Exploring the connection between violence in inner-city neighborhoods and its impact on the mental health of children and adolescents.

Written by Sara Ibrahim and Victoria Van Drost 

Children and adolescents living in environments where they are exposed to toxic stress, community violence, and poverty are at much higher risk of developing health and behavioral problems across the lifespan. However, youth can prove to be remarkably resilient especially when provided with the right relationships and resources for success. 

When we think about post-traumatic stress disorder, also known as PTSD, our first thought is of soldiers returning home from war. But there exists a high rate of PTSD among inner-city neighborhood teenagers due to gang activity and violence. According to the International Journal of Forensic Mental Health, gang membership directly connects to PTSD, anxiety, and paranoia due to the violent environment that those individuals are exposed to first-hand. 

Within inner-city neighborhoods and overseas at various war sites, individuals are forced to witness first-hand gun violence. It is important to note that “forced” was used here because the cycle of poverty keeps inner-city teenagers within these neighborhoods. To be blunt: these teenagers cannot physically escape their battlegrounds. Mentally, teenagers and soldiers will never leave their battlegrounds because these lasting traumatic effects are carried with them throughout their lives.

So what exactly is “the cycle of poverty?” First, we must understand that poverty is not a choice, but rather a situation forced upon an individual. Sociologist Janet Mola Okoko defines the cycle of poverty as “a vicious spiral of poverty and deprivation passing from one generation to the next.” In the context of this article, we will evaluate the ways in which the cycle of poverty keeps inner-city neighborhood teens involved with gangs. Gang affiliation typically begins in adolescence and is carried through developmental stages of life into adulthood. The usual reasons for joining gangs within these neighborhoods are economic instability, security, family history, and lack of academic resources. 

For most, joining a gang is a means of making fast money to provide for their families or themselves. Fast money can be used to put food on the table, clothes on their back, shelter, and any of their additional wants and needs. Oftentimes, teenagers (especially males) assume a position of power in their households once they become of age and are expected to contribute to the household. This can be due to broken homes (the absence of a parent due to incarceration or death), but also can be an attempt to escape the cycle of poverty for the next generation. 

While on the subject of family dynamics, a family’s history of gang affiliation can influence a teenager’s decision to join a gang. It all has to do with loyalty, as a gang is built off that. Older family members expect loyalty from those who are old enough to join. Teens are left with few options given that within these inner-cities, education programs are severely underfunded and teenagers are quick to realize that school will not give them the assets to provide for themselves. Since they are not given the proper resources to excel in school, they look for other ways to earn fast money to fulfill their needs. Along with this, many teenagers struggle with learning disabilities and are not given the adequate attention they require. 

Lastly, security plays a large role in why teenagers join gangs. This can be separated into two main groups: familial security and physical security. The former can be explained by a large presence of broken homes within these neighborhoods, leading some teenagers to join gangs to fulfill a missing void. Gangs are viewed as a community of providing love, loyalty, and support to one another. In an interview with Sara Robinson, a licensed professional counselor and the director of Child and Family Outpatient and Crisis Services at Region Ten Community Service Board, shared that in order for a community to do gang prevention, it needs to provide the factors that are desired in a gang “family,” as she calls it. 

“Gangs provide many of the factors that kids want or need to do well––things like a sense of love and belonging, a sense of safety, a sense of power and control, fun and entertaining relationships,” said Robinson. ‘And so, if the community wants to do gang prevention, they should really be working to provide an environment and relationships kids need to thrive, that they would otherwise, if they lack…they would otherwise find in that gang family.’”

Physical security can be described as a need for protection. There is a sense of fear when living in these gang-heavy neighborhoods, coupled with the feeling that if you are not part of a gang, you may become the next target. This leads to the significant relationship between mental health and location. An article from the Community Mental Health Journal writes that “PTSD not only affects those who are actively participating in gang violence, but also those who live in communities where the activity is high.” Raman et al. describe these urban, minority-dense, and poverty-stricken neighborhoods as “hot spots”. One study proposed to observe how residents respond behaviorally and emotionally to living in a community with a high prevalence of interpersonal and homicidal violence, comparing the prevalence of PTSD within two geographic areas. It concluded that 14.8% of residents living in crime hotspots met the criteria for moderate depression or PTSD compared to only 6.5% of residents in coldspots. These statistics support the idea that there is a significant relationship between PTSD, geographic area, and violent crime. 

Robinson emphasized that children are remarkably resilient and do a great job at adapting to their environment even when that environment is unsafe or dangerous. And, given that children and adolescents are so good at adapting, she shares that the telltale signs of distress tend to manifest as behaviors.

“We tend to recognize distress in kids through their behaviors and there can be a full range of behaviors from being particularly withdrawn or isolating––all the way to really acting out behaviors that express distress. And so, I think we can see that behavior along the continuum really communicates to us like they’re not doing okay,” said Robinson. 

When asked if children mostly communicate distress through behavior rather than speech, she explained that it depends on the individual they are speaking to and the modeling behaviors they have been taught from adults in their lives. 

“Kids have to be taught how to communicate [their feelings] and have it modeled for them. And that’s not necessarily the case for all kids who are growing up in environments where there’s high stress,” Robinson said. 

When asked what kinds of mental health adversities children living in unsafe environments may face, Robinson shared that many of the symptoms of psychological distress can show up somatically. 

“We see kids present with anxiety or depression when they are living in a community where they’re exposed to community violence. I would also say that kids would present maybe with physical or somatic complaints––things like stomach aches, or headaches… because kids really hold their stress in their body,” Robinson said. “A kid who’s making lots of trips to the school nurse for belly aches, makes me wonder––what may they be experiencing that is actually psychological distress,” Robinson said. 

Robinson details other effects of exposure to toxic stress in areas of life such as social and academic. She explains that children and adolescents may become hypervigilant and hyperware of their environment in order to keep themselves safe even in environments that are supposed to be safe, such as a classroom. 

“And that makes it difficult to be in a classroom or to problem solve, or to learn new information, or to communicate how they’re feeling or have empathy for other people, ” Robinson said. “And ultimately, we see that the impact of exposure to toxic stress is an increase in health and behavioral problems throughout the lifespan, not just as a child, but for those children when they grow up to be adults.”

A study published in the Journal of Research and Practice observed the long-term consequences of adolescent gang membership for adult functioning. 

“Animals including humans are naturally, by default, afraid of the unknown. As we grow up we learn to recognize the signals of safety, but from the very beginning we fear without a sign of threat—also known as “intolerance for uncertainty”. Thus, the stress response is always “on”, and it stays on as long as there is no obvious safety. When safety is perceived, the stress response is inhibited. Importantly, to be “on” it does not need a stressor at all: it either remains activated as long as no safety is perceived or is disinhibited when safety disappears. It is a “default” response, meaning that it is a preselected condition to which the system (the organism) falls back when there is no other input i.e., no relevant information, which for the stress response is information regarding safety. The default here is a state of generalized unsafety in which the stress response stays on.”

Robinson emphasized that along with having access to resources needed for success– such as healthcare, education, and nutrition– youth also need supporting relationships with adults to buffer against toxic stress.

“I would say the number one protective factor that buffers against toxic stress is relationships [with] predictable, nurturing adult[s], makes a huge difference for children who’ve had exposures to community violence,” Robinson said. “ It is through safety and connection that youth can learn the skills they need to manage stress and adversity. But they need adults to teach and model those skills, and reward and recognize them when they are using those good skills!”

Edited by Anna Boyarinova