Lesley Fraser says she lost eight months of her life after suffering a serious concussion from being struck by a ball in gym class at work.
The injury left Fraser, an education program assistant in Nova Scotia, with debilitating headaches, and she fell into the depths of depression.
“I was listless, I didn’t have any energy, I didn’t want to go out. The thought of even showering was exhausting,” Fraser told White Coat, Black Art’s host Dr. Brian Goldman.
In the broader health-care system, Fraser says she likely would not have been taken seriously because her symptoms would not have been viewed “as an emergency.”
“Unless, you know, God forbid — which I didn’t go there — wanted to commit suicide, is literally what I would have to do for the medical community to help me.”
The number of mental health challenges faced by Black women in Canada is growing steadily, clinicians say, as recent data and front-line experience point to persistent gaps in care that’s caused by racism, inequality and limited access to culturally safe services.
In a recent health survey of 1,966 Black women, girls and gender non-conforming people nationwide, 76.6 per cent said they felt “unheard or disbelieved” by health-care providers when accessing services. The data was published last November in a report by the Toronto-based advocacy group Black Women’s Institute for Health (BWIH).
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The minimization or dismissal of Black women’s mental health symptoms in the health-care system is rooted in racist and historical narratives, says Roberta Timothy, an associate professor at the Dalla Lana School of Public Health at the University of Toronto.
To legitimize the enslavement of Black women, white colonial systems disseminated the trope of the “strong Black woman,” framing Black women as inherently resilient and suited for forced, “really hard” labour, she said.
“If you are strong [like] an ox and you don’t break … that means we don’t have to see you, right,” said Timothy.
“You don’t suffer, you’re not in pain … we were not considered human.”
She says those harmful tropes continue to shape how Black women are perceived and treated in health care today.
“We’re [thought to be able to] take anything on and still survive, which means that we don’t have any mental health stresses,” said Timothy. “There’s no room for that kind of softness within our life.”
Mental health, in the same report, was found to be the most commonly diagnosed chronic condition among Black women in Canada, affecting 15.8 per cent of respondents.
Self-harm ideation was reported by 27.4 per cent of respondents. That is more than six times the 2021 national average of suicide ideation at 4.2 per cent, according to Statistics Canada.
But having access to culturally relevant care can make a critical difference.
The Nova Scotia Sisterhood in Dartmouth, N.S., is a primary care program that’s dedicated to serving Black women and gender-diverse individuals, says Crystal John, a clinical therapist at the practice.
“My current caseload is quite full … and those numbers are consistently growing.” She says she sees about 15 clients each week and has a waitlist of 40 people with referrals coming in on a regular basis.
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John says she takes a trauma-informed approach to her therapy, which looks at how traumatic events impact all facets of a person. The mental health issues experienced by Black women, she says, can often stem from overlapping pressures, including workplace racism, exposure to violence in the home, grief, or wider community trauma.
For example, John says many of her clients talk about being heavily scrutinized at work with heavy oversight, higher expectations, and more discipline than others.
That kind of pressure can lead to “burnout and emotional fatigue” — especially in workplaces where they may be one of only a few Black employees and don’t always feel safe speaking up, she says.
“I think the reason we’re seeing the increase in numbers [at our clinic] is because it’s spreading word of mouth that there is a safe space that you can come to,” said John.
For Fraser, who sought care at Nova Scotia Sisterhood after describing feeling exhausted and unable to leave the house, she says a nurse practitioner immediately discussed medication options and quickly determined the best fit for her, with no wait times.
“I feel comfortable coming here and seeing someone that looks like me and asking all the right questions,” she said.
John says she hopes more support will be put in place to encourage and guide Black children into fields where they are significantly underrepresented — such as medicine and teaching — because real change is about more than just hiring “one more Black clinician.”
For Timothy, that work includes training practitioners to take an anti-oppression approach to care for Black women — including in psychotherapy — that centres the impact of anti-Black violence on mental health and community well-being.
Team transforming health care for African Nova Scotian women
But she says training on its own isn’t enough. Timothy says the report’s findings need to be turned into real, long-term programs with sustained funding behind them.
That, she says, means more free or affordable mental-health care, and more spaces where Black people can access support from providers who understand their lived experiences.
In 2018, the federal government dedicated $19 million over five years to support mental wellness in Black communities. The funding has since evolved into several initiatives, including the Mental Health of Black Canadians Fund (MHBC), which supports Black-led, community-based projects that promote mental health.
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John says taking action won’t just help Black women, it’ll impact every person in the country.
“We have to keep it moving if we are going to ensure that all Canadians are healthy, because when you miss a big portion of one specific group, it doesn’t bode well for all Canadians,” she said.
“We are all in this big melting pot, and as we all do better, the whole country is better.”
