Dr. Amy Gajaria, Clinician Scientist and Psychiatrist at the Centre for Addiction and Mental Health and member of the Edwin S.H. Leong Centre for Healthy Children, provides an update on the results of a study looking at how Black youth access mental health services in the Greater Toronto Area (GTA).
Our study is informed by Critical Race Theory, which means that we specifically look at how structural racism might impact mental health care and care access for Black youth in the GTA. We were interested in how hospitals and other tertiary care settings can better support Black youth and liaise more effectively with community providers.
The study involved interviews of community stakeholders across a variety of sectors from youth justice to public health to community organizations. We interviewed stakeholders who support youth in both English and French. In addition, we completed focus groups with youth and caregivers of Black youth with mental health difficulties to get a more fulsome understanding of the problem. Our research team included clinicians working with Black youth, Black youth engagement specialists, a community partner (CAFCAN), knowledge translation experts, and a research staff who identified as Black and Francophone. It was important that most of the research team identified as Black and that all those doing interviews with participants were Black due to mistrust of research and institutions within the diverse Black community.
Our study is in the final stages of data collection, and we have started data analysis of stakeholder interviews. Thus far, stakeholders have highlighted to us that youth are reluctant to seek mental health supports from hospitals due to a lack of trust and word of mouth within the community sharing negative experiences. Youth may also be reluctant to even call an ambulance during acute medical emergencies due to fear that police will be involved, and they will be targeted by police. Stakeholders universally noted that they do not feel Black youth receive appropriate or culturally sensitive mental health care in the GTA and that adaptations to the mental health system are needed to better serve youth. Stakeholders also noted that accessing care often requires youth, families, and communities to engage with an informal network and access services through this network rather than the formal care pathways such as primary care referral that other youth might use. The contribution of stigma about mental health conditions within diverse Black communities and the need for accessible and culturally safe mental health literacy made for and by diverse Black communities was also highlighted.
The next steps are to develop and run community outreach events within community settings tailored to members of diverse Black communities. In these events, we will share information to increase knowledge of how to access services and to reduce stigma around healthcare access. Following our analysis of youth and family caregivers, we will then design a curriculum for mental healthcare providers using lessons learned from this research to improve the capacity of providers to provide culturally safe care to youth.
