Studies show that Black youth in Canada have more mental health issues and experience more challenges in accessing mental healthcare, largely due to social and economic factors. Government of Canada, healthcare providers and community organizations have launched different programs to cope with the situation; however there has been no significant improvement. A recent survey reveals that mental problems among Black youth have become even worse during the pandemic.
Calgary is the third largest city in Canada in terms of population (1.3 million), with 70,680 Black residents (5.47 %), among which a large portion is youth. Recently, I have worked at a non-profit organization on a project with six Black youth between 13 and 19 years old. All of them showed symptoms of depression and anxiety, low self-esteem, and feelings of disempowerment, as well as experiencing isolation and internal racism. Associated issues or effects included negativity towards families and community well-being, lack of culture inclusion and safety, increased interaction with the justice system, and proneness to low education level, higher level of poverty and violence and drugs, etc. One major obstacle in the Black community was the low mental health service utilization (MHSU). Some were reluctant to seek professional help while others dropped out in the middle of the treatment.
Studies [1] have shown the limitations of conventional mental health care. Mental health issues are often a result of an interaction between biological, psychological and societal factors. A pharmacological treatment may only influence the aspect of presentation and leave other factors potentially unresolved.
Between March and June this year (2023), we had weekly or bi-weekly coaching sessions with each of the Black youth, using Cognitive Behavioral Coaching (CBC), Rational Emotive Behavioral Coaching (REBC) and Motivational Interviewing along with bi-weekly training and information sessions on alternative methods such as music and art therapy, mindfulness, EFT, breathing and food and nutrition.
Cases have proven the effectiveness of culturally tailored Cognitive Behavioral Therapy / Motivational Interview on Black patients [2-3]. In our project, the combination of CBC, REBC and Motivational Interviewing not only helped identify the factors contributing to the Black youth’s reluctance to seek help or dropout from treatment, but also resolved their ambivalence and motivated them to change. We used an approach to guide them to look into the importance of changing their behaviors and negative beliefs. We were able to find out their interests, determine what empowered them, and more importantly we worked together with them to put a self-reward system in place. They felt they were in control of the sessions instead of being instructed to do tasks.
The Black youth showed remarkable improvements after the 4-month sessions. Results included reduction in depression and anxiety symptoms, strengthening of self-esteem and well-being, positive interactions with families, teachers and friends and involvement in community activities. Most of them decided to seek professional help or go back to continue their mental health treatment. All agreed to proceed with the second phase of the integrative health coaching sessions which would begin this September. They found life has purpose and is more meaningful than before. They chose to live healthier than before – having quality sleep, eating more greens and less junk or processed foods, doing exercises, and taking supplements such as B3, B12, D3, Omega 3 and Folate, etc. They have engaged in a habit of practicing mindfulness, EFT and breathing exercise daily, and many of them are very much involved in doing sports, music, arts, or other activities every week.
It is encouraging to see the positive changes of the Black youth in our case load, and how integrative health brought mainstream and alternative mental health approaches together in a coordinated way, leading to the utilization of the best of both.
References
1. An integrative collaborative care model for people with mental illness and physical comorbidities, C. Ee, J. Lake, J. Firth, F. Hargraves, M. de Manincor, T. Meade, W. Marx & J. Sarris, International Journal of Mental Health Systems, 11 November 2020
2. A mixed-methods approach to understanding the perspectives, experiences, and attitudes of a culturally tailored cognitive behavioral therapy/motivational interviewing intervention for African American patients with type 2 diabetes: a randomized parallel design pilot study, Ronald M. Cornely, Vinita Subramanya, Ashley Owen, Robin E. McGee & Ambar Kulshreshtha, Pilot and Feasibility Studies, 21 May 2022
3. Culturally sensitive application of the motivational interview to facilitate care for a Black male presenting to the emergency department with suicidal ideation, Michael Okoronkwo1, Rahn Bailey, Ifeanyi Chukwu O. Onor, Russell Ledet &Jordan Vaughn, Clinical Case Reports Journal, 15 December 2021;2(5):1–5
Ivan Leung is a 2023 graduate of Nickerson Institute's Integrative Mental Health Coach Training Program. He has over 20 years of experience providing individuals and corporations with coaching, mentoring, and HR and management consulting sessions. He is a master’s degree holder in human resources management, a certified psychological health and safety advisor, a certified compensation professional (CCP) and a global remuneration professional (GRP). Ivan is a fellow in Global Leaders in Healthcare program at Harvard Medical School. He is passionate about mental health coaching.
