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Callaghan T, Ferdinand AO, Motta M, Lockman A, Shrestha A, Trujillo KL. Public Attitudes, Inequities, and Polarization in the Launch of the 988 Lifeline. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2024; 49:473-493. [PMID: 37987198 DOI: 10.1215/03616878-11066312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
CONTEXT To address the considerable burden of mental health need in the United States, Congress passed the National Suicide Hotline Designation Act in 2020. The act rebranded the national suicide prevention lifeline as 988, a three-digit number akin to 911 for individuals to call in the case of a mental health emergency. Surprisingly little is known about American attitudes toward this new lifeline. METHODS The authors use a demographically representative survey of 5,482 US adults conducted June 24-28, 2022, to examine the influence of mental health status, partisan identification, and demographic characteristics on public awareness of the new 988 lifeline, public support for the lifeline, and intention to use it. FINDINGS The authors find that while only a quarter of Americans are aware of the lifeline, support for the 988 lifeline is widespread, with more than 75% of Americans indicating they would be likely to use the new number if needed. The authors identify key disparities in awareness, support, and intended use, with Republicans, individuals with low socioeconomic status, and Blacks less supportive of the 988 lifeline and in some cases less likely to use it. CONCLUSIONS The results point to the need for additional interventions that increase public awareness of 988 and reduce disparities in program knowledge, support, and intention to use.
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Ojukwu E, Hirani S, Sotindjo T, McKay E, Okedo-Alex I, Magagula P, Pashaei A, Agudosi GM. The Impact of Intersectional Discrimination and Stigma on HIV Care for African, Caribbean, and Black Women Living With HIV During the COVID-19 Pandemic in British Columbia: A Descriptive Study. J Assoc Nurses AIDS Care 2024; 35:175-188. [PMID: 38427789 PMCID: PMC11037459 DOI: 10.1097/jnc.0000000000000457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
ABSTRACT African, Caribbean, and Black women living with HIV (ACB WWH) in British Columbia experience discrimination on the basis of their race, sex, gender identity, sexual orientation, and HIV status. The various forms of stigma that ACB WWH experience intersect to create a uniquely marginalized experience that has negative consequences for quality of life and overall well-being. Eighteen semistructured interviews were completed with ACB WWH in British Columbia. Interviews were conducted by phone, Zoom, or in-person at the participant's request. Participants consistently reported experiences of various forms of discrimination. There was additional stigmatization due to COVID-19 pandemic that negatively influenced the lives of ACB WWH. Interventions and resources are needed to support ACB WWH in navigating how to work through the multifaceted impacts of intersectional stigmatization. Efforts are needed to identify ways to continue the delivery of resources like social support groups throughout future pandemics.
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Affiliation(s)
| | - Saima Hirani
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Tatiana Sotindjo
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Emily McKay
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Ijeoma Okedo-Alex
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Patience Magagula
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Ava Pashaei
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Ginikachukwu Marylinda Agudosi
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
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Monari EN, Booth R, Forchuk C, Csiernik R. Black family members' cultural beliefs and experiences regarding substance use and misuse by relatives: A focused ethnography. J Ethn Subst Abuse 2024:1-31. [PMID: 38557270 DOI: 10.1080/15332640.2024.2331634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Research explored substance use in Black communities in Canada, but a gap exists about the experiences of Black family members, caring for relatives with substance misuse within the Canadian context. Black family members are defined as African Canadians, Caribbean Canadian or Caribbean Blacks. This paper explores Black family members' beliefs and experiences regarding their relatives' psychoactive substance use and misuse. A focused ethnography was conducted with 26 Black family members with 17 participants originated from various parts of Africa, and nine participants originated from parts of the Caribbean. Participants comprised of mothers (n = 5), fathers (n = 2), step-fathers (n = 1), husbands (n = 1), wives (n = 2), uncles (n = 5), aunties (n = 2), siblings (n = 5), in-laws (n = 2), and guardians (n = 1). Three themes were generated: cultural beliefs and perceptions regarding substance use and misuse of family relatives; "When he starts drinking, hell breaks loose": Perceived impact of substance misuse on family safety and stability; and, the experiences of stigma and the keeping of secrets. Prioritizing public health approaches, such as public policies and campaigns that dismantle stigma and systemic barriers, and increase awareness about substance use and harm reduction interventions among Black communities.
