Dr. Amy Gajaria is a child and adolescent psychiatrist at the Centre for Addiction and Mental Health. She works with the Substance Abuse Program for African Canadian and Caribbean Youth.
It has been a sobering time to be a person providing mental health care to Black youth. My young patients are seeing anti-Black racism in real time and online, scrolling endlessly through posts talking about police violence and through videos of violence against Black individuals.
I watch as the pain of witnessing these events as young Black people crosses their faces. I listen to their voices tremble and crack, sometimes with the deep sadness of a truth that they have always known, sometimes with a simmering rage at how Black people have been left behind or actively suppressed by a system that denies their ability to enjoy their youth by imposing a too-soon adulthood at every turn. Watching these videos is not simply a sad or outrageous thing for Black youth, it is trauma.
The death of George Floyd is a tragedy, brought to bear in the light of social media and on the tails of months of COVID-19 stress and isolation. For some of my young patients, this might be the first time they confront how anti-Black racism structures their lives. More often, this is just one more such moment in lives marked by barriers that disproportionately affect the lives of young Black people. The devastation they feel is a cumulation of a lifetime of repeated traumatic experiences based on race, and this has profound effects on their mental health and sense of self.
As Canadians, we love to talk about this as an American problem – “Thank goodness we’re not in the U.S.” But these patients all live in Toronto. They are Canadian. This is their experience, too.
Starting from childhood, Black parents worry over how their children will grow in this world. In whispers, they tell me about their fears of whether their boys will make it home to them at night, or whether they will face violence at the hands of police. They wrestle with how to introduce the idea that racism exists – Black parents know it does, of course, and they know they have to tell their children, but the idea of talking about violence and pain with their tiny children breaks parents’ hearts.
As children, young Black people experience a school system that explicitly and implicitly tells them they are not smart enough, that they are “too aggressive,” that they are too much to manage, and that disproportionately suspends and expels them. And, as my constant caveat, yes, here in Canada, too. As adolescents, Black youth start to notice how they are subtly and not so subtly moved out of public spaces and are seen as “dangerous” when they gather outside. Imagine how anxious you would feel if the police, and other institutions, were watching you all the time. Imagine how this might lead you to hide inside or try and suppress every emotion – for fear that if you didn’t, the pain would break you apart and you might never find a way to put yourself back together. Imagine what it might be like to realize that all this happens because of a skin colour you can never change, and how instead of having pride in your Black identity, you might start to internalize all that negativity. Imagine all this before even turning 20. This is how structural racism affects mental health.
And then, when all this becomes too much to bear, when the suicide rate for Black youth steadily climbs, when youth feel they can only manage their pain through using substances, they find themselves in a health system that seems blissfully unaware of all they have been through. Their families may want them to get mental-health help in a crisis, but fear involving police in case this ends in death, as with Regis Korchinski-Paquet. We are not taught in medical school to ask Black, Indigenous and racialized patients about their experiences of racism or how racism affects their mental health, even though racism is a clear determinant of adverse mental-health outcomes. We don’t ensure that Black youth are able to access care from racialized or Black providers, or that they see themselves represented in our mental-health system. We also don’t ask about how they keep going every day despite all that works against them. I want us to do better and be better.
Mostly, though, I ask Canadians to consider the incredible pain that young Black people are in right now. I want us to realize how much racism affects the mental health of our youth. And I want all of us to commit to change.
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