Barriers and Facilitators to Accessing Mental Healthcare in Canada for Black Youth: A Scoping Review

Abstract

AbstractThere is evidence to suggest that Black children and youth in Canada face disproportionate challenges in accessing mental healthcare. Thus, the objective of this scoping review was to map current literature on the barriers and facilitators to care for Black youth in Canada. Both academic articles and gray literature published between January 2005 until May 2019 were reviewed. Six databases were searched for relevant academic articles: CINAHL, PsycINFO, PubMed, EBSCOhost, Social Science Citation Index, and Applied Social Sciences Index & Abstracts. Gray literature was sourced from community recommendations and Google. Thirty-three (33) sources met the inclusion criteria. Data were coded and analyzed using a thematic analysis framework. Barriers to care for Black youth were identified and occurred at multiple levels of society including systemic (i.e., wait times, poor access to practitioners, geographical challenges and financial barriers to care), practitioner-related (i.e., racism and discrimination from providers, the inability to provide culturally competent care and a lack of organizational support) and personal and community-related barriers (i.e., internalized stigma and stigma from community). Support from family and friends, as well as a good relationship with providers, were noted as facilitators. The findings of this review suggest that Black children and youth face many barriers to accessing the Canadian mental healthcare system despite its purported universality. An increase in funding, expansion of the universal healthcare system to include mental health, and concerted effort on delivering culturally competent care are requisite to facilitate access to care for this population. Further research should focus on Black youth, be rooted in community-based research, and explore intersecting identities in the context of mental illness.