing support.

What young people said about mental health support in London

1. Young people recognise that at times they may need support with their mental health. They want and try to access mental health services but often find that current services do not meet their needs.
2.  Many young people were aware of Child and Adolescent Mental Health Services (CAMHS), Samaritans and Childline. They said there was a lack of clarity or information regarding mental health support tailored to their needs.
3. The use of complex and inaccessible language creates a barrier to accessing services. This may be due to text heavy resources, clinical jargon, a lack of understanding between young people and professionals, or when English is not the first language for some young people.

4. Many services are not culturally sensitive, and the workforce is not ethnically diverse enough to meet the needs of young people from racially minioritised communities. There is a lack of awareness among staff about how their own mental models on race influence their perceptions of young people, their families, and the approach to the treatment of young people.
5. Young people from Black backgrounds are more likely to be perceived as older than their actual age.  Adultification leads practitioners to overlook the vulnerability of children and young people. Rather than receiving the support they need, they frequently face repercussions for expressing their trauma and distress.
6. Mental health services designed for young people often overlook the racialised trauma and cultural contexts unique to them. To effectively address their needs, mental health services must acknowledge and understand their racialised experiences to ensure services meet their needs.

7. Given past instances of the misuse of data, particularly concerning racially minioritised groups. Some young individuals may refrain from sharing their data, fearing potential negative consequences for themselves and their community.
8. Services often overlook intersectional discrimination experienced by young people navigating challenges related to neurodiversity, faith, migration history, immigration status and other factors.

9. To earn trust from young people, when mental health professionals share information between colleagues and institutions, young people need to be sighted on what is shared.
10. Young people value the opportunity to build long term therapeutic relationships with practitioners. They express a desire to access more informal spaces (such as non-clinical settings and community spaces) and approaches to therapy.

11. Young people feel it is important to have choice. They will be more likely to seek support if they are given the opportunity to select the type of professional, they work with and can have some influence over their treatment options or interventions.

The changes young people want to see

The thoughts and suggestions shared by young people tell us, in their own words and lived experiences, highlight the changes they want to see in services. We hope these insights will inspire services to consider how and where changes can be made as part of implementing the recommendations in this Listening Project report.
“I understand that services are full to the capacity at the moment, but the waiting times have got to improve. Find a solution to this, you’re all incredibly talented.” – (Black, male, age 20)

‘‘A service that shows what I can be and achieve – not just my problems and stereotypes. I think the service will need to have different departments – like one which is by a younger male to work with a boy like me so we can relate, and he understands the life I go though. It would be good if we could go out and socialise like trips and days out and do different things than just hanging around the ends.’’ – (Black, male, age 15)

“You should have someone to talk to about why you behave badly – not what you do but why you do it.” – (Black, Mixed background, female, age 15)

“Start helping children more – not just talking; do activities and help them. Have a relationship with them; not just professional and questions – understand where they’re coming from and relate to them. Mental health is about them but it’s also about their life, so help them with things in their life, not just what is stressing them out.” – (Black, male)

“I wish it was run by younger people with real experience— who understood, looked like me, had their own experience of life, challenges, road like you name it— everything we have to deal with.” – (Black, Mixed background, female, age 14)

“Hiring Black/Mixed/Asian workers that are relatable, who show that they care and understand the struggle.” – (Black, male, age 19)

“I think I would approach it from an art side of things and open creative spaces for young people.” – (Black, female, age 23)

‘‘There’s so many local youth offers where youth workers are trained to support young people in the most challenging times. You can introduce – not signpost, it’s such an ugly process – introduce them to the youth workers and in the meantime, check in with the youth organisation and the young person to let them know they’re not forgotten.’’

“Invite the staff to more youth clubs. Not when young people are 15/16 but when they are 12/13 years old and are not involved in road life. Stress and mental health problems come with road life and being young, if you help young people before they get trapped in a bad lifestyle, it would be more helpful.” – (Black, male, age 15)

“Work to actually help me as a person – not as someone who they’re told has bad behaviour and should be in a PRU [pupil referral unit]. They don’t even know how it affects your mental health to be in a PRU and how stressful it is – so why would they be trying to help school send kids there?” – (Black, male, age 13)

“Services need to care and understand young people, not judge or just take the school’s point of view. To make things better, it would be good to help children more around life, not just talking but doing activities and helping them.”

