Week 2 - Racism and Mental health

Question 1

Racism & Mental Health

Answer 1

Background
* Large body of American studies have found racism is pervasive, and has adverse health effects on racialized and ethnic minority groups
* In Canada there are a few studies examining the correlation due to lack of race-based data and paucity/scarcity of studies
* However, there are persistent health disparities among racialized groups especially Black and Indigenous People in Canada with deep correlations with socio-economic status and differential access to healthcare

Question 2

Racism - Williams et al (2000)

Answer 2

• Conceptualizes the term ‘racism’ to refer to an organized system that leads to the subjugation/suppression of some human population groups relative to others”

Ideology of Inferiority -> Negative attitudes and beliefs -> Differential Treatment

Ideology of inferiority:
- humans groups are categorized and ranked relative to others

Negative attitudes and beliefs:
- development of negative attitudes and beliefs toward racial outgroups (prejudice)
- incorporated into societal policies and institutions

Differential treatment:
- different treatment of members of outgroups by individuals and institutions

Question 3

3 Primary Mechanisms: Racism affects Mental Health (Williams et al, 2000)

Answer 3

Institutional Discrimination
o Restrict Socioeconomic Mobility
o Resulting in racial differences (SES) & Exposure to poor living conditions and limiting of opportunities and social mobility

Experiences of Discrimination
o Adversely Affect Mental Health
o Psychological stress & distress

Stigma of Inferiority
o Internalized negative stereotyping & stigma
o Affect psychosocial functioning

Question 4

Anti-Black Racism Historical Roots that underpin present day institutionalized racism (Williams, 2000)

Answer 4

• Perpetuated by Ideologies that reinforced Slave trade & colonization
• Actively translated into policies that restricted access to education, employment, social mobility, and integration of African Americans through segregation in the USA through racist policies and laws
• Negative Racial stereotypes pervasive in society and culture undermine and impede equitable access to opportunity, employment, and integration
• Resultant impacts on socio economic status and social determinants of health which are strong predictors of mental health
• Institutionalized discrimination in the administration of Justice in courts of law

Question 5

Anti Indigenous Racism: Historical Systemic Roots to the Present-day inequities

Answer 5

• Colonization  Systemic & Cultural Genocide  Institutionalized systemic racism in policies and practices

Question 6

Racism, Discrimination, Stigma

Answer 6

• Can arise from intersectionality of Identities (Gender, Sexual Orientation, Ethnicity, Class, Socio-economic status, power, age)

Question 7

Impacts of Racism, Discrimination, & Stigma on Mental Health and Substance Use Services

Answer 7

• Barriers to Timely Access to Services
• Poorer outcomes when accessing services
• Poorer experiences when receiving services
• Late entry to services (too sick or acute when first entry)
• Entry to services through criminal justice system

Question 8

Williams, David R Racism and Mental Health: African American Experience

Answer 8

• Describes how racial stereotypes and negative beliefs were incorporated into societal policies and institutions
• Suggests racism can adversely affect mental health status in at least 3 ways

1. racism in societal institutions can lead to reduced socioeconomic mobility (change such as increase), differential access to desirable resources, and poor living conditions that can adversely affect mental health
    beliefs of inferiority of blacks have been actively translated into policies that restricted access of African Americans to educational, employment, and residential opportunities
   
   • Most dramatic example is residential segregation (not allowing blacks to live in same neighbourhood)  reduced socioeconomic mobility
     o Desire to avoid social contact with group
     o Physical separation was only possible d/t major societal institutions
     o Restricted blacks from housing choices
     o Determines access to education and employment opportunities
2. experiences of discrimination can induce physiological and psychological reactions that can lead to adverse changes in mental health status
3. acceptance of negative cultural stereotypes can lead to unfavorable self-evaluations that have deleterious effects on psychological well-being

Question 9

Barriers and Facilitators to Accessing Care Reading

Answer 9

Barriers = “reasons or obstacles that prevent individuals from seeking, obtaining, or completing mental health treatment.”
- personal factors such as:
 self-stigma
 cultural stigma
 racism and discrimination from practitioners
 difficulty identifying mental illness or refusal
 lack of knowledge about available services
 religion
o Systemic:
 Wait times, poor access to mental health professionals, geographical and financial barriers

Facilitators = factors that aid entry to and retention within the mental healthcare system
- Examples:
 Trusting relationship and credibility w/ providers
 Positive relationship w/ providers built trust
 Cultural rapport and cultural competence
 Systemic factors could be barriers or facilitators:
* Affordability of mental health treatments
* Physical accessibility
* Transportation
* Appointment availability and timely follow up