As anti-Black racism exacerbates systemic challenges around health inequity and police brutality, many are worried about Black mental health — especially as experts are already ringing the alarm about a global mental health crisis due to COVID-19.

A Black clinical counsellor in Vancouver, Sacha Médiné sees this mental toll in his work and personal life. He calls it a “dual experience” of juggling the anxiety around continuing his work over telehealth and taking care of two young children amid a pandemic while processing the “explosion of Black rage and grief” over police brutality.

“The last few months have been heavy on everybody but especially heavy on communities of colour,” he said, “and in this moment, heavy on Black folks.”

Without access to childcare due to COVID-19, Médiné has had to reduce his workload. But he said he has seen a “spike” in the number of Black people and people of colour in general seeking his support in recent weeks — even as the lack of in-person sessions has made counselling less accessible.

In Toronto, Renee Raymond, a Black psychotherapist, said she has similarly seen an increased demand for her services.

This trend is not surprising.

This disconnect in lived experiences means those who push through mental health stigma to find care often have to educate their therapists about anti-Black racism.

A recent survey from the Centre for Addiction and Mental Health showed that 25 per cent of respondents experienced moderate to severe anxiety because of COVID-19. Similarly, 23 per cent felt lonely and 20 per cent felt depressed.

Challenges created by anti-Black racism add another layer. Black neighbourhoods in cities including Toronto, Montreal and Halifax have seen disproportionate numbers of COVID-19 cases. Ongoing news about the harassment and killing of Black people — oftentimes by or in the presence of police, such as in the recent cases of George Floyd, Breonna Taylor, Tony McDade, Regis Korchinski-Paquet — have only intensified the grief and trauma.

“I feel like COVID and the recent violence are really exposing … who in our community isn’t afforded full humanity and the mental health impacts that has,” Médiné said.

Still, mental health specialists indicate these challenges are just the tip of the iceberg. And tangible solutions must mean not only diversifying the ranks of mental health professionals but also addressing systemic barriers created by anti-Black racism.

The need for counsellors of colour

Despite this clear need for care, it’s hard for Black communities to access mental health support.

A major difficulty lies in finding therapists from a similar background.

This is even as a number of directories — like Healing in Colour — have been created to facilitate connections with therapists of colour. More recently, community members and organizers have also set up GoFundMe campaigns to raise money for Black mental health support.

This disconnect in lived experiences means those who push through mental health stigma to find care often have to educate their therapists about anti-Black racism.

“A good chunk of clients who I have seen personally have expressed the fact that if they had seen a therapist who wasn’t a therapist of colour, they would get a number of responses like, ‘Oh, I don’t see race,’” Raymond said. “It doesn’t leave you feeling confident that you’re going to get whatever you’re trying to get out of that particular interaction and so it can leave a lot of people disillusioned.”

This gap results largely from issues of access to education at all levels and the ongoing lack of diversity among instructors, said Raymond.

“For so many of us, having police show up at our door in the middle of the night is just never going to make us safer.”

Malik Adams understands these barriers well. An African-Nova Scotian high school counsellor in Halifax, he pointed to the systemic discrimination that Black students often face in school settings, including “long-documented” adverse relationships with counsellors.

“If you don’t have a good relationship, what Black kid who has come through that system would actually want to become a counsellor?” he said.

He also stressed the importance of diversifying curriculums in counselling programs, having studied with an all-Black cohort in a master’s program with an Afrocentric lens at Acadia University.

“I don’t have a problem studying Sigmund Freud, but by his own admission, his clients were generally people of Eastern European ancestry,” Adams said, noting the field’s long-standing Western bias.

“How do I know that what he believes would apply to me as [a person] of African ancestry? So I want to study Black psychologists. I want to see … for Black people around the diaspora, how do all of those people deal with mental health. So that part of the Afrocentric cohort, that was huge because that opened up a whole new world for us.”

The health harms of excessive policing

But simply adding more therapists of colour is not enough, said mental health specialists — especially when addressing the impact of policing on Black mental health.

Despite significant gaps in race-based data collection, it’s clear that Black Canadians experience excessive policing.

According to a 2018 report, Black people in Toronto were almost 20 times more likely to “be involved in a fatal shooting” by the police than white people were from 2013 to 2017. Similarly, they were “over-represented” in use-of-force cases and fatal encounters. Police also disproportionately street-check Black people across Canada, from Vancouver to Edmonton to Toronto to Halifax.

“I could ask any Black students about the police, they’d all have a story,” said Adams, whose school serves downtown Halifax.

“They would all have a story about either being profiled, or they’d have a story about a family member being profiled, or they’d have a story about police brutality.”

And repeated exposure to police violence is connected to higher risks of “psychological distress, suicidal thoughts, suicide attempts and psychotic experiences.” This challenge is compounded for those who are queer or trans, communities that have a similarly long history with police brutality.

