Entryways into the Mental Healthcare System for Black Canadians
The Black Canadian community faces unique mental health challenges as well as unique experiences of the mental healthcare system. it is worth nothing that these issues, though related and part of the same oppressive structure, are unique and complex and warrant addressing separately before looking at the system as a whole.
I have written about microaggressions as well as barriers to accessing mental healthcare for Black people in Canada but another hugely important topic to discuss is the way Black Canadians are entering the mental healthcare system. Since fewer Black Canadians enter the system through a family physician than white Canadians it is crucial to study these differences. The lack of access to a family physician was brought up in the piece on barriers to accessing care but I will now look at the impacts of this disparity.
“Black youth disproportionately access mental healthcare through both forensic and emergency pathways, which suggests that Black youth are not receiving care unless they are 1) interacting with the justice system or 2) are symptomatic enough to need intensive intervention” (Alderson 2015, Alderson et al. 2015)
Black people in Canada are accessing mental healthcare through the criminal justice system in large numbers. A study shows that 23% of Black youth were introduced into the mental healthcare system by police. Because it is so difficult to access care through voluntary channels, there are disproportionate rates of involuntary entryways as well as reliance no the judicial system. This is due in part to the systemic over-policing of Black Canadians.
Being exposed to police officers are first responders to a mental health crisis or situation puts Black people at risk. Police are not social workers, they are not mental health professionals and they are not trained as such. Combine this with the discriminatory behaviours and thought patterns that inform many white people’s view on Black people, especially men and the results can be deadly.
Furthermore, fewer Black youth than white youth access care voluntarily due in part to underfunding of culturally responsive services and stigma within their community. This means many access care involuntarily because their symptoms become severe enough to warrant intervention. Culturally responsive care is crucial to breaking the cycle of racism and trauma and a lack of this encourages Black people to avoid care altogether. They will not receive care until it is an emergency. Once they do access care, the barriers do not disappear. Racism and discrimination from clinicians greatly affects their care and most services fail to meet their cultural needs.
Essentially Black youth face far more significant barriers to accessing mental healthcare than their white counterparts, such that often their symptoms worsen until police or emergency intervention occurs and this is their entryway to treatment. This means adequate support is not available when care could be preventative.
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