Canadian healthcare providers, including mental health providers, are provided with limited training or knowledge in the social determinants of health (which contribute 50% towards a person’s health status) and the impact of those determinants on a person’s physical and mental health status.
The healthcare system itself can be and has been a cause of sickness due to barriers to access, wait times, and the way that programs and services are structured. For example, during the COVID-19 pandemic, it was documented that high-risk neighbourhoods — i.e., those that had higher levels of poverty, racialization, and proportion of workers deemed “essential” — experienced slower rollouts of vaccines.
The social determinants of health affect not only a person’s health, but also their ability to access healthcare. For example, during the pandemic, those who were able to stay at home and work in relative safety had better protection against the virus than those who were required to be physically present for work. As Birgit noted in her interview, for many, not working meant not being able to put food on the table, and this meant that some people were forced to go to work while symptomatic.
As mental health providers/peer supporters, it is important to recognize the impact that these factors have on a person’s health and ability to stay healthy. Regardless of one’s best intentions, lack of cultural understanding can lead to healthcare recommendations that are impossible for the patient to follow (e.g., asking a single parent of small children and with limited social support to isolate for 15 days) as well as poor health outcomes.
Building cultural competency requires understanding the challenges faced by those in one’s care, including shifting one’s viewpoint to think about other people and their perspectives and experiences and how these can impact health status and health practices. This perspective is critical because if not adopted, a life factor that affects a person’s ability to manage their health and wellbeing may risk being minimized or dismissed by those around them. Using a cultural competency lens means keeping at the front of one’s mind that what seems harmless to one person can be a threat to safety for another person because of a variety of reasons.