Canadians’ experience of the mental healthcare system varies by community and involves many complex variables. So many factors contribute to guiding one person’s mental health journey but most often the factors discussed are those regarding what is considered to be the default: white Canadians. Much research into the mental healthcare system fails to acknowledge the unique experiences of Canadians who are not white. Because Canada has such a significant multicultural and immigrant population as well as a rich First Nations, Metis and Inuit population, it is crucial to look at how the mental healthcare system can better serve these Canadians.
One way Canadians are greatly underserved by the mental healthcare system is due to the barriers they face to accessing care. In this piece I would like to look at these barriers specifically with regard to Black Canadians.
“Unfortunately, very little is known about the existence of disparities in access to healthcare, including mental health for Black populations in Canada, mainly because race-based data related to mental health outcomes are not collected.” (Rodney and Copeland 2009; Nestel 2012).
The fact that data is sorely lacking with regard to Black Canadians’ access to mental healthcare goes to show how improving the system’s support of BIPOC is not a priority.
Among Canadians as a whole, wait times to access mental healthcare are a significant barrier. This is logical since money is another huge barrier and lack of financial support forces Canadians to access provincially funded care, and this invariably comes with lengthy wait times.
When it comes to this group, studies done among Black youth in Canada have shows that Black youth wait on average 16 months for care while their white counterparts wait an average of 7 months. That’s more than double. For those with more severe symptoms, this can be a death sentence. Had I had to wait for care when I was in my worst crisis, I’d surely be dead.
In terms of accessing mental healthcare, for many Canadians the initial point of contact with someone who can help is through their family doctor. This in and of itself is a major barrier.
62 % of white Canadians have access to a primary care physician as their point of entry into the mental healthcare system
Only 35% of Black Caribbean Canadians do
Only 51% of Black African Canadians do
This data was hard to come by, however. There is a lack of research into barriers faced by Black people in Canada. Very few articles I read studied Black people as a population on their own. They were too often lumped in with other marginalized groups. This gap in research expresses the importance of Black Canadians’ mental health in the eyes of the system.
The lack of accessible culturally responsive mental healthcare is also a barrier for Black Canadians. It goes without saying that having access to a therapist or counsellor of your cultural background and who understands the hurdles and challenges you face is something everyon should have access to. The dearth of Black Canadian psychologists and therapists is in part a testament to the systemic racism that exists in academia. “Stigma and stereotypes follow people who pursue psychotherapy in the first place, and the added weight of being a POC contributes to the difficulty.” (https://www.google.ca/amp/s/globalnews.ca/news/4712491/finding-a-therapist-of-colour/amp/)
BIPOC in therapist roles is crucial. Canadians often search for years to find a therapist of colour who understands their cultural and social experience. There is also a larger problem of racism not being understood as a traumatic experience by white therapists. Psychology and therapy training glosses over multiculturalism and racism making many white therapists ill-equipped to serve BIPOC.
These issues are far more complex than what I could cover in one blog post but this information is a start. More research needs to be done on mental healthcare access for Black Canadians so we can start rectifying the problems and inequalities that exist.
Barriers or Black Canadians occur at the systemic, organizational and interpersonal levels of our society and addressing these barriers will require both personal anti-racism work as well as dismantling the system that upholds racist beliefs and structures.
SOURCES:
Abramovich, A., & Shelton, J. (Eds.). (2017). Where Am I Going to Go? Intersectional Approaches to Ending LGBTQ2S Youth Homelessness in Canada & the U.S. Toronto: Canadian Observatory on Homelessness Press.
Nadal, Kevin L., et al. “The Impact of Racial Microaggressions on Mental Health: Counseling Implications for Clients of Color.” Journal of Counseling & Development, vol. 92, no. 1, 2014, pp. 57–66., doi:10.1002/j.1556-6676.2014.00130.x.
Fante-Coleman, T., Jackson-Best, F. Barriers and Facilitators to Accessing Mental Healthcare in Canada for Black Youth: A Scoping Review. Adolescent Res Rev 5, 115–136 (2020). https://doi.org/10.1007/s40894-020-00133-2
Rodney, P., & Copeland, E. (2009). The health status of Black Canadians: Do aggregated racial and ethnic variables hide health disparities? Journal of Health Care for the Poor and Underserved,20(3), 817–823. https://doi.org/10.1353/hpu.0.0179.
Nestel, S. (2012). Colour Coded Health Care. Wellesley Institute. Toronto, ON. Retrieved June 25, 2017, from https://www.wellesleyinstitute.com/wp-content/uploads/2012/02/Colour-Coded-Health-Care-Sheryl-Nestel.pdf