What you need to know
- Black children and youth’s barriers and facilitators to accessing mental healthcare in Canada must be identified to understand their needs and to reduce disparities.
- Systemic barriers for Black youth to accessing mental healthcare include longer wait times, poor access to practitioners, geographical challenges and financial barriers to care.
- Practitioner-related barriers include racism and discrimination from providers, a lack of available Black professionals in the mental healthcare sector, and a lack of support to provide culturally competent care.
- Personal and community-related barriers include different forms stigma, and a lack of knowledge of services.
- Facilitators to accessing mental healthcare include support from family and friends, teachers, faith-based leaders, and a good relationship with providers.
This Research Snapshot was based on the article, “Barriers and Facilitators to Accessing Mental Healthcare in Canada for Black Youth: A Scoping Review” published in Adolescent Research Review in 2020.
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What is this research about?
Canada is one of the most ethnically diverse countries with Black people representing the third-largest population of racialized people in Canada. Research shows that Black children and youth in Canada experience more challenges to accessing mental healthcare. Evidence also shows that Black youth who do not access treatment are likely to face difficulty in school, family conflict and increased contact with the justice system. This review looks at literature on the barriers and facilitators to mental healthcare for Black youth in Canada.
What did the researchers do?
This scoping review focused on barriers and facilitators to accessing mental healthcare for Black children and youth (to 30 years old) living in Canada. Thirty-three peer-reviewed articles and gray literature documents were included in the review. The literature was mainly from Ontario and Quebec and between 2005 and 2019.
What did the researchers find?
Black youth experienced barriers at multiple levels of care, including the following:
- Systemic – longer wait times (more than twice the wait experienced by white patients) and referral delays, geographical challenges, financial barriers to care, poor access to practitioners, and underfunding of services that are culturally responsive. Services through the criminal justice system and involuntarily hospitalization were also noted as pathways to care that were more difficult or harmful for clients.
- Practitioner-related – racism, discrimination, a lack of cultural understanding from providers and organizational support to provide culturally competent care and a pronounced lack of available Black professionals in the mental healthcare sector.
- Personal and community-related barriers – internalized, anticipated, and cultural stigma from community and a lack of knowledge about services.
Facilitators to care include:
- support from family and friends
- a connection or good relationship with physicians, mental health providers and teachers providing a “social support”
- faith-based spaces and religious institutions to seek support from.
These findings show that despite a universal healthcare system in Canada, there are many challenges for Black children and youth to accessing mental healthcare.
How can you use this research
Practitioners and organizations need to understand and adapt to the needs of Black children and youth, and deliver culturally competent care. More diversity in senior leadership roles in mental health organizations is also required for culturally appropriate mental healthcare. Afrocentric standards of care must be implemented, moving away from historical Eurocentric interventions.
Funders should provide funding to expand our universal healthcare system to include mental health, which would address many of the financial barriers to accessing mental healthcare. Funding also needs to be targeted to mental health organizations, researchers and community stakeholders to create new mental health treatments, and adapt existing evidence-based practices to be culturally competent.
Changes and coordination within both the mental healthcare and justice systems is also important to prevent Black youth with mental illness from being forced to use the justice system as a pathway to accessing care.
Acknowledgements
This knowledge exchange activity is supported by Evidence Exchange Network (EENet), which is part of the Provincial System Support Program at the Centre for Addiction and Mental Health - “CAMH”). EENet has been made possible through a financial contribution from the Ministry of Health (“MOH”). The views expressed herein do not necessarily represent the views of either MOH or of CAMH.
While care has been taken in selecting and preparing the information included in this Research Snapshot, it is based on one research article. A comprehensive search was not completed to see if new evidence exists. As a result, the context behind the research, the terminology used, the research methods and the findings may not provide the full picture for this particular topic. Also, there might be a lag between when the study was conducted and when it was published, so it might not reflect the current evidence.
This Research Snapshot was based on the article, “Barriers and Facilitators to Accessing Mental Healthcare in Canada for Black Youth: A Scoping Review” published in Adolescent Research Review in 2020. https://doi.org/10.1007/s40894-020-00133-2