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Anti-racist mental health glossary
Racial trauma
Racial trauma, according to Comas-Díaz et al. (2019), refers to race-related stress that people of color and indigenous people (POCI) may experience when they experience or witness real or perceived events of racial discrimination. This trauma is the consequence of a long history of oppression and marginalization experienced by racialized people, which explains its transgenerational nature. It manifests itself in hypervigilance, social anxiety, insomnia, as well as overt or latent distrust of non-racialized people and the institutions that maintain the dominant social order. Daily microaggressions, racial profiling, and institutional barriers (in education, health, etc.) can, according to several studies, lead to racial post-traumatic stress. Examples of racial trauma have been studied in the Canadian education system, where Black students are often perceived as less gifted and, consequently, steered toward non-science majors.
According to studies, two real challenges stand in the way of healing racial trauma. On the one hand, the roots of racial wounds in a sociopolitical context and their continuing characteristics; on the other, current conceptions of trauma and traumatic stress, as well as treatment models, are rooted in European perspectives of care.
Cultural taboos related to mental health
Cultural taboos related to mental health are a set of preconceived ideas, implicit norms, and valued or prohibited behaviors related to mental health in a given social context. These representations influence how people perceive mental health and psychological suffering. Among the most widespread cultural taboos regarding the mental health of Black people are the association of depression with a sign of weakness, Black people do not suffer from depression, etc.
Mental health stigma
Although there has been a general effort to de-stigmatize mental health in Quebec, there are still several forms of stigma related to mental health, of which ethnocultural minorities, particularly Black people, are particularly affected. These are manifested by persistent prejudices (natural resilience, emotional strength, etc.), mistrust of services, minimization of psychological suffering, discrimination in access to care, and biased or erroneous mental health diagnoses. This stigma is rooted in a long history of systemic racism, marginalization, control, and dehumanization of the Black body. It contributes to the lack of access to care, ethnic isolation, and the internalization of suffering among Black people. For example, according to a Public Health Ontario report, Black people wait an average of 16 months to obtain mental health care, compared to 8 months for a white person. This situation results from the fear of being perceived as a personal failure, the lack of cultural competence, and the unconscious prejudices and biases of health professionals.
Intersectional oppression
Intersectional oppression is a particular form of oppression experienced by marginalized people because of their belonging to one or more minority social categories. The more a person is at the intersection of several minority groups (gender, race, sexual orientation), the more they risk experiencing intersecting discrimination that adds up and reinforces each other. Intersectional oppression can manifest itself through microaggressions, systemic discrimination, inequalities and social exclusions. A Black, lesbian woman with a disability risks experiencing racism, ableism, sexism and heterosexism that intersect and reinforce each other, creating a particular form of oppression that analyzing a single aspect of her identity would not allow us to grasp.
Racial microaggressions
Racial microaggressions are defined by Sue et al. (2007) as subtle and denigrating forms of aggression occurring during brief interpersonal interactions, intentionally or unintentionally, directed against racialized people because of their membership in a minority group. They can take the form of ambiguous compliments about skills, physical appearance, or hair (e.g., “You speak well for a Black person,” “You have beautiful long hair for a Black person,” “You have a small mouth for a Black person”), jokes or comments based on stereotypes or erroneous beliefs (e.g., “You can’t get a tattoo,” “You’re aggressive” when a Black person speaks confidently), or even awkward remarks such as, “Oh, you’re from such-and-such a country? It’s tough there. You’re happy here in Quebec City…”
According to research by Cary S. Kogan et al. (2022), racial microaggressions are associated with increased anxiety among Black people, due to their repetitive, insidious, and often trivialized nature.
Systemic or structural racism
Systemic or structural racism can be understood as a form of discrimination embedded in social and institutional structures, whether intentional or not, based specifically on grounds such as race, color, ethnic or national origin, religion, and language. The term was first coined in 1984 in Montreal, following a finding by the Human Rights Commission on the high level of discrimination against Quebecers of Haitian origin in the taxi industry. For many researchers, the overrepresentation of Black communities in child protection centers and prisons, the removal of Indigenous children from their families to be placed in residential schools, and the sexual, physical, and psychological abuse suffered by Indigenous women constitute tangible expressions of systemic racism in Quebec and Canadian society. In the context of mental health, this structural or systemic racism manifests itself in, among other things:
- Failure to consider cultural expression in understanding mental disorders,
- The lack of professionals from ethnocultural diversity,
- Overdiagnosis of disorders such as schizophrenia in Black populations
However, there is no consensus in Quebec on the existence of systemic racism, even though findings, reports, and scientific studies indicate that Quebec institutions have inherited historical racism linked to colonization and slavery.
Racial profiling
Racial profiling, according to the Quebec Black Communities Observatory, is a specific manifestation of racial discrimination associated with policing and security. It is defined by the Commission des Droits de la Personne et de la Jeunesse (CDPDJ) as: any action taken by one or more persons in a position of authority towards a person or group of persons for reasons of safety, security or public protection, which is based on factors of real or presumed belonging, such as race, color, ethnic or national origin or religion, without real grounds or reasonable suspicion, and which has the effect of exposing the person to different scrutiny or treatment. For example, the case of a person stopped in Montreal simply because they are Black and driving a BMW. Various studies show that Indigenous, Arab and Black people are more likely to be stopped than white people in the territories studied. Therefore, racial profiling fuels existing inter-ethnic tensions, because it affects not only the person arrested, incarcerated or accused but also their family and community due to its racist and discriminatory foundations.
Ethnocultural disparities
Ethnocultural disparities refer to a set of inequalities observed between different ethnocultural groups in various areas of social, economic, educational, and health life. Several ethnocultural disparities associated with the mental health of Black communities are identified by researchers and reports from organizations such as: a higher level of discrimination related to mental health, a low diagnosis of anxiety disorders among Black populations, etc. The Covid-19 pandemic has revealed certain ethnocultural disparities in Canada according to studies by Miconi and colleagues (2021). Black, Arab, and South Asian participants had a higher prevalence of Covid-19 compared to English-speaking participants, for example.
Distrust of the biomedical system
It refers to the feeling of embarrassment, hesitation, or reluctance to consult a health professional. This mistrust often stems from the fear of being misunderstood, judged, and/or receiving a diagnosis disconnected from personal experience and the culturally situated meaning of suffering. Some speeches illustrate this mistrust well: “they will think I’m crazy, won’t understand me, don’t have the same experience as us, they don’t care about our suffering…”.
Internalization of stigmas
It is the involuntary process by which a person or group comes to adopt and internalize negative social judgments stemming from discrimination and stigmatization. The internalization of these beliefs, experienced as true, influences the person’s behaviors, emotions, and self-image. Stigmas then become frames of reference from which the person or group perceives themselves and builds their relationships with others. For example, many Black people have internalized the idea that they are very resilient, which often pushes them to keep their suffering in silence.
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