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Affiliation(s)
- Esther N Monari
- Memorial University of Newfoundland, St. John's, Canada
- Western University, London, Canada
| | | | - Cheryl Forchuk
- Western University, London, Canada
- Lawson Health Research Institute, London, Canada
- Parkwood Institute Research, London, Canada
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Cénat JM, Broussard C, Jacob G, Kogan C, Corace K, Ukwu G, Onesi O, Furyk SE, Bekarkhanechi FM, Williams M, Chomienne MH, Grenier J, Labelle PR. Antiracist training programs for mental health professionals: A scoping review. Clin Psychol Rev 2024; 108:102373. [PMID: 38232574 DOI: 10.1016/j.cpr.2023.102373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/17/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
Racism has been shown to be directly deleterious to the mental health care received by minoritized peoples. In response, some mental health institutions have pledged to provide antiracist mental health care, which includes training mental health care professionals in this approach. This scoping review aimed to synthesize the existing published material on antiracist training programs among mental health care professionals. To identify studies, a comprehensive search strategy was developed and executed by a research librarian in October 2022 across seven databases (APA PsycInfo, Education Source, Embase, ERIC, MEDLINE, CINAHL, and Web of Science). Subject headings and keywords relating to antiracist training as well as to mental health professionals were used and combined. There were 7186 studies generated by the initial search and 377 by the update search, 30 were retained and included. Findings revealed four main antiracist competencies to develop in mental health professionals: importance of understanding the cultural, social, and historical context at the root of the mental health problems; developing awareness of individual biases, self-identity and privilege; recognizing oppressive and racism-sustaining behaviors in mental health care settings; and, employing antiracist competencies in therapy. Professionals who have taken trainings having the main components have developed skills on the interconnectedness between racialized groups' mental health and the cultural, religious, social, historical, economic, and political issues surrounding race, necessary for successful clinical practice and for providing anti-racist mental health care. This scoping review presents a summary of the essential antiracist competencies drawn from the literature which must be applied in a mental health care setting, to improve help seeking behaviors, and reduce distrust in mental health care professionals and settings.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | - Cathy Broussard
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Grace Jacob
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Cary Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Institute for Mental Health at The Royal, Ottawa, Ontario, Canada
| | - Kim Corace
- The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Institute for Mental Health at The Royal, Ottawa, Ontario, Canada
| | - Gloria Ukwu
- Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Olivia Onesi
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Monnica Williams
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; Canada Research Chair on Mental Health Disparities, Ottawa, Ontario, Canada
| | - Marie-Hélène Chomienne
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on the Health Status of Black Immigrant Francophones, Ottawa, Ontario, Canada; Institut du Savoir Montfort, Ottawa, Ontario, Canada
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5
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Clarke-Jeffers P, Keyte R, Connabeer K. "Hair is your crown and glory" - Black women's experiences of living with alopecia and the role of social support. HEALTH PSYCHOLOGY REPORT 2024; 12:154-165. [PMID: 38628276 PMCID: PMC11016946 DOI: 10.5114/hpr/177730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/05/2023] [Accepted: 12/28/2023] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Alopecia is an autoimmune condition that results in hair loss, mainly from the scalp. There are three specific types of autoimmune alopecia: alopecia areata (AA; small patches of hair loss), alopecia totalis (AT; total hair loss from the scalp) and alopecia universalis (AU; total hair loss from the scalp and body). Whilst research has explored the experiences of White women living with alopecia, there is a lack of research exploring the impact of alopecia on women in the Black community. The current study aimed to explore Black women's experience of living with autoimmune types of alopecia with a focus on the cultural importance of hair within the Black community and the impact of social support. PARTICIPANTS AND PROCEDURE Seven Black women (age range: 37-68 years; mean age: 51 years) were recruited purposively through alopecia support group organisations and social media to participate in a semi-structured interview; four participants were diagnosed with AA, two participants were diagnosed with AU, and one participant was diagnosed with AT. One-to-one interviews were conducted online, and interpretative phenomenological analysis was used to guide data collection and analysis. RESULTS Participants discussed the significance of hair specifically within the Black community and the complex relationship between psychological wellbeing, coping and seeking support. CONCLUSIONS This novel area, specific to Black women's psychological experience of alopecia, acknowledges the influence of cultural and ethnic differences. The findings suggest that proactive awareness from health professionals and social support groups are needed due to the nuances of Black women's alopecia experience to provide better support and to enhance the quality of life for Black women to manage their alopecia.
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Affiliation(s)
| | - Rebecca Keyte
- Birmingham City University, Birmingham, United Kingdom
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Goddard-Durant SK, Doucet A, Tizaa H, Sieunarine JA. "I don't have the energy": Racial stress, young Black motherhood, and Canadian social policies. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2023; 60:542-566. [PMID: 37698323 DOI: 10.1111/cars.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Significant socio-economic, health, and mental health disparities due to highly entrenched and systemic anti-Black racism in Canadian institutions, policies, and practices are now well documented in research and policy reports. Yet, few in-depth studies have addressed the mental health impacts of anti-Black racism on Canadian populations. This article is rooted in a community-based, qualitative research project with young first and second-generation Black Caribbean-Canadian mothers and is informed by Black Feminist epistemologies and intersectional theories and methodologies. Our research demonstrates how participants' childhood experiences with xenophobic and racist immigration policies and educational, child welfare, and childcare systems caused their future mental health challenges as young Black mothers, and how these struggles were exacerbated by their encounters with the racist, ageist, xenophobic medical, social, and mental health services they had to access as young mothers. Based on these findings, we recommend enhancements to current social policies to minimize the differential mental health impacts on young Black Canadian mothers.
