I use my platform to promote mental health advocacy, awareness and education. I use my lived experiences as well as my training and education to make mental health information more real, human and accessible. As such, my platform centres my voice: that of a white woman who benefits from privilege on many levels.
It is time I centre different narratives and voices. It is time I educate on the unique variables that are involved in mental health and mental healthcare in different communities.
I have spent the last few days doing research, reading medical and academic journals and compiling information on the experiences of mental health and mental healthcare for Black Canadians. I hope you will read and learn alongside me.
Allow me to start with some numbers:
· Black Canadians represent 2.9% of the Canadian population, but represent 18% of Canadians living in poverty. Poverty can be an extremely powerful socioeconomic determinant of health.
· Ontarians of Caribbean, East and West African descent have a 60% increased risk of psychosis.
· Black immigrants to Canada are 76% more likely to assess themselves as “unhealthy” than any other racialized group.
· Access to a family physician is often a primary pathway to mental healthcare and 80% of Canadians rely on their family doctor for this. Only 35% of Black-Caribbean Canadians and 51% of Black-African Canadians have access to a family physician, compared to 62% of white Canadians.
There are many variables that contribute to these numbers; discrimination and stereotypes, socioeconomic factors, stigma from mental healthcare professionals, cultural stigma surrounding mental health, hate crimes and violence, for immigrants; adapting to a new culture. And this list is not exhaustive.
What I’d like to examine in this piece are the psychological impacts of microaggressions for Black Canadians.
Many people do not consider themselves racist – they do not participate in hate crimes or overtly racist activities – but they still hold racial biases and engage in subtle racially motivated behaviours. Because these patterns persist there has been an increase in research focusing specifically on racial microaggressions and their detrimental impact on the mental health of Black people.
Microaggressions are defined as “brief and commonplace, daily verbal, behavioural and environmental indignities, while intentional or unintentional that communicate hostile, derogatory, negative racial slights and insults to the target person or group.” (D.W. Sue, Copadilupo, et al., 2007, p.273.) Imagine being subjected to such interactions everyday. Your psychological safety and ability to cope would definitely be affected.
Despite the fact that these occurrences are common, Black people continue to be undermined and gas-lighted, being told microaggressions do not exist. One author in the research I looked at stated that the concept of microaggressions is “pure nonsense” (Thomas, 2008, p.274). He went on to explain that clinicians should not consider race an important variable. Another author presented alternative hypotheses focusing on white people’s intentions and the potential that Black people misinterpreted their actions. Gas-lighting at its finest. He concluded from this that microaggressions are not worth researching. (Harris, 2008.)
When Black people’s experiences are belittled, invalidated and denied, those negative and harmful experiences are perpetuated.
It is said that empirical evidence for the existence and damage of microaggressions is needed for mental health professionals to acknowledge them and consider them in their course of treatment. It should be sufficient to believe Black clients when they share their experiences.
Research is slowly being done on this topic, showing that racism is a strong determinant of mental health and is highly correlated with issues like stress and depression. Furthermore, evidence shows it to be related to unhealthy behaviours and lack of engagement in healthy behaviours. People experiencing microaggressions are likely to have symptoms like anxiety, negative affect and lack of behavioural control.
It is important for Black people to have access to Black counsellors; counsellors who can understand and validate their experiences and help them cope when microaggressions come up.
Part of the problem is gas-lighting. Black people often seek validation from those who have witnessed the microaggression; a sanity check of sorts to say “That really just happened, right?” (W.D. Sue, Capodilupo and Holder, 2008, p.332). Can you imagine getting kicked in the shin at work, turning to your coworker and saying “Did you see that?” just for them to reply “What are you talking about?” That would be maddening.
It is crucial to understand that microaggressions and their invalidation happen within the mental healthcare system as well. A counsellor might express that a Black client brings up issues of race too much or inversely, assume that all Black people’s experiences are the same and fall within a trope.
Racism is historically ingrained in the mental healthcare system and “overlaps with the stigma of mental illness to encourage further prejudiced treatment of Black [people] seeking care.” (Lovell and Shahsiah, 2006)
Black Canadians’ mental health is greatly impacted by racism, as is their experience of the mental healthcare system. The stigma and discrimination entrenched in the field of mental health must be dismantled for Black Canadians to be given effective, humane and compassionate care.
Next time I will look at barriers faced by Black people in Canada to accessing mental healthcare.
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