In February 2021, CAMH launched Dismantling Anti-Black Racism, a landmark strategy that includes 22 actions to decrease anti-Black racism at CAMH by the end of fiscal year 2022/23. Across Ontario and at CAMH, oppression of and disadvantage against Black communities is evidenced by ongoing racial disparities in mental health and well-being. Specifically at CAMH, in 2020, data showed the rate of restraint use was significantly higher with Black patients compared with white patients. CAMH’s Dismantling Anti-Black Racism strategy, a key focus of the hospital-wide initiative Fair & Just CAMH, outlines a plan to accomplish the following:
- ensure safe, accessible and equitable care for Black patients and families;
- build an equitable working environment for Black staff; and,
- eliminate unfair treatment for Black populations within CAMH and across the mental health system.
This strategy was developed by CAMH’s Office of Health Equity and launched with the support of CAMH’s Board of Trustees, Executive Leadership Team and Anti-Black Racism and Mental Health Advisory Committee. It has been enthusiastically received by patients, their families, CAMH staff, physicians, volunteers and learners, and the broader health care system.
The work of dismantling anti-Black racism does not rest with only one area of our organization – it requires all facets of CAMH to be actively engaged to identify, address, and prevent implicit and explicit instances of anti-Black racism.
We would like to thank everybody who is taking part in the delivery of this important work, including the hundreds of people who have completed the Foundational Knowledge in Anti- Black Racism training, the clinical teams who are changing the way they deliver care and the committee members who are diligently assessing hospital-wide processes and policies with an equity lens. We especially recognize members of the Anti-Black Racism and Mental Health Advisory Committee for their dedication and partnership, and the Black health care leaders who have contributed to our learning along the way. This is One CAMH in action.
CAMH recognizes that accomplishing the 22 actions outlined in this strategy is only the beginning of a long journey for our organization. This strategy will continue to evolve and conversations are already taking place about the next iteration of this work, which will continue to include strong engagement with CAMH staff, patients, families, and our wider community.
We are happy to report that progress has been made on all 22 action items. Click here for a full list of actions.
Progress on Dismantling Anti-Black Racism as of the end of fiscal year 2021/22
RESULT 1: Care for Black patients and families that is safe, accessible and equitable (Actions 1-6)
Key Partners: Anti-Black Racism and Mental Health Advisory Committee, Black Health Alliance, clinical teams, Communications and Partnerships, Education, Empowerment Council, Patient and Family Advisors, Substance Abuse Program for African and Caribbean Canadian Youth (SAPACCY), Professional Practice Office, Provincial System Support Program (PSSP), Quality Improvement
- After years of advocacy, the Ontario government increased funding for SAPACCY. This funding is enhancing the program at CAMH and will build a SAPACCY network of seven community-based sites.
- The CAMH forensics team has adapted their care for Black patients. Based on 217 employees participating in an Equity-Based Response Training Program, forensic units have introduced new tools such as the Cultural Formulation Interview, Adverse Childhood Experience Tool, and Culturally-adapted CBT (CA-CBT) to support the provision of equitable care.
- CAMH is training staff in CA-CBT for Black populations. This cultural adaptation of CBT, developed by Dr. Akwatu Khenti, Dr. Kwame McKenzie and Dr. Caroline Vidal at CAMH, is shown to improve outcomes for Black populations and has meant that thousands of people have been able to access culturally appropriate mental health care. Black communities are accessing this through Wellness Connection, a partnership with Women’s Health in Women’s Hands Community Health Centre, Sherbourne Health and the Canadian Centre for Victims of Torture Centre.
- The Office of Health Equity is supporting clinical services to improve care for Black patients through a new Health Equity Coaching Model. This program is designed to help improve clinical health outcomes at planning, policy, and program levels. It has been piloted and delivered to four clinical teams to date.
- The Health Equity and Inclusion Framework for Education and Training aims to embed a health equity lens in the planning, development and delivery of education and training. It is now used at the University of Toronto, Toronto Academic Health Science Network hospitals and Canadian education departments.
- The CAMH Medical Advisory Committee and Clinical Care Committee have started the process of revising all CAMH policies to ensure they work equitably for Black patients. They have incorporated the Health Equity Impact Assessment in a review of all policies.
RESULT 2: An equitable working environment for Black staff (Actions 7-12)
Key Partners: Clinical teams, Education, Horizontal Violence, Anti-Racism, Anti-Oppression Working Group, People & Experience
- CAMH’s incident reporting system, STRIDES, is being updated to include incidents of racism, providing an additional option for staff reporting and addressing incidents of racism, and improving data collection.
- Spearheaded by the Anti-Black Racism Subcommittee, CAMH has begun launching Employee Resource Groups (ERGs), with Black, Black Managers, Asian and 2SLGBTQIA+ ERGs already formed.
- Foundational knowledge on anti-Black racism: An Introductory course for CAMH staff launched in November 2021. This is an introductory course specific to the Canadian context, and includes real-life case scenarios experienced by Black staff, patients and families at CAMH. Over 600 staff had completed the course by the end of fiscal year 2021/22.
RESULT 3: A mental health system, inside and outside CAMH, which aims to eliminate unfair treatment for Black populations (Actions 13-22)
Key Partners: Anti-Black Racism and Mental Health Advisory Committee, Black Health Alliance, community partners, Clinical teams, Education, Horizontal Violence, Anti-Racism, Anti-Oppression Working Group, CAMH Managers, PSSP, CAMH Research, Performance Improvement
- The Black Health Alliance’s Pathways to Care initiative, in partnership with CAMH, is integrating insights gained from over 300 stakeholder interviews across Ontario to produce better community pathways to mental health care.
- With leadership and support from PSSP, the Office of Health Equity, Black Health Alliance and community partners across Ontario, the expansion of expansion of SAPACCY is poised to be a main driver of innovation in Black health in communities across Ontario.
- Dr. Kwame McKenzie, Director, Office of Health Equity, Co-Chairs Ontario’s Black Health Plan group. The Black Health Plan is a new plan to improve the health of Black communities – a goal in Ontario Health’s Strategic Plan.
- As Ontario Structure Psychotherapy (OSP) evolves, CAMH has supported the delivery of CA-CBT and is actively working with the Ministry of Health and Long Term Care to improve cultural sensitivity in OSP.
- CAMH’s PSSP brings to life our advocacy work in a number of areas including an anti-racism strategy within Youth Wellness Hubs Ontario, and third-party evaluation of the Toronto Community Crisis Service.