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Affiliation(s)
| | - Andrea Doucet
- Department of Sociology, Brock University, St. Catharines, Ontario, Canada
| | - Helena Tizaa
- Department of Sociology, Brock University, St. Catharines, Ontario, Canada
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Jarvis GE, Andermann L, Ayonrinde OA, Beder M, Cénat JM, Ben-Cheikh I, Fung K, Gajaria A, Gómez-Carrillo A, Guzder J, Hanafi S, Kassam A, Kronick R, Lashley M, Lewis-Fernández R, McMahon A, Measham T, Nadeau L, Rousseau C, Sadek J, Schouler-Ocak M, Wieman C, Kirmayer LJ. Taking Action on Racism and Structural Violence in Psychiatric Training and Clinical Practice. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:780-808. [PMID: 37198904 PMCID: PMC10517653 DOI: 10.1177/07067437231166985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Affiliation(s)
- G Eric Jarvis
- Division of Social and Transcultural Psychiatry, McGill University, Montréal, QC, Canada; Cultural Consultation Service and Culture and Psychosis Working Group, Jewish General Hospital, Montréal, QC, Canada
| | - Lisa Andermann
- Equity and Inclusion Council; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Oyedeji A Ayonrinde
- Department of Psychiatry, Queen's University, Kingston, ON, Canada; Community Psychiatry, Providence Care, Kingston, ON, Canada
| | - Michaela Beder
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, ON, Canada
| | - Imen Ben-Cheikh
- Department of Psychiatry, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Kenneth Fung
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Asian Initiative in Mental Health, University Health Network, Toronto, ON, Canada; Society for the Study of Psychiatry and Culture, Beverly Hills, CA, USA
| | - Amy Gajaria
- Margaret and Wallace McCain Centre for Child, Youth, and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ana Gómez-Carrillo
- Montréal Children's Hospital (MCH), McGill University Health Centre (MUHC), Montréal, QC, Canada; Inuulitsivik Health Centre, Puvirnituq, QC, Canada; Ungava Tulattavik Health Centre, Kuujjuaq, QC, Canada
| | | | - Sarah Hanafi
- Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Azaad Kassam
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Ottawa Newcomer Health Centre, Ottawa, ON, Canada; Wholistic Health and Wellness, Mohawk Council of Akwesasne, Akwesasne, QC, Canada
| | - Rachel Kronick
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montréal, QC, Canada; Lady Davis Institute and Sherpa Research Institute, Montréal, QC, Canada
| | - Myrna Lashley
- Department of Psychiatry, McGill University, Montréal, QC, Canada; Research Ethics Board, CIUSSS du Centre-Ouest-de-l'île-de-Montréal, Sir B. Mortimer Jewish General Hospital, Montréal, QC, Canada; Lady Davis Institute for Medical Research, Sir B. Mortimer Jewish General Hospital, Montréal, QC, Canada
| | - Roberto Lewis-Fernández
- Columbia University, New York, NY, USA; New York State Center of Excellence for Cultural Competence and Research Area Leader, Anxiety, Mood, Eating and Related Disorders, New York State Psychiatric Institute, New York, NY, USA
| | | | - Toby Measham
- Department of Psychiatry, McGill University, Montréal, QC, Canada; Divisions of Child Psychiatry and Social and Transcultural Psychiatry, McGill University, Montréal, QC, Canada
| | - Lucie Nadeau
- Department of Psychiatry, McGill University, Montréal, QC, Canada; Montréal University Health Centre, Montréal, QC, Canada; Inuulitsivik Health Centre, Puvirnituq, QC, Canada
| | - Cécile Rousseau
- Division of Social and Cultural Psychiatry, McGill University, Montréal, QC, Canada
| | - Joseph Sadek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Meryam Schouler-Ocak
- Social Psychiatry, Charité - Universitätsmedizin, Berlin, Germany; Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - Cornelia Wieman
- Indigenous Physicians Association of Canada (IPAC), Vancouver, BC, Canada; First Nations Health Authority (FNHA), Vancouver, BC, Canada
| | - Laurence J Kirmayer
- Division of Social and Transcultural Psychiatry, McGill University, Montréal, QC, Canada; Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montréal, QC, Canada
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8
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Cénat JM, Dromer É, Darius WP, Dalexis RD, Furyk SE, Poisson H, Mansoub Bekarkhanech F, Diao DG, Gedeon AP, Shah MS, Labelle PR, Bernheim E, Kogan CS. Incidence, Racial Disparities and Factors Related to Psychosis among Black Individuals in Canada: A Scoping Review. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:713-731. [PMID: 37269120 PMCID: PMC10517652 DOI: 10.1177/07067437231178957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Black communities are increasingly concerned about psychosis, a worry echoed by provincial health-care systems across Canada. Responding to the lack of evidence on psychosis in Black communities, this scoping review examined the incidence and prevalence of psychosis, access to care (pathways to care, coercive referrals, interventions, etc.), treatments received, and stigma faced by individuals with psychosis. METHOD To identify studies, a comprehensive search strategy was developed and executed in December 2021 across 10 databases, including APA PsycInfo, CINAHL, MEDLINE and Web of Science. Subject headings and keywords relating to Black communities, psychosis, health inequalities, Canada and its provinces and territories were used and combined. The scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping review (PRISMA-ScR) reporting standard. RESULTS A total of 15 studies met the inclusion criteria, all of them conducted in Ontario and Quebec. Results highlight different disparities in psychosis among Black communities. Compared to other Canadian ethnic groups, Black individuals are more likely to be diagnosed with psychosis. Black individuals with psychosis are more likely to have their first contact with health-care settings through emergency departments, to be referred by police and ambulance services, and to experience coercive referrals and interventions, and involuntary admission. Black individuals experience a lower quality of care and are the ethnic group most likely to disengage from treatment. CONCLUSION This scoping review reveals many gaps in research, prevention, promotion and intervention on psychosis in Black individuals in Canada. Future studies should explore factors related to age, gender, social and economic factors, interpersonal, institutional and systemic racism, and psychosis-related stigma. Efforts should be directed toward developing trainings for health-care professionals and promotion and prevention programs within Black communities. Culturally adapted interventions, racially disaggregated data, and increased research funding are needed.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Élisabeth Dromer
