COVID 19 is impacting the mental health of the world’s populations and Canadians are no different in this regard. Mental Health as defined by the World Health Organization is “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” One would certainly expect coping challenges given that this is well beyond normal stresses of life. Covid-19 has indeed exacerbated vulnerabilities and has thrust many racialized Canadians into a state of distress and deteriorating mental health. Fueling such Canadians’ unease is the intensification of stigma and discrimination deeply embedded within health systems across Canada. Deep seated stigma has demonstratable effects on mental health across the board and it is only through proactive public health and the magnification of solutions to these underlying societal problems, that these issues will be addressed; both at the individual level and collectively at the societal helm.
Discriminatory experiences related to socially perceived race, sexual orientation, gender, religion and/or age have burgeoned and put undue pressures on socio-economically marginalized communities; especially persons belonging to racialized groups who live in vulnerable neighborhoods. Implicit and explicit bias is amplifying a great deal of negative public opinion towards persons and communities deemed to be undeserving; sustaining the perception that some members of society are more deserving of better healthcare than others. As a result, multiple intersecting drivers of stigma and discrimination have surfaced during this catastrophic time. Associated fears of infection and racialized communities may be compounding risks of discrimination for Canadians of East Asian descent as a prime example. Not surprisingly, Chinese, Korean and Japanese groups within Canada have reported greater levels of discrimination during the pandemic.
The dissemination of misinformation (or deliberate disinformation) is also playing a significant role in fueling stigma and discrimination; for instance, with inaccurate information about the origins of diseases. Racial and/or ethnic blaming and shaming has been surging because of social medial influences. The impact of stigma toward certain groups and the discrimination that follows, also leads to poorer mental health, amplifies fear and mistrust, and can then increase individuals’ vulnerability to mental health problems. It may even engender poor coping mechanisms such as alcohol and drug use.
Taking a ‘belonging approach’ to mitigating the effects of stigma and discrimination on the mental health of racialized Canadians, we can identify a few ways of moving toward structural and cultural change. Firstly, we need to prioritize policies, training and public education that reduce all forms of othering in our public and health spaces. A slew of evidence based stigma reducing practices can now be used to reduce negative experiences and provide a stimulus for racialized persons to speak up and voice concerns about any unfair treatment. Secondly, culturally safe service delivery, which include trauma and violence informed approaches to health care and social services can be scaled up to meet the growing needs. To break the cycle of intersecting race and health inequities, governments should mandate anti-racism and stigma reduction competencies for health professionals. Governments should also acquire and utilize race-based data for health equity purposes and to benchmark service quality goals and related equity objectives. These problems can be solved but only if we can effectively draw upon both data and determination.
The Health Equity approach proposed by Canadian public health officials span a wide range of initiatives geared toward meeting the needs of the people. These include increasing awareness of mental health, mental illness and the various pathways to care; screening for mental health; stigma reduction strategies for those seeking help; and breaking down barriers to access.
All the components are essential and yet It may not go far enough, fast enough. Racialized communities impacted by COVID 19 are sinking into deeper, more concentrated poverty along with amplifying risks of mental distress. Black women and children living in low income neighborhoods are now eating less food, buying fewer fresh fruit and vegetables and waiting longer before seeking mental health support (which was a problem before the pandemic). Emergency support is critical at this moment but not a medium- or long-term solution. It may not even be a short-term solution given the shortfalls that are already occurring in some neighborhoods. The only option that can meaningfully stem this racialized, socio-economic tsunami appears to be basic income support, a matter for provincial and federal jurisdictions. This fundamental demand must be the focus of concentrated policy and advocacy minds for the foreseeable future.
A multiple combination approach maybe our only chance as deconstructing stigma and discrimination faced in mental health adversity.