What if mental healthcare could move beyond managing symptoms and diagnosing conditions to address the root causes of suffering? Clinical activism does just that—it’s the intentional integration of advocacy, social justice, and transformative action into clinical practice.

Drawing on my experiences with patients and my work in grassroots advocacy, I’ve come to understand that true healing requires challenging systemic inequities, defending dignity, and empowering communities. From helping a survivor reconnect with her children to fighting punitive charges against a traumatized teen, clinical activism is about co-creating pathways to justice, safety, and liberation.

Mental healthcare is often presented as a refuge of safety and support, with providers emphasizing adherence to the “standard of care” as a guarantee of quality. However, for racially marginalized communities, this standard frequently conceals significant harms. Families can find themselves blindsided and betrayed by a system they trusted to provide help, only to face inequities and systemic failures instead.

This is where full informed consent becomes vital—not just as a legal requirement, but as a transformative practice. By exposing hidden risks, acknowledging systemic inequities, and fostering collaboration, full informed consent restores trust and empowers families to navigate mental healthcare with clarity and confidence.

Racism is a pivotal determinant of mental health, yet mental health providers are not legally required to address it in clinical care. Standard practice guidelines remain glaringly silent on racism, perpetuating harm to marginalized communities, especially Black individuals. This failure to confront systemic inequities is not just oversight—it’s deadly. The time for half-measures and empty apologies is over; mental health care must be trauma-informed and fundamentally antiracist.

We all know that mental health care is just as crucial as physical health care. In fact, the division between the two is artificial and counterproductive. Yet insurance companies continue to treat mental health care as an afterthought. Though federal law mandates equal access to mental and physical health services, my experience shows that insurance companies regularly deny or delay coverage for the person-centered psychiatric care I provide.

This shady behavior has devastating effects on patients, families, and mental health providers alike.

The doctors are not okay, and the medical profession is not well.

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?

ODD is a disruptive, impulse-control and conduct disorder characterized by at least four symptoms occurring in three categories of behavior: anger or irritability, being argumentative or defiant, and vindictiveness. Difficulty with rules and authority figures or adults is also a key feature. Black children are far more likely to be diagnosed with a disruptive behavior disorder like ODD than White children, even when these groups demonstrate similar externalizing behaviors. Children entangled in carceral settings, like juvenile detention or child welfare—most of whom are of color—are also more likely to carry an ODD diagnosis. However, treatment guidelines from the American Academy of Child and Adolescent Psychiatry, do not account for these inequities at all. They recommend adult supervision, proper discipline, and parent training as primary interventions.

“If you or your child is having a psychiatric emergency, please hang up and call 911 or go to your closest emergency room.” Virtually all mental health providers feature this statement in their voicemail recordings. They also recite it when “safety” planning for acute psychiatric emergencies related to suicide, aggression, and other out of control behaviors. Prominent organizations like the National Alliance for Mental Illness and the American Academy of Child and Adolescent Psychiatrists recommend these options as the surest way to promote safety and prevent further harm. But this unanimous messaging betrays the inequitably distributed dangers and harms embedded within the mental health crisis continuum of care.

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.

Many parents enter child mental health care assuming that assessment, testing, and evaluation will lead to greater clarity regarding their child’s diagnosis, core problem, and optimal treatment. After all, blood draws, cultures, biopsies, and advanced imaging modalities, like CT-scans and X-rays, are hallmarks of American (bio)medicine. However, child mental health care is not like other medical specialties, for which tests and assessments might definitively point to a root cause of pathology with few if any risky “side effects.”

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. If children are doing well in one space and poorly in another, that finding can help providers pinpoint root causes of distress and determine appropriate interventions. Child mental health providers routinely gather collateral from schools through phone calls to counselors, teachers, and school psychologists. Other sources of collateral information include individualized educational plan (IEP) and 504 plan meetings and reports, as well as assessments completed by teachers. Examples include the Strengths and Difficulties Questionnaire used to evaluate children’s mental health overall and the Swanson, Nolan, and Pelham (SNAP) Questionnaire used to diagnose attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).