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COUN 6785: Social Change in Action:

Prevention, Consultation, and Advocacy

Social Change Portfolio

J Herring

Contents

Introduction

Scope and Consequences

Social-ecological Model

Theories of Prevention

Diversity and Ethical Considerations

Advocacy

The phrase school-to-prison pipeline is now trite, overused, and watered down, although the seriousness of the practice remains a real concern. Across the country, suspensions and expulsions from school, referrals to alternative schools, and school-based arrests have increased, especially among minority students, which blurs the line between the education and criminal justice systems. The consequences adolescents face for their behavioral issues address only the behavior but not the cause of the behavior. The socioeconomic disadvantage of minority adolescents can have significant adverse effects on their mental health, including depression and behavior problems, anxiety disorders such as posttraumatic stress disorder, and a range of other adjustment difficulties. Many minority adolescents also experience “compounded community trauma” which has been defined as the experience of children when they witness violence in both their homes and their neighborhoods. Additional factors that increase the risk for mental illness for minority youth are neighborhood exposure to violence, repeated experiences of discrimination, and chronic exposure to racism. As a result, early interventions for minority adolescents, intended to maximize their effective coping in these disadvantaged and at-risk environments, can be advantageous for their future mental health. Thus, effective adovacation that push for early prevention and intervention are essential to reduce the burden of mental disorders for minority adolescents (El Bouhaddani, et. al., 2019).

PART 1: SCOPE AND CONSEQUENCES

Advocating for Minority Adolescents in Sanford, Florida

The conditions in which a person is born, grows, lives, and works have a significant impact on his health, both physical and mental. Sanford is the County Seat of Seminole County, Florida. Sanford has an African American population of 30.5%. The high school and its cluster schools reflect the dichotomy that exists within the community of Sanford. While Seminole High (where I once taught English Language Arts) was awarded the Silver ranking in 2015 by US News & World Report, the percent of disadvantaged students who were determined proficient was 46.5%, whereas the proficiency of non-disadvantaged students was 74.5%. In addition, the suspension and graduation rates for students of color are disproportionate when compared to white students (.

Sanford became the center of national and international media attention following the February 2012 fatal shooting of Trayvon Martin, a 17-year old African American high school student. However, when the marches and protests dissipated, so did the care and concern of the youth in Sanford. They were left with the invisible scars from the overt racism they faced and continue to face for looking, acting, and existing like Trayvon Martin. These children need effective mental health care to teach them coping and anger management strategies and tools, not expulsion from school.

The mental health needs of minority adolescents are not well served: they are treated less frequently, and when they are treated, the services they receive are less frequently and adequate. Recent studies show that 6.6% of ethnic minority children and youth receive services compared to 20% of white children (Yasui, 2014). The result of insufficient mental healthcare for minority adolescents is that they are more likely to engage in problematic behaviors later in life, such as increased depression, anxiety, engagement with deviant peers, involvement with violent crime, poor academic performance, school dropout, drug and alcohol abuse, unsafe sex, and unemployment (Alegria, Vallas, & Pumariega, 2010). Therefore, my goal is to push for effective adovacation that provides resources for early prevention and intervention to reduce the prevalence of mental disorders for minority adolescents.

One cannot deny that disparities exist in the mental health care arena, much like in general healthcare. Strategies to lower or remove discrepancies involve improving access to care, improving quality of care, and reducing the stigma associated with mental healthcare.

Some of the risk factors for minority adolescents are common for all adolescents, as this is an important time for physical, emotional, and mental development. However, if this stage of development does not occur in a safe, supportive environment, then a mental disorder may occur. Some of the risk factors on the individual level include being a female, having low self-esteem, insecure attachment, difficult temperament (poor concentration, inflexibility, low positive mood), poor social skills, and extreme need for approval and social support. Some risk factors on the family level are parental depression, parental divorce, poor parenting, negative family environment, child abuse, parent(s) with mental disorders, and sexual abuse. School and community risk factors include peer rejection, poor academic achievement, community-related stressful or traumatic events, school and community violence, association with deviant peers, and loss of close relationship or friends.

On the other hand protective factors include having physical development, high self-esteem, academic achievement, emotional self-regulation and good coping and problem-solving skills on the individual level; strong family structure with clear expectations, limits, rules, and monitoring on the family level; the presence of mentors for support and development of skills and interests, having opportunities for engagement within the school and community, the reinforcement of positive norms, clear expectations for behavior, and having physical psychological safety are important school and community protective factors (O’Connell, Boat, & Warner, 2009).

Albert Bandura's social learning theory is popular among current prevention programs. According to Bandura, learning is acquired and shaped by positive and negative reinforcements (rewards and punishments), as well as by observation of other people's behavior (Johnson, 2018). This theory is based on the idea that people can predict the consequences to certain behaviors and earn the rewards or endure the punishments. Bandura recognized the potential for using modeling as a way of directing and changing behavior.

