An Uncomfortable Narrative: Mental health, the legal profession and racialized communities

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Authored by Joanne D’Souza, Adrian Canagasuriam, and SALSA (Osgoode South Asian Law Students Association)

You’re a young, racialized person. You come from an ethnic community where mental health issues are severely stigmatized, ignored, and silenced. You join the legal profession—which comes with long hours and high demands—and that takes a similarly neglectful approach to mental health and wellbeing. Your identity is underrepresented in the profession, compared with the demographics of the wider population. You work your way into a type of practice where this underrepresentation is all the more evident.

 

What are the chances of you facing mental health struggles in the course of your profession? What are the chances you have adequate supports you can turn to, without shame or fear of the repercussions?

 

Due to the general lack of health information and research on Canada’s racialized communities, let alone within the legal profession, we can’t provide definitive answers to these questions. So, let’s work with what we do have at present.

 

20 percent of Canadians will personally experience a mental illness in their lifetime.[1] By now, eight years into Bell’s Let’s Talk mental health campaign, you are probably familiar with this statistic. All of us will likely have someone in our lives who will be challenged by a mental health issue.

 

Mental illness affects people of all ages, genders, and ethnic backgrounds. Nevertheless, specific socio-economic factors make South Asian communities more susceptible. Chief among them, as highlighted by the Canadian Mental Health Association, are discrimination and social exclusion, as well as poverty. While these factors are not exclusively characteristic of South Asian communities, they are features of the broad institutional disadvantages faced by racialized people in the GTA.

 

In the context of public health, discrimination and social exclusion manifest themselves in the underrepresentation of racialized groups in the medical profession and a deficit of culturally-sensitive care.[3] A dialogue paper submitted by Sana Halwani to the Ontario Human Rights Commission suggests that “the services provided by the public health care system and the models of delivery employed are defined and shaped by health professionals and administrators within that system.” If racialized peoples are not involved in the design and delivery of healthcare, the system will not be adequately responsive to racialized populations.

 

Furthermore, cultural insensitivity in the healthcare system aggravates linguistic and religious barriers to effective communication. Together, these issues ultimately result in discouraging many South Asian people in Canada from utilizing resources that should be equally accessible to everyone.

 

Research has found a positive correlation between poverty and mental illness,[4] yet while 28 percent of South Asian people in Toronto live in poverty, only 1.5 percent of South Asians self-reported moderate to high mental health distress.[5] We should be concerned about the serious disparity between the number of people likely facing mental health issues, and the number of people coming forward.

 

The shame and embarrassment associated with mental illness in the South Asian community leaves many to suffer in silence. This is problematic because one of the strongest tools we have in mitigating the impact of and responding effectively to mental illness is open dialogue.

 

A recent American study, considered to be of relevance to Canadian lawyers, found that American lawyers have a much higher risk of depression, anxiety, and substance abuse issues compared to the general population. The rate of problem-drinking among American lawyers is two to three times higher than other highly-educated professionals, while the rate of depression is three times higher than that of the general population. [6] Lawyers in private firms experience some of the highest levels of problematic alcohol use, and being in the early stages of one’s legal career is strongly correlated with a high risk of alcohol use disorder. [7]

 

While the struggle against mental health problems in the South Asian and legal communities is ongoing, high-profile initiatives are changing the public discourse surrounding mental health. In 2017, Bell’s “Let’s Talk Day” Campaign resulted in over 150 million social media interactions and raised 6.4 million dollars for mental health initiatives. This campaign, and others like it, encourage people to reach out for help. York Regional Police proudly reported that they received more than 4,000 mental health-related calls for service in 2016, which is 1000 more calls than the previous year.

 

At the same time, concerns have been raised over which communities benefit most from these efforts, and which are excluded. Last year there was another, smaller campaign called #BellLetsActuallyTalk. It explained: “Mental illness does not see race, sex or economical status; yet, those who are marginalized are the ones whose voices and needs are not prioritized in such campaigns and dialogue.” The point is simple but requires concerted effort: Let’s start including everyone in these conversations. [8]

 

As we start to see shifts in law student demographics (at least at Osgoode), it becomes all the more important to be cognizant of and vocal about mental health concerns in the legal community, and supportive of our law school peers. Consider that 13 percent of the 2017 incoming class at Osgoode identifies as South Asian/West Indian, compared to 8 percent in the previous year; and 43 percent of the 2017 incoming class identifies as racialized, compared to 32 percent previously. [9]

 

Ultimately, mental wellness requires a collaborative effort that encourages openness between all members of our communities. Taking part in honest dialogue with our family members, friends and colleagues will eventually pave the road to both recovery and prevention.

 

Looking for support? There are a number of resources:

 

 

[1] Canadian Mental Health Association, Fast Facts about Mental Illness, http://www.cmha.ca/media/fast-facts-about-mental-illness/#.WIrob1MrKpo

[2] Helen Keheler and Rebecca Armstrong (2006) Evidence-Based Mental Health Promotion Resource, Melbourne: Victoria Government Department of Human Services.

[3] Sana Halwani, Racial Inequality in Access to Health Care Services, Ontario Human Rights Commission, http://www.ohrc.on.ca/en/race-policy-dialogue-papers/racial-inequality-access-health-care-services

[4] Zahra Ismail, Advancing Equity in Mental Health within the South Asian Community, http://ontario.cmha.ca/files/2014/11/Zahra-Ismail_Presentation-for-CASSA.pdf

[5] Zahra Ismail, Advancing Equity in Mental Health within the South Asian Community, http://ontario.cmha.ca/files/2014/11/Zahra-Ismail_Presentation-for-CASSA.pdf

[6] Ireland, Nicole, ‘The impact on society is enormous’: In legal profession, depression, addiction hurt clients, too, CBC News, Nov 26, 2016,http://www.cbc.ca/news/health/lawyers-mental-health-addiction-problems-1.3865545

[7] Krill, Patrick R. et al., The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys, Journal of Addiction Medicine: January/February 2016 – Volume 10 – Issue 1 – p 46–52 https://journals.lww.com/journaladdictionmedicine/Fulltext/2016/02000/The_Prevalence_of_Substance_Use_and_Other_Mental.8.aspx

[8] Let’s Actually Talk, January 23, 2017, https://lets-actually-talk.tumblr.com/

[9] Admissions Suvey – Fall 2017 Entering Class, Osgoode Hall Law School, https://www.osgoode.yorku.ca/wp-content/uploads/2015/07/20172016_entering-class-survey.pdf

 

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Adrian Canagasuriam

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