The doctors are not okay, and the medical profession is not well. But what does that mean for you and your child’s healthcare? It means that the care is often uncaring. However, don’t expect to find any informed consent paperwork explaning to you the risks of receiving care from people who are depressed, suicidal, or enduring mistreatment and abuse as part of their training. That informed consent process is one you’ll have to do on your own.

Providers and health organizations alike encourage children and families to pursue mental healthcare as if it were universally healing. Amidst the pediatric mental health crisis–characterized by increased rates of anxiety, depression, and suicide attempts–”access to quality mental healthcare” remains the prevailing discourse. But what if child psychiatry was not originated or designed to protect and serve your children’s best interests. What if it refused to acknowledge the unique harms facing your child? What if it carried unstated risks of harm that are not accounted for in these general recommendations to pursue it?

“Oppositional defiant disorder is the 21st century version of drapetomania because it overpathologizes children of color surviving White supremacist violence in public education, healthcare, and other community settings. It poisons clinical decision-making, dictating which children get restrained and secluded and which children are showered with compassion and empathy. It exonerates the teachers, police officers, and doctors and nurses who adultify them and resort to punition as an option of convenience, rather than last resort. Finally, it removes any accountability for child mental health providers, allowing them to prescribe meds and behavioral interventions while turning their backs against the root structural causes of harm.

It amounts to accusing children of color of rascality. “

“If you or your child are having a psychiatric emergency, please hang up and call 911 or go to your closest emergency room” should–at the very least–be replaced by “If you or your child are having a psychiatric emergency, the standard of care is to recommend that you hang up and call 911 or go to your closest emergency room.” And this standard of care is problematic. Though the Joint Commission regulates the use of seclusion and restraint, it does not require policies and practice to prevent racism and abuse. Mental health providers are not mandated to explain these risks as part of their professional code of ethics. Nor are they required to forewarn of their “right” to make decisions infringing upon civil liberties and parental rights during psychiatric emergencies, allowing them to be agents of state violence (by calling police or reporting to child welfare). These oversights raise serious concerns about whose “safety” is being preserved when mental health providers blindly tell chidlren and families to call 911 or go to the emergency room during crises.

Working with schools is a hallmark of child mental health. Schools are important sources of collateral information that supplement parents’ reports about how their children are doing at home. Unfortunately, these sources of collateral are frequently taken at face value by child mental health providers. Interrogating this information with the critical lens necessary for contextualizing, understanding, and protecting children against the oppression embedded within school settings is not a child mental health standard of care. Child mental health providers gathering school-based collateral for mental health evaluations must recognize how entrenched the American educational system is in white supremacy.

Child mental health providers typically require parents initiating care to sign a “Notice of Privacy Practices” indicating that providers are mandated reporters legally required to report actual or suspected instances of abuse and neglect of a minor. Some providers might also explain the reporting mandate during an opening session. What is not often discussed, however, is what the reporting process looks like, how families and children are notified, and what if any responsibility providers take to protect families of color from reporting’s endemic racism.

Mental health assessments masquerade as objective markers of truth and clarity, when in fact they are flawed and limited tools that too often decontextualize symptoms from the environments giving rise to them. Child mental health providers falsely advertise them as neutral instruments paving the one-way road to diagnosis and treatment, when they can be surgically invasive, cause unnamed harmful side effects, and do little to promote widespread healing.

Pediatric healthcare providers and organizations’ response to the Capitol riots focused on mitigating children’s anxiety and distress in the here and now. But they did little to promote examining the past, grappling with the present, or developing the skills to construct a more just future. While antiracist parenting is a lifelong endeavor, the Capitol riots have the potential to open the door for parents willing to walk through it for the sake of their own children and for the sake of generations to come.