Beyond individual deficit: A structural analysis of mental health access for Black immigrant youth of African descent in Canada.

Abstract

BackgroundBlack populations have deep ancestral ties to Canada, yet little research examines what shapes access to mental healthcare for Black immigrant youth of African descent (BIYAD), defined here as first-generation African-born Black young adults aged 18 to 34. Almost none of these studies examine how race, immigration status and young adulthood intersect to shape that access.PurposeTo argue that persistent underutilisation of mental health services by BIYAD is structurally produced rather than a failure of individual help-seeking or resilience, and to identify the structural drivers that clinic-centred models obscure by treating distress as personal deficit.Research DesignConceptual and critical policy analysis integrating Levesque and colleagues' multidimensional model of access with intersectionality theory. No empirical study was undertaken.Study SampleNot applicable. The analytic focus is BIYAD in Canada. No primary data were collected.Data Collection and/or AnalysisPeer-reviewed and grey literature on anti-Black racism, immigration and settlement, socio-economic position and Black mental health in Canada was assembled purposively and analysed against the five access dimensions and these intersecting axes.ResultsAccess narrows at every dimension: outreach that misses African-born communities and mistrust after racist encounters (approachability); stigma and few providers sharing language, faith or race (acceptability); thin Black-led provision and long waits (availability); precarious work and uninsured psychotherapy (affordability); and clinic-centred care that misreads spiritually grounded distress (appropriateness). These constraints compound rather than add. Framing resilience as the remedy recasts structural failure as personal attribute.ConclusionHealth equity for BIYAD requires structural and community-grounded reform rather than individual remediation: accountable anti-racism and cultural safety measures, culturally responsive community-based care, and sustained investment in Black-led services.