By Dr. CHRISTOPHER J. MORGAN
Drug addition, violence, trauma, incarceration, homelessness, poverty, social isolation, anger, fear and suicide. These are the various realities of many people around us. Many are young people with undiagnosed, untreated mental illness.
Mental illness is no stranger to the Black community, in fact there is growing evidence that it is at dangerously high levels. Barriers such as stigma, misconceptions about mental illness, lack of access or delayed access to appropriate mental health services and mistrust in mainstream services are some of the factors that fuel the growth of this public health problem.
In November 2015, the Black Health Alliance (BHA) organized the forum, “A Sound Mind: Mental Health in the Black Community”. Powerful testimonials reminded us how easily any one of us could find ourselves struggling with a mental illness and how deep and long-lasting the impact can be. Yet there was also a strong message of hope that with support we can cope with, recover, heal and go on to help others as many are now doing.
For Mental Health Week, May 2-8, the BHA will be featuring on its Black Health Matters page videos, articles and tweets all related to mental health on its website (blackhealthalliance.ca), Twitter and Facebook platforms. The videos will include sections of “A Sound Mind: Mental Health in the Black Community”, including the keynote address from Dr. Kwame McKenzie, “State of Mental Health in the Black Community” and the BHA 2015 Annual General Meeting which features an address by Nene Kwasi Kafele titled “Mental Wellbeing and African Canadians: Crisis, Resilience, and Opportunities for Change”.
Currently BHA is creating a database of organizations and mental health professionals that serve our diverse Black communities – because knowing where to find help is often the first step. If you are a mental health provider or know a health professional or organization that should be a part of this database, contact BHA at 647-367-6656 or email firstname.lastname@example.org.
Today we will shine a spotlight on one such program and individual, the Substance Abuse Program for African Canadian and Caribbean Youth and long-time social worker, Donna Alexander.
Donna graduated from the University of Toronto in 2005 with a Master of Social Work specialization in concurrent disorders. She previously worked in correctional services and residential treatment service before transitioning to the Substance Abuse Program for African Canadian & Caribbean Youth (SAPACCY) program in 2006. Donna is the vice president of the Black Health Alliance and is also serving on the Community Advisory Committee for the Children’s Aid Society. She lectures on treatment related issues at colleges and universities as well as provide training to staff at community based agencies as part of Centre for Addiction and Mental Health (CAMH) efforts to engage with the community.
Tell us the history of SAPACCY, how did it start and why?
The Substance Abuse Program for African Canadian and Caribbean Youth (SAPACCY) is one program in the Child, Youth & Family Program Department at the CAMH. SAPACCY was implemented in 1997 to address the needs of Black youth who were overrepresented in the criminal justice system. Most of these youth were mentally ill or substance dependent but they were not accessing treatment and support and were being recycled through the system. SAPACCY’s mandate was to provide effective intervention and support that was life affirming and would promote a more pro-social future for these young people.
What services does SAPACCY provide?
SAPACCY provides comprehensive assessments, treatment planning, individual and family counseling, case management and referrals to other services in CAMH as well as to staff psychiatrists for diagnosis and treatment. The program is structured to make it easier to engage with clients so a significant part of the work takes place in the community through home visits and visits to detention centres and shelters if necessary.
Is the need for programs such as SAPACCY as urgent today as it was almost 20 years ago?
It is more urgent. This population is extremely vulnerable and is significantly underserved. Most of the clients that are served in this program are living with serious mental illness and substance dependence and the effects of complex trauma. They have experienced death, violence, loss and overall oppression from the various systems at a level that no one should ever have to experience. Most of them have little social or familial support and just meeting the basic needs for food and shelter is a major challenge for them.
They are however very difficult to engage with because of a lack of trust in mainstream service providers and organizations who they believe do not understand the realities of their lives. In order to provide effective services to these clients it is beneficial to possess lived experiences, to understand the importance of cultural safety and have insight into the unwritten codes and the cultural norms and mores that is crucial to service delivery. Programs such as SAPACCY are able to do this and to obtain the desired outcomes.
This is your tenth year at SAPACCY, what motivates you?
Working in this program is a labour of love for me. I am very privileged to be able to work with these youth and support their recovery. I see the potential for a better future for each client that I work with and it is my role to work with them in a manner that will facilitate the transition to a better life.
Could you share with us a challenging story or time and a rewarding one?
Due to the complexities involved in providing services for clients that are concurrently disordered it is often very challenging. I recall a client that I was working with that I was trying to have admitted to the inpatient unit for more acute care but she was arrested and charged with attempted murder before I was able to have her admitted.
The social worker from the prison contacted me and requested that I visit her because she was trying to take her life. I remember shaking behind the wheel on the way there because I was caught in a major storm and visibility was so poor but my role was to go and convince her to live until the trial which I did and the charges was eventually withdrawn and she was released.
What public health policy recommendations would you make regarding how we could better address mental health and addictions for Black (African or Caribbean descent) youth?
Unfortunately Black Canadians, who are the third-largest visible minority group in Canada, experience worse health outcomes and are less likely to use health care services than other groups. Furthermore, social factors including poverty, unemployment, racism and discrimination increase the likelihood of Black people being impacted by mental illness.
So the issue is the need for more equitable services to reduce the disparities in health outcomes among youth of African descent because mental illness greatly increases one’s vulnerability. Based on this need, I would support the implementation of a Black Health Strategy with a focus on reducing the differences in health outcomes for Black people.
This strategy would include culturally safe clinical treatment, education, training and promotion on how to better engage a group of people that are underserved but whose fear and past negative experiences of the health care system constitute a major barrier to accessing services.
Next week (May 2-8) is Mental Health Week in Canada. What message or call to action would you like to communicate to the community and/or decision makers?
My message is that we tend to take our mental health for granted but it is the most important thing in our life. It does not matter how much money we have, how good we look, or how good our prospects and social position are. If we are not mentally healthy nothing else matters. Untreated mental illness affects our ability to care for our physical selves so our lifespan is shortened. We need to do more to promote mental wellness in the allocation of resources. Wait times for treatment is often too long and services are too fragmented.
Thank you Donna for the excellent work you do, the passion you do it with and advocating for our youth and programs such as SAPACCY which are so urgently needed in our community. Next week we will hear firsthand from a young person who was helped through the SAPACCY program.
Dr. Christopher J. Morgan is the director of Morgan Chiropractic & Wellness, an interdisciplinary health centre in Toronto; the founder and former president of the Black Health Alliance, a network of community organizations, health professionals and community members working in partnership to advance the health and well-being of the Black community. He can be reached at 416-447-7600 or email@example.com.