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Hannah Poisson
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | | | - Muhammad S. Shah
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Emmanuelle Bernheim
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Law, Civil Law Section, University of Ottawa, Ottawa, Ontario, Canada
- Canada Research Chair on Mental Health and Access to Justice, University of Ottawa, Ottawa, Ontario, Canada
| | - Cary S. Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
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9
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Cassivi C, Blanchet Garneau A. More than juxtaposition: a commentary to Willis et al.'s (2023) mixed method study on mobile mental health interventions. Mhealth 2023; 9:38. [PMID: 38023780 PMCID: PMC10643217 DOI: 10.21037/mhealth-23-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
| | - Amélie Blanchet Garneau
- Nursing Faculty, University of Montréal, Montréal, Québec, Canada
- Chairholder at Quebec Indigenous Research Chair in Nursing- IRSC, Québec, Canada
- Center for Public Health Research (CReSP), Montréal, Québec, Canada
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10
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Jacob G, Faber SC, Faber N, Bartlett A, Ouimet AJ, Williams MT. A Systematic Review of Black People Coping With Racism: Approaches, Analysis, and Empowerment. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:392-415. [PMID: 36006823 PMCID: PMC10018067 DOI: 10.1177/17456916221100509] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reviews the current research literature concerning Black people in Western societies to better understand how they regulate their emotions when coping with racism, which coping strategies they use, and which strategies are functional for well-being. A systematic review of the literature was conducted, and 26 studies were identified on the basis of a comprehensive search of multiple databases and reference sections of relevant articles. Studies were quantitative and qualitative, and all articles located were from the United States or Canada. Findings demonstrate that Black people tend to cope with racism through social support (friends, family, support groups), religion (prayer, church, spirituality), avoidance (attempting to avoid stressors), and problem-focused coping (confronting the situation directly). Findings suggest gender differences in coping strategies. We also explore the relationship between coping with physical versus emotional pain and contrast functional versus dysfunctional coping approaches, underscoring the importance of encouraging personal empowerment to promote psychological well-being. Findings may help inform mental-health interventions. Limitations include the high number of American-based samples and exclusion of other Black ethnic and national groups, which is an important area for further exploration.
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Affiliation(s)
| | | | | | - Amy Bartlett
- Department of Classics and Religious
Studies, University of Ottawa
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11
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Dolsen EA, Nishimi K, LeWinn KZ, Byers AL, Tripp P, Woodward E, Khan AJ, Marx BP, Borsari B, Jiha A, Neylan TC, O'Donovan A. Identifying correlates of suicide ideation during the COVID-19 pandemic: A cross-sectional analysis of 148 sociodemographic and pandemic-specific factors. J Psychiatr Res 2022; 156:186-193. [PMID: 36252348 PMCID: PMC9553642 DOI: 10.1016/j.jpsychires.2022.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/09/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has created a global health crisis, with disproportionate effects on vulnerable sociodemographic groups. Although the pandemic is showing potential to increase suicide ideation (SI), we know little about which sociodemographic characteristics or COVID-19 experiences are associated with SI. Our United States-based sample (n = 837 adults [mean age = 37.1 years]) completed an online survey during August-September 2020. The study utilized an online convenience sample from a prior study, which was enriched for exposure to trauma and experiences of posttraumatic stress symptoms. We assessed SI using the Beck Depression Inventory-II. Traditional (i.e., logistic regression) and machine learning (i.e., LASSO, random forest) methods evaluated associations of 148 self-reported COVID-19 factors and sociodemographic characteristics with current SI. 234 participants (28.0%) reported SI. Twenty items were significantly associated with SI from logistic regression. Of these 20 items, LASSO identified seven sociodemographic characteristics (younger age, lower income, single relationship status, sexual orientation other than heterosexual as well as specifically identifying as bisexual, non-full-time employment, and living in a town) and six COVID-19 factors (not engaging in protective COVID-19 behaviors, receiving mental health treatment (medication and/or psychotherapy) due to the COVID-19 pandemic, socializing during the pandemic, losing one's job due to COVID-19, having a friend with COVID-19, and having an acquaintance with COVID-19) associated with SI. Random forest findings were largely consistent with LASSO. These findings may inform multidisciplinary research and intervention work focused on understanding and preventing adverse mental health outcomes such as SI during and in the aftermath of the pandemic.
