I’ve been wrestling with this post for over a week, trying to come up with an eloquent reflection. I do not have one. My words are not the words you need to read. Instead, please read the two articles listed below. These articles are aimed at pediatric health care providers, but they are relevant for anyone and everyone who works with kids or young adults - teachers, day care providers, youth group leaders, tutors, parents of kids who have friends. Below the article summaries, I have included my script for asking questions about social topics with my patients (called a ‘social history’ by physicians).
Them and Me — The Care and Treatment of Black Boys in America by Kevin M. Simon, M.D., NEJM; Nov 2020.
This piece was published Nov 12, 2020 and it has been shared with my on 6 separate physician listservs. So yes, it is touching a nerve and is making subtext text. It is beautifully written. The author is a psychiatrist in Boston, and he takes us quickly through 3 cases of Black boys brought to his office. My heart squeezed in recognition, because I have seen each of these kids on my office.
“The Talk,” Physician Version: Special Considerations for African American, Male Adolescents by Terry Maroney and Barry Zuckerman, Pediatrics; February 2018.
Summary:
Young, minority patients are more likely to experience police interactions, perceive them as negative, and have them escalate
Physicians can play an important role in helping their patients stay safe in police encounters by
Asking about police interactions
Communicate three fundamental points:
First, Know Your Legal Rights With the Police
Second, Remember That Your Main Goal Is to Get Home Safely
Third, It Is Not Fair That You Have to Worry About Negative Police Interactions
Youth cannot unilaterally eliminate these risks; police also have a role. Youth have a better chance of reducing their risks by taking control over their reactions, understanding their rights, and knowing they have your support.
For my fellow physicians, here is a script of my social history that I do with each new patient. The questions I’ve added in the last month are in bold. I have a template of this in every note so it’s easy to document.
Who does <Patient> live with at home? If siblings, ask for # and ages.
Mom/Dad, how old are you? How far did you go in school? Are you currently working? What do you do?
And your partner, how old are they? How far did they go in school? Are they currently working? What is their work?
If partner not in home - How involved is the child’s other parent/your partner with your family?
If child foster or adopted - ask same set of questions of bio parents, as best parent knows.
Are there any smokers in the home?
What weapons do you have in the home - this could be a gun, a hunting knife, or bow? What type? Where is it stored? Where is ammo stored?
Do you have any pets? Type/#?
In the last six months,
have you experienced any major changes? (i.e. moving, loss, new job, new people in home?)
has anyone in the home been unable to pay the bills?
has anyone in the home experienced discrimination?
has anyone in the home had an encounter with police?
What languages do you speak in the home, in addition to English (Spanish/language of visit)?
Does anyone in the home: receivecash assistance, housing assistance or food assistance? Get or give child support? Receive SSI or disability?
Has anyone in the home ever experienced violence - this could have been in a home situation, the community, or through the military, any experience of violence?
Has CPS been involved with the home?
Please let me know if these are helpful and share what social history questions you use!
