A Call to Action on Racism and Social Justice in Mental Health

Laurence J. Kirmayer, MD, FRCPC, FCAHS, FRSC¹; Suman Fernando, MD²; Jaswant Guzder, MD³; Myrna Lashley, PhD⁴; Cécile Rousseau, MD⁵; Meryam Schouler-Ocak, MD⁶;

Roberto Lewis-Fernández, MD⁷; Kenneth Fung, MD⁸; G. Eric Jarvis, MD, MSc⁹

A position statement developed by the Canadian Psychiatric Association’s (CPA) Transcultural Section and approved by the CPA Board of Directors on July 9, 2020.

We write as academics who study the impact of culture on mental health, clinicians who strive to provide equitable mental health care and representatives of organizations devoted to advancing the field of cultural psychiatry. We join our voices to those in the USA and around the world calling for social change to address the longstanding violence and inequities of systemic racism and discrimination.

As mental health practitioners, we see up close the devastating personal consequences of racism and discrimination on those viewed as other and dehumanized. Beyond the shocking examples of murderous hatred, crushing the breath of Black individuals or hunting them in the streets, there are persistent and pervasive inequities in society that result in members of the dominant group receiving daily benefits while others—people of colour, racialized minorities, people with diverse gender or sexual orientations, languages or religions—are disqualified, silenced and attacked or else rendered invisible in the name of an illusory equality.

As researchers, we have documented the ways in which the social systems and structures created by colonization, slavery and economic exploitation have become institutionalized and incorporated into our ways of life and perceptions of each other so that they are seen as natural or necessary, and violently defended by targeting those who challenge the status quo. Seeing these poisons in society clearly requires coming to terms with one’s own position. Not surprisingly, it seems to be more difficult for those in positions of power and privilege to recognize the violence and inequity than for those who feel the boots of oppression every day.

As advocates, we want to add our voices to those calling for change and to insist that this is vital and urgent for the mental health and well-being of all in society. We thus commit ourselves and our organizations to work assiduously toward ensuring that:

1. The mental health professions train and sustain a workforce that fully reflects the diversity of society.

Representation within the profession is a basic step toward equity and service users, as well as the larger community, must be engaged to help reshape education and practice.

• Our educational and clinical environments are inclusive, responsive, empowering and safe for people of colour and anyone facing discrimination. This safety means that it is possible for individuals to talk about the predicaments they face and to call out injustice without fear of reprisal.

• We actively question, challenge and counter the biases and assumptions built into mental health theory and practice. These biases are present in how people are described, problems are framed and explained, and in what remains unstated and ignored in clinical practice.
• Beyond the clinical realm, we actively engage with public health approaches to address the social suffering caused by inequities and resist the pathologization of the distress stemming from injustices and human rights violations.
• We support the larger social forces of change set in motion by people of colour and others committed to social justice to transform our institutions of education, health, policing, government and commerce, both locally and internationally.

At this moment of societal recognition, we call on our colleagues in the fields of psychiatry, psychology and other mental health professions, as well as the wider community at home and internationally, to join us in this global effort to push back against oppression and remake civil society into a place of solidarity, mutual recognition and respect, with constant striving for equity and justice.