“It’s a lot of extra emotional labour that people of colour have to navigate in addition to navigating just the daily activities of life, so it can be quite taxing,” Raymond said.

“It’s very, very exhausting.”

At the same time, the police are increasingly used as first responders to mental health issues.

In Canada, there is renewed interest in defunding the police, though discussion at the political level has been slower.

According to a 2019 report, police in B.C. tackle over 74,000 mental health–related calls every year. The Canadian Mental Health Association BC Division (CMHA BC) also noted that over 30 per cent of people interacted with the police while trying for the first time to get mental health support.

As a result, more police forces across the country are partnering with mental health professionals when responding to mental health emergencies. Jonathan Morris, CEO of CMHA BC, added that there is also work around virtually connecting officers with psychiatrists at hospitals to enable better assessment of the emergency.

“We have to remember if you’re a person who’s hearing voices and you’re in distress … it’s an additional voice in terms of those commands to ‘Get on the ground, drop whatever you might have in your hand,’” he said.

“So having an integrated team can help in the moment. … The use of these teams has also increased across Canada and often there are requests for these kinds of teams to be built and integrated into care.”

But there are still many gaps in the spread and implementation of the model.

On June 4, the police fatally shot Chantel Moore, an Indigenous woman in New Brunswick, during a wellness check. In late May, Regis Korchinski-Paquet, a Black and Indigenous woman in Toronto, died after falling from her apartment in the presence of police. Korchinski-Paquet was in distress following a family conflict, and her family had requested police help to bring her to the Centre for Addiction and Mental Health.

Both cases are currently under investigation.

Beyond the police

Médiné referred to this model as “harm reduction” because it does not address the need for a health and social response to mental health emergencies.

“That’s still a police response to something that I don’t think should be a police response,” he said. “I know that for so many of us, having police show up at our door in the middle of the night is just never going to make us safer.”

Morris agrees, stressing the need to support people before they reach their breaking point. In particular, he called for more investment into mental health support from all levels of government.

“We need to do a much better job getting to people sooner,” he said.

“It’s really important to remember that the risk factor is racism. Systemic injustice is the risk factor. Colonization is the risk factor. And that requires all of us to do better, we have to do better, or to drive change in those regards.”

Precarious housing and employment are also major sources of chronic stress that Médiné has noticed in his counselling practice.

“‘I’m just always terrified about what happens if I lose my job because I wouldn’t be able to find housing’ — there are just a million different versions of it and that’s the source of so many of our crises later on,” he said. “What if we really cared about addressing those?”

“There’s nothing wrong with us, but there’s something wrong with the world.”

Raymond added that there should also be consideration for those who might look like they are doing fine economically but are facing stressors from workplace discrimination and wage inequity. She noted that adequate solutions for these systemic barriers must include Black perspectives and input.

One solution that has recently gained massive traction online and through protests is defunding the police. Some advocates want to reduce police departments’ budgets and reallocate the funding for support services, addressing both the disproportionate force that Black communities face from the police and the lag in services for them. Others believe police departments should be replaced with alternative civilian services.

This advocacy has seen results in some American cities. New York’s mayor pledged to cut the budget of the city’s police department, and most city councillors for Minneapolis, where George Floyd lived, have promised to disband the department entirely.

In Canada, there is renewed interest in defunding the police, though discussion at the political level has been slower.

Toronto’s mayor, John Tory, has so far called for more mental health funding and body cameras for the city’s police department. But two city councillors have now submitted a motion to cut the department’s budget by 10 per cent.

In Vancouver, city council approved a 1 per cent cut to the police budget in May due to COVID-19 shortfalls, but the police board is now rejecting it.

‘When the dust settles’

In the midst of protests, mental health specialists say that it is already important to be thinking ahead about how to systemically tackle anti-Black racism — the root of many mental health issues for Black communities — in the long run.

“When the dust settles … how do you mobilize those people as it relates to education, as it relates to housing, as it relates to justice, as it relates to economics, as it relates to law?” Adams asked.

Similarly, Raymond stressed the need to continue having these difficult conversations around anti-Black racism and working on solutions before focusing on healing.

“If you have a tumour, you have to remove the tumour and then you can start the healing process,” she said.

“And so if we are having these conversations and looking at how to heal from this, we need to start seeing actual demonstrable changes. Otherwise, we’ll just, in a few weeks, stop talking about it and it gets swept back under the rug.”

Ultimately, these sentiments form the backbone of the anti-oppressive lens that some practise in their counselling.

“I think one of the things that people who end up connecting with me are often looking for is somebody who will have a deep sense that there’s nothing wrong with us, but there’s something wrong with the world and that we’re all trying to find ways to stay alive and cope and find liberation from it,” Médiné said.

“That is the sense of connecting with somebody else who knows in their bones what it is to experience and survive white supremacy.”