Black youth face multiple barriers to accessing mental health care, experts say

Black youth in Canada face multiple barriers to accessing mental health services, and health care providers can complicate the situation, experts say.

The Ontario Black Doctors Association will hold a conference in Toronto on Saturday for family physicians, nurse practitioners, psychiatrists, psychologists, social workers and other health care providers to address those issues and help them provide safer care from the point of view. cultural view.

“Young black people experience the mental health system very differently than other races,” said Dr. Mojola Omole, president of the association and a general surgeon in Toronto.

“That’s partly due to anti-Black racism and implicit bias,” said Omole, who also works with the Canadian Medical Association Journal to address such issues in health care.

Many young Black people have experienced trauma, sometimes stemming from racism or discrimination, which can affect their mental health and the way they express themselves, he said.

“What might seem like apathy is a sign that there are actually problems,” Omole said.

“There have been a lot of adjustments made due to ongoing PTSD and active trauma that don’t necessarily have the same reaction that you would see in others.”

If young black men speak loudly, it is often falsely perceived as aggression, Omole said, noting that it is something he has personally observed at the hospital where he works.

Dr. Amy Gajaria, a child and adolescent psychiatrist at the Center for Addiction and Mental Health in Toronto, agreed that black youth are often misunderstood and also misdiagnosed.

“(Healthcare) providers have a lot of stereotypes and, you know, we may have internalized unconscious biases toward Black children and families,” said Gajaria, who is not Black but said she learns from her colleagues, patients and families. blacks. .

“Teenagers who are depressed and anxious can be very irritable. That’s kind of a given among young people who struggle with their mental health,” Gajaria said.

For non-Black youth, mental health care providers are more likely to dig deeper into what’s behind irritable behavior and reach a diagnosis of anxiety, depression or trauma, he said.

“Unfortunately, we know that for young black men, many doctors just stop at the behavior,” Gajaria said.

“They see the anger, they see the irritability and they stop there. And then their diagnosis goes to things like ADHD, oppositional defiant behavior disorder, which really does a disservice to kids and misses what’s really driving all of those things.” things”.

Gajaria also worries about young black men who don’t receive any mental health treatment because there are “a million barriers to getting through the door of a place like CAMH.”

Black youth wait much longer than other patients to access mental health care, said Tiyondah Fante-Coleman, a researcher with the Black Health Alliance’s Pathways to Care project.

Fante-Coleman, who spoke at Saturday’s conference, said a 2015 Canadian study showed that black children and youth in the Caribbean 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 current demand.

There is a great need for more Canadian race-based data to improve care for Black youth, Fante-Coleman said.

“We have very little data on the incidence and prevalence of mental illnesses (e.g., depression, anxiety, and schizophrenia) in the entire national population.”

The mental health system is “pretty chaotic for everyone accessing care,” Fante-Coleman added.

“What’s different for young Black people is that not only is it difficult to access the system, but they also have to deal with the consequences of (including) systemic, institutional and interpersonal anti-Black racism,” he said.

“Many families fear the medical system… because of racism and discrimination. That means that sometimes mental health problems are not necessarily addressed as quickly as they could. And very often what happens is that sometimes people end up In crisis.”

Those crisis situations can lead to police involvement in communities that are already overly criminalized, he said.

“We know that when we experience a mental health crisis, we are often seen as dangerous and a threat.”

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 the court system rather than voluntarily, Fante-Coleman said.

Black youth in Canada are also “four times more likely to first enter the mental health care system through the emergency department, suggesting worse symptoms than white youth,” the Pathways to project website says. Care.

Although greater Black representation in the health care system could help some young people feel more comfortable receiving care, all health care providers must be part of the solution, said both Fante-Coleman and Omole, president of the doctors’ association. blacks.

That includes becoming aware of your own biases and assumptions, learning about young patients’ communities, and making them feel as comfortable as possible sharing their experiences.

“If we all had the same (cultural) competencies, then it wouldn’t matter,” Omole said.

This report by The Canadian Press was first published May 4, 2024.

The Canadian Press health coverage is supported through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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