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Affiliation(s)
- Emily A. Dolsen
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA,Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Health Care System. San Francisco, CA, USA,Corresponding author. 4150 Clement Street, Building 8, San Francisco, CA, USA
| | - Kristen Nishimi
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA,Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Health Care System. San Francisco, CA, USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA
| | - Amy L. Byers
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA,Research Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA,Department of Medicine, Division of Geriatrics, University of California, San Francisco, CA, USA
| | - Paige Tripp
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA
| | - Eleanor Woodward
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA
| | - Amanda J. Khan
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA
| | - Brian P. Marx
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA,Boston University School of Medicine, USA
| | - Brian Borsari
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA
| | - Ahmad Jiha
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA
| | - Thomas C. Neylan
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA,Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Health Care System. San Francisco, CA, USA
| | - Aoife O'Donovan
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco. San Francisco, CA, USA.
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12
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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13
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Melton F, Palmer K, Solola S, Luy L, Herrera-Theut K, Zabala L, Knapp SM, Yee R, Yee E, Calhoun E, Hebdon MCT, Pool N, Sweitzer N, Breathett K. Race and Gender-Based Perceptions of Older Septuagenarian Adults. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:944-956. [PMID: 36479377 PMCID: PMC9712052 DOI: 10.1089/whr.2022.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 06/17/2023]
Abstract
Objectives Older adults face racism, sexism, and ageism. As the U.S. population ages, it is important to understand how the current population views older adults. Methods Participants recruited through Amazon's Mechanical Turk provided perceptions of older Black and White models' photographs. Using mixed-effect models, we assessed interactions between race and gender of participants and models. Results Among Participants of Color and White participants (n = 712, 70% non-Hispanic White, 70% women, mean 37.81 years), Black models were perceived as more attractive, less threatening, and sadder than White models, but differences were greater for White participants (race-by-race interaction: attractive p = 0.003, threatening p = 0.009, sad p = 0.016). Each gender perceived their respective gender as more attractive (gender-by-gender interaction p < 0.0001). Male and female participants perceived male models as happier than female models, but differences were greater for male participants (p = 0.026). Irrespective of participant age group, women were perceived as more threatening (p = 0.012). Other perceptions were not significant. Discussion Participants had few biases toward older Black and White models, while gender biases favored men.
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Affiliation(s)
- Forest Melton
- Department of Clinical Translational Sciences, College of Medicine, University of Arizona, Phoenix, Arizona, USA
| | - Kelly Palmer
- Department of Promotion Science, College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Sade Solola
- Division of Cardiology, Brown University, Providence, Rhode Island, USA
| | - Luis Luy
- University of Rochester, Rochester, New York, USA
| | - Kathryn Herrera-Theut
- Department of Internal Medicine and Pediatrics, College of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Leanne Zabala
- Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Shannon M. Knapp
- Division of Cardiovascular Medicine Statistics, College of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Ryan Yee
- Clinical Research Office, Indiana University, Indianapolis, Indiana, USA
| | - Erika Yee
- College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth Calhoun
- College of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | | | - Natalie Pool
- School of Nursing, University of Northern Colorado, Greeley, Colorado, USA
| | - Nancy Sweitzer
- Division of Cardiology, Washington University, St. Louis, Missouri, USA
| | - Khadijah Breathett
- Division of Cardiovascular Medicine, College of Medicine, Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana, USA
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14
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Lazaridou F, Fernando S. Deconstructing institutional racism and the social construction of whiteness: A strategy for professional competence training in culture and migration mental health. Transcult Psychiatry 2022; 59:175-187. [PMID: 35373653 PMCID: PMC9026223 DOI: 10.1177/13634615221087101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The position presented in this article draws on the professional insights of the authors, reflecting on issues of global political importance in culture and migration mental health. As institutional theory perspectives continue to develop, solutions to complex social problems such as racism require embodied knowledge if the lines of authority and basic occupational routines are to be meaningfully renegotiated. Embodied knowledge is socially situated and self-reflexive and reflects cumulative and marginalized experiences that contribute to a better understanding of institutional racism and the social construction of whiteness. The authors foreground the development of critical consciousness and emotional literacy in order to be more professionally competent in institutional contexts of mental health training, education and practice. To this end, elements of due process, transparency, inclusiveness, community engagement and accountability are at the center of a political and intellectual movement towards epistemological justice to promote antiracism and social justice in culture and migration mental health. The authors define decolonial intersectionality as a clear philosophical vision outlining how best to respond to those at risk of experiencing racism and the associated mental health burdens.