“Analyse before you prescribe any type of drugs you give people, analyse the person extensively to make sure you are truly doing what’s best for them as people who are looking for such services, people who are seeking help are often at a very sensitive point in their life, so you must make sure you don’t push them towards the wrong direction, whether this be through bad advice or introducing a new possible addiction into their life.”

 “[Mental health support should be] separate from school” – (Black, male, age 14)

“There has been a lot of learning done and this piece of work that Healthy London Partnership (now known as Transformation Partners in Health and Care) are developing is a step in the right direction.” – (Black, male, age 20)

Key recommendations

The following section brings together recommendations from the Listening Project. These recommendations should undergo further development in collaboration with young people, parents, carers, and community members ensuring their active involvement and their voices centred. The process should be mindful of their social identities and acknowledge the existence of structural barriers. Implementation of initiatives such as NHS England’s Patient and Carer Race Equality Framework and other anti-oppressive and anti-racism endeavours like A Strategic Framework to Tackling Ethnic Health Inequalities through an Anti-Racist approach can enhance this process. 

• Integrated Care Systems, Integrated Care Boards (ICBs), Integrated Care Partnerships (ICPs) and provider trusts, along with system leaders and commissioners, should prioritise preventive approaches to tackle the root causes of systemic racism, and holistic approaches to improve access, experience, and outcomes for young people from racially minioritised backgrounds.
  Effectively tackling the root causes of systemic racism will require close collaboration with communities and organisations capable of supporting statutory organisations to address inequities across the social determinants of health.
  
  Holistic improvement approaches will include reviewing existing pathways, commissioning services designed to counteract stressors faced by young people from racially minioritised communities, investing in community organisations, and making use of intergenerational wisdom in community spaces.
• Provider organisations and mental health trusts should nurture their workforce’s cultural capability and awareness in anti-racism, while diversifying their workforce at all levels. This will involve senior leaders showing commitment to addressing inequalities, embedding reflective practice, supporting staff to engage in open dialogue around race and identity, to embody antiracism to enable them to build positive therapeutic relationships with young people and improving the representation and visibility of staff from racially minioritised backgrounds.

• The mental health system in London should come together to develop a co-produced pan-London Action Plan that addresses mental health services, education, health and social care, and the police. This plan should set out responsibilities, learning, and reflections to improve outcomes for young people. Actions can include supporting systems, improving data quality, workforce development, research, and partnership working and collaboration.

Advice to young people from their peers

We would like to thank the young people for their contributions which enabled us to produce this report. During the project we asked young people to share advice they would give to their younger selves and peers around mental health and the support that is available: 

“Don’t always believe what you think. I did a lot of work on my thoughts and emotions with Hammersmith, Fulham, Ealing and Hounslow Mind. Learning the different types of negative thinking was really useful for me to understand that I can think the wrong things or the worse things which are not always true. When I do this, I can get myself wound up and angry and it’s hard to stop that. So, taking time out before you react is the best advice I have learnt and would tell someone else.” (15-year-old)

“Learn to understand yourself, then learn to accept your feelings. If someone asked you for support because they were upset about something you would automatically accept and understand why they feel sad. So, do the same you’ve done for that person, do it for you. However, if you find it hard to actually support yourself, I’d recommend getting support from someone you trust or a professional.” (16-year-old)

“Because I’m older, I’m better at managing my wellbeing whereas back in school – given the circumstance I was in and my experience with dealing with the noise – I would be learning as I go on. Feel comfortable with therapy. There’s a lot of stigma within communities which is completely understandable given the historical context, but humans are emotional beings, and it can be a good way to support your wellbeing.” (20-year-old)

“The only advice I can offer for others is to call someone even if they aren’t able to be there with you physically. A phone call can go very far and while I do understand that people may find it difficult to do so when in that state, I implore you to reach out however you can to someone who cares about you. If unfortunately, you do not have anybody, then use any crisis service available to you and talk to someone. Honestly, the pain does not vanish, nor is there a quick fix to it, however it is the most gratifying feeling knowing where you were and seeing how far you have come when you do get through it, and you will. The feelings you felt at the time may linger but there is an unexplainable beauty in knowing this feeling ruled you at one point in time and now it is something that you can manage and move on.” (20-year-old)