Black youth in Canada face significant hurdles when trying to access mental healthcare services. There are several factors contributing to this issue, including racial bias within the healthcare system and long wait times for treatment.
Dr. Mojola Omole, president of the Black Physicians’ Association of Ontario and a general surgeon in Toronto, explains that Black youth have a distinct experience within the mental health system compared to other races.
“That is in part due to anti-Black racism and implicit biases,” Omole said in a Global News interview. Omole also works with the Canadian Medical Association Journal on addressing these issues.
These biases can lead to misunderstandings and misdiagnoses. Dr. Amy Gajaria, a child and adolescent psychiatrist at the Centre for Addiction and Mental Health (CAMH) in Toronto, acknowledges that Black youth are often misunderstood and also misdiagnosed. She attributes this partly to unconscious biases among healthcare providers.
“We might have internalized unconscious bias towards Black kids and families,” Gajaria said to Global News.
Gajaria provides an example of how these biases can manifest. She explains that teenagers experiencing depression or anxiety might exhibit irritability. However, with non-Black youth, healthcare providers are “more likely to dig more deeply into what’s behind the irritable behaviour and reach a diagnosis of anxiety, depression or trauma.”
For Black youth, Gajaria says clinicians often just stop with the behaviour and misdiagnose them with conditions like ADHD, overlooking the underlying mental health issues.
Long wait times and systemic issues
Beyond misdiagnosis, Black youth also face long wait times to access mental health care. Tiyondah Fante-Coleman, a researcher with the Pathways to Care project at the Black Health Alliance, points to a Canadian study showing Black-Caribbean youth waiting an average of 16 months compared to seven months for white patients. Several factors contribute to these long waits, including financial barriers and a lack of mental health providers in Black communities, according to Fante-Coleman.
Stigma surrounding mental health and overwhelmed healthcare services are additional barriers. Furthermore, Fante-Coleman emphasizes the critical need for more data on mental health issues within Black communities to improve care.
Fear and entering the system in crisis
The lack of trust in the healthcare system due to racism is another significant obstacle.
“For a lot of families, there is a fear of the medical system […] because of racism and discrimination,” says Fante-Coleman.
This fear can prevent Black youth from seeking help until a crisis arises. These crisis situations often involve police intervention, further complicating matters since Black youth are already “viewed often when we’re experiencing a mental health crisis as dangerous and seen as a threat,” according to Fante-Coleman. Research shows Black youth are much more likely to enter the system through police encounters compared to voluntary means.
While increased Black representation in healthcare could improve access, both Omole and Fante-Coleman believe all healthcare providers need to be part of the solution. This includes cultural competency training to address unconscious biases and creating a welcoming environment where Black youth feel comfortable sharing their experiences.