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Affiliation(s)
- Felicia Lazaridou
- Department of Psychiatry and Psychotherapy, 14903Charité University of Medicine Berlin, Berlin, Germany
| | - Suman Fernando
- School of Social Sciences, 4904London Metropolitan University, London, UK
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15
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Williams MT, Khanna Roy A, MacIntyre MP, Faber S. The Traumatizing Impact of Racism in Canadians of Colour. CURRENT TRAUMA REPORTS 2022; 8:17-34. [PMID: 35345606 PMCID: PMC8943361 DOI: 10.1007/s40719-022-00225-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 01/27/2023]
Abstract
Purpose of Review While research has identified racial trauma in other contexts, it is often overlooked amongst Canadian society. Racial trauma occurs as a result of an event of racism or cumulative events over time whereby an individual experiences stress and consequent mental health sequelae. Given that the BIPOC (Black, Indigenous, and/or Person of Colour) population in Canada is increasing, it is imperative to identify racial discrimination and the subsequent stress and trauma associated with being racialized in Canada, which subjects BIPOC Canadians to various forms of racism, including microaggressions. Recent Findings This paper reviews the published literature on racism and racial discrimination that identifies or infers racial trauma as the source of the mental health implications for various groups (e.g., Indigenous people, Black Canadians, Asian Canadians, immigrants, and refugees). In addition, intersectionality of racialized persons is prominent to their psychological well-being as their psychosocial and socioeconomic position are complex. Therefore, this paper both provides insight into the Canadian experience as a person of colour and signifies the need for further research on racial trauma in a Canadian context. Summary Despite Canada’s emphasis on multiculturalism, racialized individuals are at risk for racial trauma due to prejudice and discrimination. The politicization of multiculturalism has permitted Canada to deny claims of racism, yet the historical basis of established institutions results in irrefutable systemic and systematic barriers for Canadian people of colour.
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Affiliation(s)
- Monnica T Williams
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5 Canada.,Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada
| | | | - Marie-Paule MacIntyre
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5 Canada
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16
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Teo K, Churchill R, Riadi I, Kervin L, Wister AV, Cosco TD. Help-Seeking Behaviors Among Older Adults: A Scoping Review. J Appl Gerontol 2022; 41:1500-1510. [PMID: 35156428 PMCID: PMC9024019 DOI: 10.1177/07334648211067710] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although older adults may experience health challenges requiring increased care, they often do not ask for help. This scoping review explores the factors associated with the help-seeking behaviors of older adults, and briefly discusses how minority ethnic populations can face additional challenges in help-seeking, due to factors such as language barriers and differing health beliefs. Guided by Arksey and O’Malley’s scoping review framework and the Preferred Reporting Items for Systematic Reviews and Meta-AnalysesScoping Review guidelines, a systematic search of five databases was conducted. Using a qualitative meta-synthesis framework, emergent themes were identified. Data from 52 studies meeting inclusion criteria were organized into five themes: formal and informal supports, independence, symptom appraisal, accessibility and awareness, and language, alternative medicine and residency. Identifying how factors, including independence and symptom appraisal, relate to older adults’ help-seeking behaviors may provide insights into how this population can be supported to seek help more effectively.
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Affiliation(s)
- Kelly Teo
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Ryan Churchill
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Indira Riadi
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Lucy Kervin
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Andrew V Wister
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada.,Gerontology Research Centre, 416185Simon Fraser University, Vancouver, BC, Canada
| | - Theodore D Cosco
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada.,Oxford Institute of Population Ageing, 416185University of Oxford, Oxford, UK
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17
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All are equal, but some are more equal than others: social determinants of leisure time physical activity through the lens of intersectionality. BMC Public Health 2022; 22:36. [PMID: 34991542 PMCID: PMC8739989 DOI: 10.1186/s12889-021-12428-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background To date, no research has investigated social determinants of leisure time physical activity through the lens of intersectionality in a low- and middle-income country. Therefore, the aim of this study was to explore the intersectionality in leisure time physical activity in a nationwide sample of Brazilian adults. Methods Data from the Brazilian National Health Survey conducted in 2013 were analysed (N = 58,429). Prevalence of sufficient leisure time physical activity (150+ minutes per week in moderate-to-vigorous physical activity) was estimated according to gender, racial identity, education and income, and according to multiple combinations of these sociodemographic characteristics (i.e., multiple jeopardy index). Results The prevalence of sufficient leisure time physical activity was 22.9% (95%CI: 22.3 to 23.6). Overall, the prevalence of sufficient leisure time physical activity was highest among men, individuals with white skin colour, and among those in the highest group of education and income. Among men, white, with a university degree and in the highest quartile of income (3% of the population), the prevalence of sufficient leisure time physical activity was 48%. Among non-white women with low education and low income (8.1% of the population), the prevalence of sufficient leisure time physical activity was 9.8%. Conclusion Informed by the theory of intersectionality, findings of this study have shown that intersections of gender, racial identity and socioeconomic position of the Brazilian society strongly influence leisure time physical activity at the individual level. Targeted interventions to increase leisure time physical activity should address the complexities of social status intersections.
