Talking to experts about the mental health impacts of racial discrimination
March 21 marks the International Day for the Elimination of Racial Discrimination. This day engages us all through #FightRacism, which aims to foster a global culture of tolerance, equality and anti-discrimination and calls on each one of us to stand up against racial prejudice and intolerant attitudes.
We spoke with Dr. Kenneth Fung and Dr. Bukola Salami, mental health experts specializing in ethno cultural communities. They shed light on experiences of racial discrimination lived by members from the Asian and Black community, the impacts on their mental health and support available to achieve mental well-being.
Dr. Kenneth Fung, MD FRCPC MSc FAPA DFCPA
How long have you been a mental health practitioner/expert for and whom do you serve?
Since 2000, I have been a practising psychiatrist serving Cantonese and Mandarin speaking Chinese Canadians at the Toronto Western Hospital, UHN, as well as the East Asian Canadian communities, including Vietnamese, Cambodian, and Korean-speaking Canadians through Hong Fook Mental Health Association. I have a special interest and expertise in cultural psychiatry, providing care for diverse communities, educating residents and allied mental health professionals on aspects of cultural psychiatry, and conducting community-based research to promote mental well-being. I have also been engaged in mental health psychoeducation and promotional initiatives to help combat stigma against mental illness and build resilience.
Can you give examples of racial discrimination experiences lived by members of the Asian community?
The Asian community has a long history of experiencing racial discrimination dating back to the founding of Canada when many Asians, especially Chinese, were brought over to finish the railway under perilous and unjust conditions. While things have improved from the days when the head tax was imposed or when Chinese were not allowed to vote, racism against Asians and systemic inequities have persisted. The “myth of model minority” obscures anti-Asian racism and perpetuates systemic racism against all visible minority groups in the process. With the pandemic, both overt and covert discrimination have increased dramatically and this has become almost inescapable. Asians have been blamed for causing the virus or spreading it. The act of wearing masks, which occurred early on among many Asian communities, is really a caring action to protect everyone. However, this has, at times, been met with discriminatory attacks, with some becoming the victims of violent hate crimes. In Vancouver, there has been a 717% increase in hate crime against Asians, and a National Angus Reid survey found that half of Chinese Canadians reported being insulted because of the pandemic, and 43% have been threatened or intimidated.
What are the mental health impacts of these experiences of racial injustice?
An experience of an act of discrimination can be highly traumatic to an individual. One can feel a variety of emotions from shock, to anger, to shame, to powerlessness. For some, this may lead to or exacerbate symptoms of depression or anxiety. Some of my patients, for instance, have been afraid to go out of their homes. Systemic racism and structural inequities have also been a cause of health disparities, resulting in higher rates of morbidity and mortality, including more severe or longer untreated mental illness. Anti-Asian racism also has an impact on income, job security, and housing, undermining mental well-being. Perhaps one of the most widely devastating impact is that a lot of Asian community members feel a loss of sense of belonging to Canada. It does not matter how many generations you have lived in Canada, how hard you work, or how well you speak the language. Racist attacks like “go home” or “you people brought the virus here” may still rob its victim of their Canadian identity, their home, and their psychological safe space. Partly because of culture and partly because of the perpetuated “myth of model minority”, many Asians Canadians minimize their experiences of racism, with some even internalizing certain perceptions of inferiority or guilt. It is important for all of us as Canadians to actively stop racism of all forms.
What would you say to someone from the Asian community considering getting support for his or her mental health?
I would empathize with the person’s suffering and their felt experience of mental illness, including symptoms of depression, anxiety, or psychosis, such as hallucinations or paranoid fears. Sometimes, symptoms of mental illness may include physical symptoms, such as headaches, insomnia, dizziness, or stomach pains. When mental suffering gets too much, this may include suicidal thoughts. Recognizing symptoms of mental illness is important. Mental illness is real and not a sign of weakness or character flaw. There is no need to feel ashamed or guilty, even though it is common to feel this way. While one may fear getting treatment may bring shame to the family, actually, it is a courageous action to get help, important both for oneself and for one’s family. There are now many treatment options available, from medications to psychotherapy. As early treatment helps with earlier and better recovery, as captured by the traditional saying 病向淺中醫 from Huangdi Neijing, the time to seek treatment is now.
For people who are facing mental health stigma in their community/family, what steps would you recommend they take to start a conversation or seek culturally appropriate support?
It is important to acknowledge that the mental health stigma they face from some family or community members is real. At the same time, they may still be able to get support from other family, friends, or community members who have a more positive view towards getting treatment of mental illness. There are dedicated culturally specific mental health clinics such as my own, as well as community organizations like Hong Fook Mental Health Association, which are ready to provide help and support. Indeed, access to culturally specific and appropriate resources are quite limited, especially to the proportion of Asian populations in Canada, and at a systemic level, this is an area that we do need more investment in, and support from the healthcare system and the community.
You can access Dr. Fung’s clinic at the Toronto Western Hospital here. A virtual group program that incorporates Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP) to build resilience is also available for all healthcare staff and providers of all ethnicities and for the Chinese Canadian communities impacted by COVID-19 is available here.
Dr. Bukola Salami, RN MN PhD
How long have you been a mental health expert for and whom do you serve?
I am largely an immigrant health researcher. I have been engaged in research on immigrant mental health since 2015, have been a nurse since 2004 and have been engaged in addressing immigrant health since 2009.
Can you give examples of racial discrimination experiences lived by members of the Black community?
Canada has a history of racism, including anti-Black racism. For instance, in 1910, a policy was implemented to ban individuals who were non-White from coming to Canada. Black people continue to experience anti-Black racism and micro-aggression. Examples of anti-Black racism include being called racist names, being physically attacked due to their racial background, social exclusion, denial of promotion at work, discrimination in the hiring process, Black children being streamlined into lower skilled professions, Black people being more likely to be arrested by police for equivalent conduct as white people, etc.
What are the mental health impacts of these experiences of racial injustice?
In my research on mental health, I found that anti-Black racism has implications for mental health. Research shows that individuals who have experienced racism are more likely to have mental health problems. Youths, in a previous research I conducted, indicated that internalized racism has an influence on their mental health. It influences the ability to sleep well, concentrate, think, conduct oneself and behave.
What would you say to someone from the Black community considering getting support for his or her mental health?
I encourage anyone to ensure they get the support they need including from formal and informal sources. Positive social support network, counselling services and medical treatment can contribute to and improve one’s mental health.
For people who are facing mental health stigma in their community/family, what steps would you recommend they take to start a conversation or seek culturally appropriate support?
Finding cultural appropriate support can be difficult. However, some immigrant serving agencies have culturally appropriate mental health support. Also, some have found it helpful to draw support from community and religious leaders.
A list of support for Black Canadians’ mental health is available here.
If you want to learn more about the state of mental health in the BIPOC communities, we encourage you to access the following additional information:
- A CTV News interview with Dr. Kwame McKenzie, CEO of Wellesley Institute and a Bell Let’s Talk Diversity Fund Advisor, as part of the Coping Through COVID series which aired in November 2020
- A webinar “Mental health in diverse communities. A discussion about resiliency and mental well-being,” which took place in January 2021, builds on Bell’s commitment to take meaningful action to address the impacts of systemic racism across Canada’s ethno cultural communities. It highlights a conversation between community leaders, people with lived experience, and experts in the field of mental health in BIPOC communities about the current state of mental health in the Black, Indigenous and People of colour populations. We also encourage you to register for our newsletter to stay informed of our mental health initiatives.
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