COVID-19 has taken a considerable toll on all of us – adults and youth alike. For children, there has been an especially weighty impact on mental health.

As we mark National Child’s Mental Health Awareness Day this May 7, parents, guardians, teachers, doctors, and other caregivers are raising alarms about the supports we need to be providing children who have experienced trauma related to the year-plus-long pandemic.

COVID-19 has upended families, who are struggling with illness, death, lost employment, and housing and food insecurity. It has upended everything that was regular and routine in a child’s life – school, play dates, activities, even leaving the house. And it has brought the near-constant fear of infection.

Although people 16 and older who are able to be vaccinated are starting to see the hope and possibility of a return to a more normal routine – and there is good news this week that a vaccine will soon be approved in the U.S. for those ages 12-15 – there is not quite light at the end of the tunnel yet for younger children.

Layered on top of the COVID-19 pandemic is the epidemic of racism and violence that daily threatens the lives and well-being of BIPOC children and their communities. Our thoughts go in particular this week to Mikayla Miller of Hopkinton, a vibrant and promising Black, LGBTQ young woman who tragically died in late April. We mourn Mikayla, and stand in support of her family as they seek a full, independent investigation into the circumstances of her death.

National Child’s Mental Health Awareness Day also coincides with the beginning of National Foster Care Month. COVID-19 has exacerbated problems within our already stressed and malfunctioning foster “care” (certainly a misnomer) system. Nowhere are these stresses more obvious than in Massachusetts where the tragic death of David Almond, a teenager who died in the care and custody of DCF in October 2020, has laid bare, yet again, the failure of DCF to serve the needs of individual children and the failure of the many interlocking systems touching youth.

The child welfare system fails LGBTQ youth in particular ways, and that was true before the pandemic. LGBTQ youth, particularly youth of color, are overrepresented nationally in our child welfare systems. We should know more details about their representation in every New England state, but we do not because the U.S. government does not require state child welfare systems to collect data on sexual orientation and gender identity. Trump eliminated this requirement in May 2020. LGBTQ youth are not seen and counted in all of their dimensions. They are, effectively, rendered invisible.

What do we know? We know, anecdotally and directly from LGBTQ youth in care that they are often placed in congregate care settings rather than in foster homes. We know that they face bullying, harassment, and bias in school because the child welfare system entrusted with their care does not support them and advocate for them in school. We know that transgender youth are wrongfully placed in congregate care settings according to their birth sex, not according to their gender identity. And we know that transgender youth wait for months, sometimes years, for best-practice, medically necessary gender-affirming care.

What else do we know? That workers’ refusal to affirm youth just as they are, failure to provide medical care, wrongful placements, and lack of educational advocacy causes harm, trauma and erodes the mental health of LGBTQ youth who are child welfare involved. The isolation and restriction of the pandemic only heightens these negative effects.

On this day, I urge us all to look at our state child welfare systems and wonder:

• Do LGBTQ youth have access to LGBTQ mentors, peer supports, and community resources?
• Are parents and guardians of LGBTQ youth getting services and resources addressing the importance of family acceptance to child well-being?
• Are transgender youth placed according to their gender identity, not their birth sex?
• Does the agency have a clear, comprehensive LGBTQ policy that affirms LGBTQ youth and clearly guides all agency employees, contractors, and volunteers on how to affirm and support LGBTQ youth in all contexts? And does the agency comprehensively train adults on this policy so that they operationalize support for LGBTQ youth?
• Does the agency have a clear policy for transgender youth to access best-practice, gender-affirming medical care without any unnecessary barriers?
• Does the state have a statutory Foster Child Bill of Rights that includes explicit protections for LGBTQ youth?

LGBTQ youth in care are precious. The youth I have had the pleasure to know in my work – particularly transgender youth of color – radiate strength and resilience. They are true to themselves – proud to be transgender and fierce self-advocates – in the face of a harsh and uncaring system. On this day, let’s all acknowledge their strength, center their voices and needs, and recommit to doing the work to support them to flourish and thrive.