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18
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Salami B, Denga B, Taylor R, Ajayi N, Jackson M, Asefaw M, Salma J. Access to mental health for Black youths in Alberta. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2021; 41:245-253. [PMID: 34549916 DOI: 10.24095/hpcdp.41.9.01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The objective of this study was to examine the barriers that influence access to and use of mental health services by Black youths in Alberta. METHODS We used a youth-led participatory action research (PAR) methodology within a youth empowerment model situated within intersectionality theory to understand access to health care for both Canadian-born and immigrant Black youth in Alberta. The research project was co-led by an advisory committee consisting of 10 youths who provided advice and tangible support to the research. Seven members of the advisory committee also collected data, co-facilitated conversation cafés, analyzed data and helped in the dissemination activities. We conducted in-depth individual interviews and held four conversation café-style focus groups with a total of 129 youth. During the conversation cafés, the youths took the lead in identifying issues of concern and in explaining the impact of these issues on their lives. Through rigorous data coding and thematic analysis as well as reflexivity and member checking we ensured our empirical findings were trustworthy. RESULTS Our findings highlight key barriers that can limit access to and utilization of mental health services by Black youth, including a lack of cultural inclusion and safety, a lack of knowledge/information on mental health services, the cost of mental health services, geographical barriers, stigma and judgmentalism, and limits of resilience. CONCLUSION Findings confirm diverse/intersecting barriers that collectively perpetuate disproportional access to and uptake of mental health services by Black youths. The results of this study suggest health policy and practice stakeholders should consider the following recommendations to break down barriers: diversify the mental health service workforce; increase the availability and quality of mental health services in Black-dominated neighbourhoods; and embed anti-racist practices and intercultural competencies in mental health service delivery.
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Affiliation(s)
- Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Benjamin Denga
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Robyn Taylor
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nife Ajayi
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Margot Jackson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Msgana Asefaw
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jordana Salma
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Gajaria A, Guzder J, Rasasingham R. What's race got to do with it? A proposed framework to address racism's impacts on child and adolescent mental health in Canada. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2021; 30:131-137. [PMID: 33953765 PMCID: PMC8056965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
This commentary responds to current events that have highlighted the ways that systemic racism affects a wide variety of health outcomes. We specifically discuss how systemic racism adversely affects the mental health of children and adolescents in a Canadian context and use a structural framework to demonstrate how race is embedded in various Canadian systems and thus affects child and adolescent mental health in both conscious and unconscious ways throughout the lifespan. Experiences of systemic racism affect the mental health of Canadian young people in multiple complex and intersecting ways including access to care, experience of mental health services, and outcomes of care. We currently lack a national best practice framework for mental health professionals that unifies approaches to research, education, and clinical care for young racialized Canadians; in addition, concerted efforts to collect race-based data are lacking. We suggest that a blueprint for improved services for racialized young people in Canada would include: Development of a funded and sustainable research agenda responsive to community expertise, development and implementation of a Canadian Child and Adolescent task force focused on educational strategies on racism and service provision at both the postgraduate and continuing professional development (CPD) levels, and consideration of clinical parameters that improve access to, and experience of, care for Canadian racialized youth.
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Affiliation(s)
- Amy Gajaria
- Staff Psychiatrist, Centre for Addiction and Mental Health (CAMH), Assistant Professor, Department of Psychiatry, University of Toronto, Clinician Scientist, Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Toronto, Ontario
| | - Jaswant Guzder
- Professor, McGill University Department of Psychiatry, Division of Social and Cultural Psychiatry, Division of Child Psychiatry, Institute of Community and Family Psychiatry, Montreal, Quebec
| | - Raj Rasasingham
- Director of Continuing Professional and Practice Development, Department of Psychiatry, University of Toronto, Director of Post-Graduate Education, Psychiatry, Humber River Hospital, University of Toronto, Clinical Head, Outpatient Child and Youth, Humber River Hospital, University of Toronto, Section Head, Global Psychiatry, Canadian Academy of Child and Adolescent Psychiatry., Toronto, Ontario
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20
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Okoye HU, Saewyc E. Fifteen-year trends in self-reported racism and link with health and well-being of African Canadian adolescents: a secondary data analysis. Int J Equity Health 2021; 20:108. [PMID: 33902594 PMCID: PMC8077748 DOI: 10.1186/s12939-021-01446-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/12/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND We assessed the prevalence and trends in racial discrimination among African Canadian adolescents in British Columbia. The association between racial discrimination and self-rated health, access to mental health services, substance use, suicidal thoughts and attempts, experience of extreme stress, among others were examined within the 2018 dataset. METHODS Secondary analysis used the data collected from African Canadian adolescents (n = 2448) as part of the British Columbia Adolescent Health Surveys (2003-2018). We examined whether racial discrimination increased, decreased, or remained stable over time. We evaluated experiences of racial discrimination for all adolescents, and then disaggregated analyses for boys, girls, immigrant, and Canadian-born African adolescents. We used Rao-Scott's adjusted chi-square to test differences in racial discrimination and adjusted logistic regressions to test trends across survey years, widening or narrowing gaps in racial discrimination, as well as the link to health outcomes. RESULTS Racial discrimination was significantly different across the survey years (Adjusted F = 4.60, p < .01), with the highest percentage of adolescents reporting past year racial discrimination in 2018 (29.9%) and the lowest percentage in 2013 (21.3%). Girls and immigrant African Canadian adolescents were more likely to have experienced racial discrimination. However, girls and Canadian-born adolescents had the highest odds of reporting racial discrimination in 2018 compared to 2003, AOR = 1.85, and 1.58, respectively. The findings reveal significant differences in the experiences of racial discrimination for boys and girls, as well as for immigrant and Canadian-born African adolescents. Significant differences were noted in the link between racial discrimination and self-rated health and engaging in behaviours that might expose them to health risks. The worst negative health outcomes were found for boys and immigrant African Canadian adolescents. CONCLUSION The study suggests that more than 1 in 4 African Canadian adolescents in British Columbia report racial discrimination, which is an increasing trend in recent years. Those who reported racial discrimination also had the worst adverse health outcomes. There is a need for more public health action to reduce racism, create awareness about the negative health impacts, and provide better support for African Canadian adolescents.
