For many Black women in Canada, seeking help for mental health challenges can come with an additional burden: the fear of not being heard, understood, or taken seriously.
A recent nationwide survey highlights the scale of the problem. Among nearly 2,000 Black women, girls, and gender-diverse people surveyed across Canada, 76.6 per cent said they had felt unheard or disbelieved by health-care providers when accessing services.
The findings point to significant gaps in mental health care and the need for services that are not only accessible, but also culturally responsive and sensitive to the experiences of Black women.
One organization in Nova Scotia is working to provide exactly that kind of support.
A Growing Mental Health Concern
Mental health was identified as the most commonly diagnosed chronic condition among respondents in the survey, affecting 15.8 per cent of those surveyed.
The survey also found that 27.4 per cent reported experiencing self-harm ideation. The figure is significantly higher than the 2021 national average for suicide ideation reported by Statistics Canada.
These numbers highlight the seriousness of the mental health challenges facing Black women and the importance of ensuring that people can access appropriate support before they reach a crisis point.
But statistics alone do not tell the full story.
Behind them are women dealing with workplace discrimination, grief, trauma, family pressures, financial challenges, violence, and other experiences that can affect mental well-being.
When Women Feel Unheard
For Lesley Fraser, a serious concussion left her dealing with debilitating headaches and eventually depression.
Fraser, an education program assistant in Nova Scotia, described losing months of her life after the injury. She experienced severe exhaustion, a lack of motivation, and difficulty carrying out everyday activities.
She feared that the broader health-care system might not take her symptoms seriously unless her condition became an immediate emergency.
Eventually, Fraser found support through the Nova Scotia Sisterhood, a primary care program dedicated to serving Black women and gender-diverse individuals.
For her, finding a space where she felt comfortable and understood made a significant difference.
“I feel comfortable coming here and seeing someone that looks like me and asking all the right questions,” Fraser said.
The Impact of Systemic Racism
Experts say the challenges faced by Black women cannot be separated from the broader effects of racism and inequality within health care.
Roberta Timothy, an associate professor at the University of Toronto’s Dalla Lana School of Public Health, says historical stereotypes have contributed to the way Black women are sometimes perceived.
One particularly damaging idea is the stereotype of the “strong Black woman” — the belief that Black women are naturally resilient and capable of enduring extraordinary hardship without needing help.
Timothy argues that these perceptions can contribute to Black women’s pain and mental health concerns being minimized or overlooked.
The result can be a situation in which women feel they must continue carrying their burdens without acknowledging that they need support.
Mental Health and Workplace Pressure
Mental health challenges can also be connected to experiences in the workplace.
Crystal John, a clinical therapist with the Nova Scotia Sisterhood, says some of her clients describe being subjected to intense scrutiny at work, including higher expectations, increased oversight, and greater disciplinary pressure.
These experiences can contribute to burnout and emotional fatigue.
The pressure can be particularly difficult when Black women are among only a small number of Black employees in their workplace and do not feel comfortable speaking openly about their experiences.
For some women, the accumulation of these pressures can have a serious impact on their mental health.
John takes a trauma-informed approach to therapy, recognizing that mental health can be influenced by multiple overlapping experiences, including workplace racism, violence in the home, grief, and broader community trauma.
Creating a Culturally Safe Space
The Nova Scotia Sisterhood is responding to these challenges by creating a health-care environment specifically designed to serve Black women and gender-diverse individuals.
John says her caseload is consistently full, with about 15 clients each week and a waitlist of approximately 40 people, along with regular referrals.
The demand suggests that there is a significant need for culturally safe mental health services.
John believes word of mouth has also helped spread awareness that the clinic provides a space where Black women can seek care and feel understood.
For patients who have previously felt dismissed or overlooked by the health-care system, that sense of safety can be an important part of seeking help.
Representation Matters
Culturally responsive care is not simply about having more Black clinicians. It also requires health-care professionals to understand how racism, discrimination, historical experiences, and social circumstances can affect mental health.
Timothy argues that practitioners should receive training that takes an anti-oppression approach to care, including recognizing the impact of anti-Black racism and violence on mental health and community well-being.
At the same time, John believes there needs to be greater encouragement and support for Black children and young people who are interested in careers where Black people remain underrepresented, including medicine and teaching.
Increasing representation within the health-care system can help create more opportunities for patients to see themselves reflected in the people providing their care.
Making Mental Health Care More Accessible
Culturally responsive care must also be affordable and accessible.
Even when people recognize that they need support, cost, wait times, and limited availability can prevent them from receiving it.
Timothy says the findings from the national survey need to translate into long-term programs with sustained funding.
That includes increasing access to free or affordable mental health services and creating more spaces where Black Canadians can receive support from professionals who understand their lived experiences.
Federal efforts have included funding for mental wellness initiatives in Black communities. In 2018, the federal government committed $19 million over five years, with funding later evolving into initiatives such as the Mental Health of Black Canadians Fund, which supports Black-led, community-based mental health projects.
Supporting the Whole Community
Improving mental health outcomes for Black women benefits more than the individuals receiving care.
When people have access to appropriate support, families and communities can also become stronger.
John emphasizes that addressing these challenges is ultimately about the health of the entire country. When a significant portion of the population faces barriers to receiving appropriate care, the consequences extend beyond one community.
Creating equitable access to mental health support therefore benefits everyone.
Moving From Awareness to Action
The experiences highlighted in this story demonstrate why awareness must be accompanied by meaningful action.
Black women need health-care environments where their concerns are taken seriously, their experiences are respected, and their cultural and social realities are understood.
That requires better access to affordable services, culturally responsive care, anti-oppression training, greater representation among health-care professionals, and sustained investment in Black-led community programs.
The Nova Scotia Sisterhood offers one example of what culturally responsive care can look like in practice. Its growing demand also demonstrates how much work remains to ensure that similar support is available to Black women across Canada.
Mental health should never depend on whether someone feels believed or understood when they seek help. By creating accessible, culturally safe spaces and addressing the systemic barriers that affect care, Canada can move closer to a health-care system where Black women can receive the support they need — when they need it.