by Louise Boileau
A friend went to a youth shelter when it was cold. He was in distress, having a mental health crisis. He was told firmly to leave, or else they would call the police.
In July 2015, police arrived at subsidized housing unit at Eglinton West and Gilbert
The question has come to my mind helplessly many times: Where does a Black person in a mental health crisis go when they need help?
Left Illustration by Eli WiPe
There is no safe place to go in this city when experiencing crisis where a black person will not be treated as a threat; including in one’s own home, be that a shelter or a private residence. It is a tired fact, and one that requires urgent attention, that Black youth are treated as problem in Toronto, on many institutional levels.
If reproductive justice is the ability to raise children in a community that is free from violence, it must also encompass mental health, and our ability to receive culturally relevant supports without being isolated or removed from the community, whether it be by child welfare, push out from school, incarceration or institutionalization.
In the school system, Black youth experiencing anxiety, depression and trauma (which can manifest in many ways), are often summarized as having behavioural issues and are discarded. Expulsions as early as grade one show the incredible reach of anti-Blackness – that a child could be considered not worthy of an education and so lacking in hope for their potential that they should be isolated from their peers and “expelled” from opportunity. The treatment of Black students, and the problematization of Blackness at early ages is consistent with Black overrepresentation in the criminal system.
Although Black communities represent 3% of the general population in Canada, we represent 9% of the prison population. People with mental health challenges are overwhelmingly filtered into the prison system. So, the chances of a Black person with mental health challenges spending timae in prison at some point in their life is extremely high. Furthermore, mental health challenges such as psychosis and paranoia are so extremely stigmatized, those who experience these symptoms are ostracized and isolated especially when they are most in need of support.
A Punitive Model Across the Board
When you begin to look at the methods of management in the education system, prison and hospital systems, the approach to Black students, youth and adults are very coordinated.
It seems that each uses a punitive approach to trauma, where Black people are being punished, ostracized and further traumatized for needing support, expressing anxiety, depression or distress, even though we are experiencing some of these things as a direct result of the hostile environment we are in.
In psychiatric hospitals in Ontario, there seems to be a chronic issue of overuse of force and restraints. On paper, restraints are meant to be used as a last resort measure. For those who are unfamiliar, to place someone in restraints is to secure them to a bed using straps. First, however, the person is forcibly sedated, sometimes by as many as 8 people (as a friend recounted), and then have their pants brought down so that they can be injected with a sedative in the buttocks. Then they are transported to a bed, and secured with the restraints for an unspecified period of time. A friend recounts being placed back in restraints whenever a nurse who didn’t like them would come back on shift. When she left her shift, they would be released. This is against standard protocol which dictates that restraints are to be used only in extreme situations, where staff either fear the “patient” will harm themselves or somebody else. So their discretion on using restraints lies on their perception of whether or not the “patient” is a threat. It is unreasonable to assume that anti-Blackness never plays a role in their decisions.
Placing a person in isolation is another approach, on paper, used to maintain “patient” or worker safety. However, I have also known it to be used in reaction to something a “worker didn’t like” about a patient, where the patient was then placed in isolation for a period of weeks, and was disallowed from contacting family or advocates. The use of isolation has drastic negative mental health impacts on any person, as has been documented in relation to the use of solitary confinement in prison and remand centres, where most of Canada’s imprisoned population are kept awaiting trial.
Remand facilities receive no resources or training in terms of caring for a person undergoing mental health challenges. Their primary go to, for the “safety” of the person imprisoned (the inmate), is to place them in solitary confinement. Furthermore, people are often denied their right to healthcare, medications or otherwise while in remand. The numbers and demographics of solitary confinement in Canada’s prisons and remand centres is not publicized, similar to the numbers and demographics of deaths inside both prisons and psychiatric institutions.
A Picture of The Mental Health System in Ontario
The mental health system in Ontario is a network of services and institutions, that follow two models intended to work together. The first is the the community based model which is meant to allow people access to support while staying within their communities. and The second is the institutional or medical model, which includes both inpatient and outpatient programs such as CAMH. The community model of mental health services is relatively new and certainly not perfect. Many services are rarely accessed by youth of colour, or and present services are often not culturally relevant.
Only two services in Toronto, that I am aware of, provide services focused on racialized people, and there is only one that provides counselling specifically for Black people in all of Canada. Across Boundaries, and The Substance Abuse Program for African Canadian and Caribbean Youth (SAPACCY) which runs as a program out of CAMH.
