To lead a healthy life, access to culturally safe and effective mental health services is essential. However, for Black youth seeking support, there are often barriers to accessing this care. Barriers could be geographic or financial, and include anti-Black racism and a lack of cultural competency among clinicians supporting Black patients from diverse backgrounds.
“Black youth seeking care can often experience anti-Black racism and discrimination from the front desk through to seeing their clinician. The reality is that the frequent experiences of discrimination these youth face can lead to racial trauma and that can be the underlying factor for mental health distress and depression. If a clinician does not understand the complexities of how anti-Black racism functions in society, and how it affects young people, it becomes difficult for a patient to receive the care they need,” said Paul Bailey, Executive Director of the Black Health Alliance.
The Substance Abuse Program for African Canadian and Caribbean Youth (SAPACCY) at CAMH is addressing these gaps by providing accessible, Africentric and racial trauma-informed support to Black youth who are dealing with mental health and substance use concerns.
“SAPACCY was created in Toronto during the mid-1990s to address a clear gap in services for the Black community. The program has always been community-oriented, even after it became a part of CAMH in 1999, working closely with Black grassroots organizations to address health disparities,” said David Grant, Social Worker at SAPACCY. “As a clinician within SAPACCY, we are acutely aware of the social and cultural issues that are affecting youth on the ground.”
SAPACCY provides a wide range of services and supports to Black youth, offering assessment, individual and group treatment, and counselling to assist youth in reducing harm and making the best choices for themselves and their families on the path to recovery. For decades, the SAPACCY program has experienced positive results due to its commitment to being a collaborative effort with Black youth, their families and the community based on principles of Africentric and racial trauma-informed care.
“I’ve worked with street-involved youth who are engaged in gang activity and sex work, so it’s important that they feel like they can speak candidly about these complex circumstances with a clinician who is already knowledgeable about the nuances of these phenomena,” explained David.
“I remember working with a young man who struggled with drug abuse and other symptoms related to PTSD including paranoia and anxiety related to his traumatic upbringing and numerous encounters with gun violence. At the beginning of our first session, he presented quite guarded and spoke minimally about his experiences, but as he began to feel comfortable with me, he broke down crying to the point that I needed to console him as he divulged his traumatic experiences. He said that it was the first time he felt safe enough to openly and authentically express himself, and receive support from a professional from his community who understands him and his experiences. Following that session, he attended therapy sessions regularly and was actively engaged in the sessions as we worked through his trauma.”
Between 2016 and 2020, patient visits to this program doubled despite remaining a small team. Over the last five years, CAMH and community partners, including the Wellesley Institute and Black Health Alliance, have advocated for access to services for Black youth by building a network of community based services across Ontario built on the SAPACCY model.
In November 2021, good news finally arrived. The Black Health Alliance supported by the Office of Health Equity at CAMH and CAMH clinical leadership secured annual funding of $2.9 million to build a SAPACCY network. In addition to an increase in staffing for SAPACCY at CAMH, seven new community services inspired by SAPPACCY will be created in community organizations.
“Health inequities are avoidable differences in health between populations and are not fair or just. That’s why we undertook extensive consultations with CAMH leadership, grassroots organizations and the communities we serve to present a plan to the provincial government that would see new, predictable, and stable funding allocated to SAPACCY,” said Dr. Kwame McKenzie, Director of Health Equity at CAMH and the CEO of the Wellesley Institute.
In addition to adding new community satellite locations in Toronto, Peel, Hamilton, Ottawa and Windsor, this expansion will also allow SAPACCY to grow its program levels and deliver these important services to more youth.
“The recent funding announcement and expansion of satellite locations is a huge step in the right direction and shows young people that we are taking their mental health seriously. SAPACCY serves as a bridge to these communities by responding to the immediate needs of youth without placing them on waitlists. These youth are often in crisis by the time they reach out—so waiting for support is not an option,” said Nicole Waldron, a mental health advocate who has been pushing for the expansion of SAPACCY. “This is an opportunity to build a program that is robust, sustainable and equitable. That means ensuring that additional resources and supports are available to respond to the needs of youth throughout the growing list of communities that SAPACCY serves.”
Systemic anti-Black racism is a barrier for Black patients and their families seeking care—at CAMH and across the health care system. The expansion of SAPACCY represents just one of the ways CAMH is working with Black communities to dismantle anti-Black racism at the hospital and more broadly.
“We’re doing the important work within CAMH to address the calls to action outlined in our Dismantling Anti-Black Racism strategy to push for real and meaningful change,” said Dr. McKenzie. “As a starting point, we are having difficult, but necessary, conversations with those who have experienced racism and discrimination at CAMH. While we have a long way to go, I’m heartened by the progress that CAMH is making towards addressing and dismantling systemic anti-Black racism within the organization.”