The negative effects, stigma and societal disparity toward people of African descent are no secrets. Soccer, hockey and cricket lovers continue to witness bananas being thrown on fields and fans making monkey chants at players. Are the fans even aware of the roots of their repugnant expressions? That a huge contingent of Western scientists (from Johan Blumenbach to Philip Rushton) have falsely tried to demean African people for generations by brazenly suggesting we are a variation of monkeys. I doubt it. The irony is that all humanity has genetic links to primates but that’s not the point of this blog. The main point is that the many expressions of intolerance, hate and racial stigmatization, are having significant effects on the mental health and well-being of Black people the world over, especially children and youth.
Such impacts should not be a surprise. Many researchers have confirmed that victims of racial discrimination often develop mood and anxiety problems. Some engage in unhealthy coping mechanisms and behaviour, especially alcohol and drug abuse. Of course, engaging in negative coping behaviour is damaging to health and compounds the harms of racial discrimination. This tendency is more pronounced among males than females and is particularly frequent among both incarcerated and post-incarcerated males. Consequently, Black people are approximately 2.5 times more likely to be committed to mental institutions compulsorily (Study conducted by Barnet et. Al). At admission, some may be fortunate to receive top notched care undiminished by racial stigma; many will not be so fortunate. Too many will have their chances of recovery and well-being further impeded by racialized diagnosis and treatment. The fundamental problems linked to associated prejudice asserted by various Health Professionals creates a vicious cycle; with even Black persons in distress declining to consult with mental health practitioners. The onus is now on the representatives of the health care system and the wider society (you and me) to embrace the root problem and deliver health care that meets the needs of all Canadians; especially those of African descent, without any further delay and prejudice.
So, what are we to do during an epidemic of anti-Black racism?
A good start would be for each Canadian to make it their duty to recognize and promote our common humanity and common human origins in Africa. All human beings have a Black ancestor from ancient Africa and are therefore all members of the same human family. The odious assumption that one group of human beings could conceivably be superior to another should be consigned to the list of crimes against humanity and treated with the due legal diligence befitting the crime. If we see legal authorities becoming decisive, and ceasing to fudge about freedom of expression when hate promotion is involved, then the winds of change may be near.
Canada’s governmental leaders and private sector decision makers need to adopt policies and programs broadly aimed at completely eradicating racial profiling.
The good news is that racial stigmatization toward people in Black and minority communities, by health and other service providers, can be effectively reduced. The challenge is that such change requires long term commitment and resources for capacity building and transformational collaboration between professional communities and communities of African descent. Our community of anti-racism practice subscribes to evidence-based research to produce meaningful and effective strategies to aid in the fight toward a more equitable society. We are delighted to see anti-racism health measures being advanced, based on old and new evidence, for health professionals the world over. The Lancet Psychiatry Journal (published July 8 2020) recently elaborated four critical areas to guide practitioners to provide anti-racist mental health care.
They urged health practitioners to become fully informed about the diverse expressions of racial stigma and implicit bias in service delivery. They must also be trained to deliver anti-racism care that can prevent discrimination, micro-aggressions, and the associated mental problems faced by Black and racialized groups within their own space. Only through deliberate cultural competency, and anti-racism skill building process, can professionals be equipped to administer empathetic and tailored care to meet the needs of a diversified population. Awareness of subliminal reactions to skin colour and African phenotypical characteristics, as well as subtly disparaging attitudes and beliefs about various cultural backgrounds, can allow for the construction of truly safe spaces for constructive healing. The ideology that intervention approaches are standardized is archaic. Each health discipline should investigate how its practitioners address anti-Black racism and incorporate the requisite anti-racism knowledge and skill-building for providing adequate service.
Appreciating the tremendous cultural diversity within and across Black communities is also an essential next step on the road to effective anti-racist care and services. Health practitioners must be able to conduct culturally appropriate assessments of their clients’ needs for effective treatment and care. It is critically important to have a fundamental understanding of clients’ ethnic identity, religious beliefs and cultural values. During an assessment, it is imperative for a practitioner to assess the continuum of causes of particular mental health problems; from genetic risks to experiences of racial stigma and discrimination. Care should be given that harnesses clinical aspects of racial trauma as well as culturally enriched resilience.
Another area of growing concern is the over prescription of drugs to treat problems that are socio-economic, cultural and political in nature. Practitioners are encouraged to administer drugs only after exhausting other treatment options. Researchers have confirmed an over-reliance on prescription of medicine rather than talk therapies for Black people. Not that talk therapies have all been updated and culturally adapted to meet cultural and anti-racism needs. Treatment strategies that address the real needs and issues related to racism have to be developed and tested. Identifying and treating traditional symptoms associated with discrimination must be strengthened by interventions for internalized racism and self-stigmatizing behaviours. This latter approach is crucial to helping Black people cope effectively with racial trauma. Therapeutic conversations about racializing experiences and victimization, coupled with beliefs about spirituality and culture, can well serve to alleviate mental strains and distress. Tools and strategies to help clients regulate their emotions, and energy spent on hypervigilance and racism-related thoughts will only strengthen psychotherapies for clients of African descent.
The guidelines we briefly touched on can assist practitioners to better deliver person-centered care. Adopting a humanistic approach to dealing with Black mental health care patients serves to eliminate mistrust, misplaced diagnoses and leads to anti-racist and culturally appropriate care. The provision of such tailored care could restore hope and confidence by Black communities that meaningful change is on its way.
Within our communities, as well as societies at large, we must incur a degree of responsibility toward change management in the health system. Others may be to blame, but we still have responsibility for ensuring that our expectations are clear and concise about excellence in service delivery. Black communities must do the necessary homework to identify the approaches they want for their particular mental health needs. We cannot settle for health care services that lack an evidence base with respect to our diverse bio-psycho-social-spiritual and harms reduction needs. Prime Minister Justin Trudeau announced just recently an incentive program run by the government in collaboration with numerous financial partners, geared toward stimulating entrepreneurship. Given the political history, it could be smokes and mirrors. On the other hand, it could be a way forward for attaining greater equity across our lives. No stone should be left unturned in our efforts to attain real progress on these issues.