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Affiliation(s)
- Helen U Okoye
- University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada.
| | - Elizabeth Saewyc
- University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
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Teo K, Churchill R, Riadi I, Kervin L, Cosco T. Help-seeking behaviours among older adults: a scoping review protocol. BMJ Open 2021; 11:e043554. [PMID: 33593783 PMCID: PMC7888354 DOI: 10.1136/bmjopen-2020-043554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/14/2021] [Accepted: 02/02/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Despite evidence that illustrates the unmet healthcare needs of older adults, there is limited research examining their help-seeking behaviour, of which direct intervention can improve patient outcomes. Research in this area conducted with a focus on ethnic minority older adults is also needed, as their help-seeking behaviours may be influenced by various cultural factors. This scoping review aims to explore the global literature on the factors associated with help-seeking behaviours of older adults and how cultural values and backgrounds may impact ethnic minority older adults' help-seeking behaviours in different ways. METHODS AND ANALYSIS The scoping review process will be guided by the methodology framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched from January 2005 onwards: MEDLINE/PubMed, Web of Science, PsycINFO, CINAHL and Scopus. Studies of various designs and methodologies consisting of older adults aged 65 years or older, who are exhibiting help-seeking behaviours for the purpose of remedying a physical or mental health challenge, will be considered for inclusion. Two reviewers will screen full texts and chart data. The results of this scoping review will be summarised quantitatively through numerical counts and qualitatively through a narrative synthesis. ETHICS AND DISSEMINATION As this is a scoping review of published literature, ethics approval is not required. Results will be disseminated through publication in a peer-reviewed journal. DISCUSSION This scoping review will synthesise the current literature related to the help-seeking behaviours of older adults and ethnic minority older adults. It will identify current gaps in research and potential ways to move forward in developing or implementing strategies that support the various health needs of the diverse older adult population. REGISTRATION This scoping review protocol has been registered with the Open Science Framework (https://osf.io/69kmx).
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Affiliation(s)
- Kelly Teo
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Ryan Churchill
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Indira Riadi
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Lucy Kervin
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Theodore Cosco
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
- Oxford Institute of Population Ageing, University of Oxford, Oxford, Oxfordshire, UK
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Mejia-Lancheros C, Lachaud J, O’Campo P, Wiens K, Nisenbaum R, Wang R, Hwang SW, Stergiopoulos V. Trajectories and mental health-related predictors of perceived discrimination and stigma among homeless adults with mental illness. PLoS One 2020; 15:e0229385. [PMID: 32106225 PMCID: PMC7046214 DOI: 10.1371/journal.pone.0229385] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 02/04/2020] [Indexed: 12/27/2022] Open
Abstract
Stigma and discrimination toward individuals experiencing homelessness and mental disorders remain pervasive across societies. However, there are few longitudinal studies of stigma and discrimination among homeless adults with mental illness. This study aimed to identify the two-year group trajectories of stigma and discrimination and examine the predictive role of mental health characteristics among 414 homeless adults with mental illness participating in the extended follow-up phase of the Toronto At Home/Chez Soi (AH/CS) randomized trial site. Mental health-related perceived stigma and discrimination were measured at baseline, one, and two years using validated scales. Group-based-trajectory modelling was used to identify stigma and discrimination group trajectory memberships and the effect of the Housing First treatment (rent supplements and mental health support services) vs treatment as usual on these trajectories. The associations between mental health-related characteristics and trajectory group memberships were also assessed using multinomial logistic regression. Over two-years, three group trajectories of stigma and discrimination were identified. For discrimination, participants followed a low, moderate, or increasingly high discrimination group trajectory, while for stigma, participants followed a low, moderate or high stigma group trajectory. The Housing First treatment had no significant effect on discrimination or stigma trajectories groups. For the discrimination trajectories, major depressive episode, mood disorder with psychotic features, alcohol abuse, suicidality, severity of mental health symptoms, and substance use severity in the previous year were predictors of moderate and increasingly high discrimination trajectories. History of discrimination within healthcare setting was also positively associated with following a moderate or high discrimination trajectory. For the stigma trajectories, substance dependence, high mental health symptoms severity, substance use severity, and discrimination experiences within healthcare settings were the main predictors for the moderate trajectory group; while substance dependence, suicidality, mental health symptom severity, substance use severity and discrimination experiences within health care setting were also positive predictors for the high stigma trajectory group. Ethno-racial status modified the association between having a major depression episode, alcohol dependence, and the likelihood of being a member of the high stigma trajectory group. This study showed that adults experiencing mental illness and homelessness followed distinct stigma and discrimination group trajectories based on their mental health-problems. There is an urgent need to increase focus on strategies and policies to reduce stigma and discrimination in this population.
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Affiliation(s)
- Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - James Lachaud
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Patricia O’Campo
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kathryn Wiens
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Applied Health Research Centre, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Ri Wang
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Stephen W. Hwang
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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