This theory can serve as a framework for a mental health awareness program for minority youth as it emphasizes “using the team or buddy approach, teaming individuals, small groups, families, and even communities, in which new health related behaviors can be modeled and reinforced, helping to set new norms” (Johnson, 2018, p. 579). In this way, peer mediation and group therapy principles can be utilized to help the adolescents learn and adapt new behaviors, thus helping reduce the chances of depression, drug-use, and/or expulsion from school.

In addition to school, the social learning theory can also be applied in the home-setting. Bandura believed that children learn vicariously by observing their surroundings, so if family violence is present in the home, then the children are at risk for imitating these behaviors. They are also at a higher risk for developing mental health disorders (Abbassi & Aslinia, 2010). According to the theory, once mental health professionals learn more about the home and school ennvironment, then they can put curricula in place that will prevent cycles of abuse, mental health disorders, suicidal ideation, and antisocial behaviors.

Conducting research with minors in a school setting for preventive purposes and investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. This is because prevention specialists may be tempted to impost their values on this marginalized group (Hage & Romano, 2013, p. 39), although they do not have any shared experiences. Another reason mental health professionals must exercise caution is because of the historial mistreatment of ethnic minorities in a medical research setting. Historical events may bring about skepticism about the real purpose of a prevention program. The well-known Tuskegee Experiment, where over 600 African American men were intentionally injected with syphilis and not given antibiotics, which would cure them. Instead, they were given placebos, aspirin, or herbal suppliments, so the medical community could observe the disease’s natural progression in the body. As a result, the men either died, went blind or insane or incurred severe health problems due to the untreated syphilis (Green, et.al., 2013). While the Tuskegee Experiment is not an isolated incident, it does serve as a symbol of how minorities can be taken advantage of under the guise of programs of help and prevention.

In addition to the exploitative research and prevention programs, there is also evidence of medical and mental health-related programs that are designed to support racist ideology. In other words, these programs are designed to show the “physical, intellectual, and emotional inferiority of minorities to justify slavery, discriminatory immigration policies, and educational segregation” (Alvidrez & Arean, 2002, p.104). Because of the aforementioned, mental health professionals must work hard to establish rapport, especially building trust, with the minority youth they are aiming to help. They must also work carefully to validate the experiences of people who may be culturally different from them.

Informed consent and confidentiality are especially important with this population of adolescents because they do not have the legal right to consent, nor do they have the emotional maturity to understand the benefits and the possible dangers of participating in mental health programs. They must also understand the confidentiality has its limitations and it must be broken in some cases. Mental health professionals must understand that many minority adolecents seek validation and acceptance. If they feel these needs are being met in a therapeutic setting, but they disclose information that must be shared, then the trust that has been established may be irretrievably broken.

In addition to informed consent and confidentiality, collaboration are some of the the core ethical considerations that should be taken into account when working with minority adolescents. The type of change defined in this proprosal will require systemic change; therefore, ethical considerations indicate that not only should the target population be involved in the prevention plan, but also their individual families, entire communities, and the entire school (Hage & Romano, 2013). This type of collaboration will promote trust and prevent opposing values being placed on the adolescents.

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References

Abbassi, A., & Aslinia, S. D. (2010). Family violence, trauma and social learning theory.

(Undetermined). Journal of Professional Counseling: Practice, Theory & Research, 38(1), 16–27.

Alegria, M., Vallas, M., & Pumariega, A. J. (2010). Racial and ethnic disparities in pediatric

mental health. Child and adolescent psychiatric clinics of North America, 19(4), 759–774. https://doi.org/10.1016/j.chc.2010.07.001

Alvidrez, J., & Areán, P. A. (2002). Psychosocial treatment research with ethnic minority

populations: Ethical considerations in conducting clinical trials. Ethics &

Behavior, 12(1), 103-116. https://doi.org/10.1207/s15327019eb1201_7

El Bouhaddani, S., van Domburgh, L., Schaefer, B., Doreleijers, T. A. H., & Veling, W. (2019).

Psychotic experiences among ethnic majority and minority adolescents and the role of discrimination and ethnic identity. Social Psychiatry and Psychiatric Epidemiology, 54(3), 343–353. https://doi-org.ezp.waldenulibrary.org/10.1007/s00127-019-01658-1

Gary, A. F. (2005) Stigma: barrier to mental health care among ethnic minorities, Issues in

Mental Health Nursing

Green, B. L., Maisiak, R., Wang, M. Q., Britt, M. F., & Ebeling, N. (2013). Participation in

health education, health promotion, and health research by African Americans: Effects of the Tuskegee syphilis experiment. Journal of Health Education, 28(4), 196-201. https://doi.org/10.1080/10556699.1997.10603270

Hage, S., & Romano, J. L. (2012). Ethical and professional issues in prevention. In Best

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O’Connell, M. E., Boat, T., & Warner, K. E.. (2009). Preventing mental, emotional, and

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The National Academies Press; and U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (2009).

Yasui, M. (2014). Minority youth: Needs for mental health services grow with population. The

University of Chicago School of Social Service Administration Magazine, 22(2).