Mental Health Trust: An Analysis of African-American Apprehension Following the Overreach of Executive Power

African American adolescents represent one of the largest groups of underrepresented populations in the United States mental health care system. Despite this, they remain among the least studied populations across the literature. This study examined the extent to which the expansion of executive power during the early phases of the COVID-19 pandemic eroded trust in mental health support services among African-American teenagers. Drawing from patterns of historical discrimination alongside patterns of modern policy failure, the purpose of this research was to situate adolescent mistrust within a broader framework of systemic inequity. Using a mixed-methods approach, this study combines a retrospective survey administered to African American teenagers in rural Georgia who engaged in pediatric mental health care during the years 2019-2022, combined with over twenty peer-reviewed studies on healthcare access, democratic backsliding, and institutional discrimination.
The findings suggest that federal policy during COVID-19 disproportionately impacted Black communities and increased perceived mistrust, drawing parallels to historical apprehension. This limited patient-provider relationships, and a lack of local inclusion was a key driving factor, along with apprehension of the political status quo. This study addresses a critical gap by centering the first-hand experiences of African-American adolescents. Ultimately, this study addresses a critical scholarly gap by centering the lived, firsthand experiences of African American adolescents. Moving forward, policymakers must prioritize equitable healthcare reforms grounded in rebuilding institutional trust, a foundational yet frequently overlooked element in pediatric mental health outcomes.

mental health, adolescents, COVID-19, democratic backsliding, discrimination

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