Black youth in Canada face multiple barriers in getting access to mental health services B次元官网网址� and health-care providers can make the situation more difficult, experts say.
The Black PhysiciansB次元官网网址� Association of Ontario is holding a conference in Toronto on Saturday (May 4) for family doctors, nurse practitioners, psychiatrists, psychologists, social workers and other health-care providers to address those issues and help them provide more culturally safe care.
B次元官网网址淏lack youth experience the mental health system very differently than other races,B次元官网网址� said Dr. Mojola Omole, president of the association and a general surgeon in Toronto.
B次元官网网址淭hat is in part due to anti-Black racism and implicit biases,B次元官网网址� said Omole, who also works with the Canadian Medical Association Journal on addressing those issues in health care.
Many Black youth have experienced trauma, sometimes stemming from racism or discrimination, which can affect their mental health and the way they express themselves, she said.
B次元官网网址淲hat might seem like apathy is the sign of actually having problems,B次元官网网址� Omole said.
B次元官网网址淭hereB次元官网网址檚 been a lot of adjustment made from constant PTSD and just active trauma that they donB次元官网网址檛 necessarily have the same reaction that you would see in others.B次元官网网址�
If Black youth speak loudly, thatB次元官网网址檚 often falsely perceived as aggression, Omole said, noting thatB次元官网网址檚 something sheB次元官网网址檚 personally observed in the hospital where she works.
Dr. Amy Gajaria, a child and adolescent psychiatrist at the Centre for Addiction and Mental Health in Toronto, agreed that Black youth are often misunderstood B次元官网网址� and also misdiagnosed.
B次元官网网址�(Health-care) providers have a lot of stereotypes and, you know, we might have internalized unconscious bias towards Black kids and families,B次元官网网址� said Gajaria, who is not Black but said she learns from her Black colleagues, patients and their families.
B次元官网网址淭eenagers who are depressed and anxious can be very irritable. That is just like a fact about young people who are struggling with their mental health,B次元官网网址� Gajaria said.
With non-Black youth, mental health-care providers are more likely to dig more deeply into whatB次元官网网址檚 behind the irritable behaviour and reach a diagnosis of anxiety, depression or trauma, she said.
B次元官网网址淯nfortunately, we know for Black youth, a lot of clinicians just stop with the behaviour,B次元官网网址� Gajaria said.
B次元官网网址淭hey see the anger, they see the irritability, and they stop there. And so then their diagnosis goes to things like ADHD, oppositional defiant conduct disorder, which really does a disservice to kids and misses whatB次元官网网址檚 actually driving all those things.B次元官网网址�
Gajaria also worries about the Black youth who arenB次元官网网址檛 getting mental health treatment at all because there are B次元官网网址渁 million barriers to get through the door of a place like CAMH.B次元官网网址�
Black youth wait significantly longer than other patients to get access to mental health care, said Tiyondah Fante-Coleman, a researcher with the Pathways to Care project at the Black Health Alliance.
Fante-Coleman, who is speaking at the Saturday conference, said a Canadian study from 2015 showed Black-Caribbean children and youth waited an average of 16 months for mental health care, compared to seven months for white patients.
There are a variety of reasons for the long waits, Fante-Coleman said, including the fact that Black youth may face more financial barriers or there may be a lack of mental health care providers in their area.
Other barriers include stigma and the fact that mental health services are overwhelmed by the current demand.
ThereB次元官网网址檚 a big need for more Canadian race-based data to improve care for Black youth, Fante-Coleman said.
B次元官网网址淲e have very little data on the incidence and prevalence of mental illnesses (e.g., depression, anxiety and schizophrenia) throughout the national population.B次元官网网址�
The mental health system is B次元官网网址渜uite chaotic for all accessing care,B次元官网网址� Fante-Coleman added.
B次元官网网址淲hatB次元官网网址檚 different for Black youth is that not only is the system difficult to access, theyB次元官网网址檙e also having to deal with the consequences of anti-Black racism (including) systemic and institutional and interpersonal,B次元官网网址� she said.
B次元官网网址淔or a lot of families, there is a fear of the medical system B次元官网网址� because of racism and discrimination. That means that sometimes mental health challenges arenB次元官网网址檛 necessarily addressed as quickly as they could be. And so often what happens is that sometimes people end up in crisis.B次元官网网址�
Those crisis situations can lead to police involvement in communities that are already overcriminalized, she said.
B次元官网网址淲e know that we are viewed often when weB次元官网网址檙e experiencing a mental health crisis as dangerous and seen as a threat.B次元官网网址�
Research shows that Black youth are much more likely than non-Black youth to enter the mental health system through encounters with the police or justice system instead of voluntarily, Fante-Coleman said.
Black youth in Canada are also B次元官网网址渇our times more likely to first enter the mental health care system through the emergency department, which suggests worse symptoms than white youth,B次元官网网址� the Pathways to Care project website says.
Although more Black representation in the health-care system could help some youth feel more comfortable receiving care, all health-care providers need to be part of the solution, said both Fante-Coleman and Omole, the Black physiciansB次元官网网址� association president.
That includes becoming aware of their own biases and assumptions, learning about the young patientsB次元官网网址� communities and making them feel as comfortable as possible in sharing their experiences.
B次元官网网址滻f we all have the same (cultural) competencies, then it wouldnB次元官网网址檛 matter,B次元官网网址� Omole said.
This report by The Canadian Press was first published May 4, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Nicole Ireland, The Canadian Press