The SAPACCY program began in 1996 from community concerns over the amount of Black youth incarcerated for drug related crimes. It was proposed to the ministry and then amalgamated into the CAMH Queen and Shaw location. The SAPACCY program, due to lack of allocated resources is currently hanging on by a thread with only one counsellor with an unusually large caseload, and an even larger waitlist. The waitlist includes only those people who qualified for the services because they are in the catchment area. CAMH recently received a donation of $100 million. It appears they are determined to allocate these funds entirely towards “high-risk” research and the hiring of “top scientists,” in the midst of our current housing and resource crisis. What they intend to research, and how this is suppose to help anyone, I am unsure.
Toronto Police Services & The Mental Health System
The mental health system in Ontario maintains a tight relationship with Toronto Police Services (TPS). The Mobile Crisis Intervention Team (MCIT), which is intended to respond to mental health crisis, is a partnership between Toronto Police Services and participating hospitals. The team is a mental health nurse and a police officer (who may or may not be trained by the TPS in mental health awareness). To what extent they receive any training on de-escalation is entirely unclear. The Mobile Crisis team is only available between the hours of 6am and 11pm. TPS is usually the first point of contact for people undergoing mental health crisis. Police officers may bring the detained person to a hospital, where they will be kept for anywhere from an hour to several weeks if admitted. Or they may be charged with an offence and placed in remand.
To call the police in the case of a crisis, is to risk the death of yourself, your family member or friend. But this is the only option presented in a mental health related emergency. Even if a person calls the MCIT, they are still calling the police. There is little assurance that this is in anyway a safer option. At the many times I have made a list in my head of the greatest risk to my family members’ life, police interactions was always the one I feared most.
The only route made available to access mental health care in crisis is the trauma of police services, and the trauma of psychiatric institutionalization. If we must cope with the pain inflicted on us by those systems that we are asked to call supports than we have very few options at all within the current structure of mental health care.
Community-Led & Self Determined Futures
Because of shame and exhaustion it is often difficult to seek out community or support services. Although we must teach ourselves how to navigate systems and how to survive, there is little space to share these tools with each other.
Intercepting the Pipeline to Prison is a project, lead by Black youth, to address the intersection of mental health, anti-Blackness and criminalization. It is a project created to share survival skills and strategies and to document our experiences. We have developed workshops in three streams: Youth Justice and Advocacy, Family and Community and Creative Solutions. The workshops provide skill building on safety tools for interactions with police, getting access to advocates while in remand, daily self care and coping methods, discussing mental health in our families, the ways we do support and advocate in our families and communities and how to strengthen them, and designing the kind of supports that we would like to see gain funding. In these community conversations we will have the opportunity to pool our knowledge and skills and create take-away resources for each other. The workshops are written from a lived experience perspective, with supports from our organizational mentors such as Legal Swipe. The Project also includes a short documentary interviewing Black youth on their experiences surviving, accessing services, living and creating.
We are creating spaces where we are able to talk about things we have never felt safe bringing up in mental health care spaces, institutional or otherwise: Anti-Blackness as we see and feel it in the mental health system, Caribbean perspectives on mental health, spiritual affliction, “pray it away” and stigma in the Church, spiritual or religious supports that we need, how the option of medication can be complicated by medical trauma, self-determination and the need for supports where people look you in the eye and understand you beyond the idea that you are an impossible problem.
We believe it is within the community; friends, family, partners and chosen family that long-term support for mental health come from. And any service or support that a person seeks along the way should strengthen their chosen support circle.
There are many directions to work in and issues to tackle; prison reform and abolition, deinstitutionalization, and the creation of Black focused mental health supports that strengthen the community. There are conversations and actions happening now in regards to Anti-Blackness in the Peel Board lead by community, the scrapping of the SRO program (s/o to the many people who worked tirelessly for that), the Black Youth Action Plan, and the 10 year health accord that will see $1.9 billion allocated to mental health initiatives in Ontario over the next decade.
It is a very important time to document our experiences, demand resources, and lead solutions as we connect the conversations on Anti-Blackness to mental health and the criminal system.
If you are interested in getting involved in the project as a youth, mentor, interviewee, creative collaborator, researcher etc., or you have questions or comments, please feel free to get in touch by email at firstname.lastname@example.org or by phone at 647-207-9376. We are also interested in Indigenous community collaboration on the project.
Lou Boileau is a mental health advocate and writer of creative non-fiction and short stories. She works in the areas of youth work and food justice. She is based out of Tkaronto. Her work in mental health and advocacy is from lived experience, and family support caregiving.
Mia Ohki is a Metis Japanese-Canadian artist, born in Connecticut, USA, and raised in Alberta, Canada. She presently lives and works between Edmonton and Calgary, AB. Mia primarily illustrates with