Chapter 4: More Than Mind Over Matter: Why Equity, Diversity, Inclusion, & Decolonization Matter For Mental Well Being

This chapter explores the positive contributions of EDID for the mental health and well-being of individuals. Incorporating various psychological frameworks, we analyze the protective roles and risk reductions that EDID can contribute and its importance. This chapter reviews the impacts of experiencing racism and discrimination on an individual’s mental health and well-being while suggesting improvements. By changing elements in the structure of the environment and prioritizing the implementation of EDID through various frameworks and practices, safe and stable environments can be developed to promote positive mental health outcomes and well-being.

 Well-Being & The Role of The Environment

An individual’s environment plays a significant role in their mental health and well-being. One’s environment can “restrict choices and limit opportunities,” affecting their ability to function and develop healthy practices (Nikelly, 2001), especially for those who are already limited through being racialized and marginalized. Health, both physical and mental, is determined by sets of biological and physiological variables in conjunction with social determinants of health such as socioeconomic position and community context. One key aspect of the social basis of health is social integration, which promotes attachment to the community and reduces feelings of alienation, victimization, fear, and mistrust (Nikelly, 2001). Therefore, it is paramount that individuals have access to a community that is diverse, inclusive, and equitable in order to reduce the risk of further alienation, victimization, and marginalization.

Growing research suggests that targeting the modification of behavior itself is not sufficient to improve mental health outcomes if the adverse structures remain intact (Nikelly, 2001). The importance of promoting EDID within organizations is to facilitate environmental and social restructuring, creating spaces that are healthy and safe for all individuals, rather than relying on individuals to navigate adverse environments and cope with the subsequent consequences independently.

The Intersection of Racism & Mental Health and The Role of Structural Changes and EDID Frameworks

Racism, from microaggressions to discrimination, has significant implications for mental health, particularly among racialized and marginalized communities, such as Black Canadians and Indigenous Peoples. Research exploring the complex relationships between racial discrimination, mental health outcomes, and coping mechanisms highlights the need for structural changes to mitigate these issues.

Data has shown a clear link between increased levels of racial discrimination and microaggressions and higher rates of anxiety (Kogan, 2022). A study conducted by Cary Kogan et al. (2022), focusing on the experiences of Black Canadians, found that nearly one third of participants showed clinically significant levels of anxiety as a result of the psychological toll of racial discrimination. Persistent exposure to racism is associated with a variety of negative mental health outcomes, including increased depressive symptoms, PTSD, and anxiety (Jacob, 2023). Psychological resilience was shown to provide modest protection against the effects of microaggressions. However, it does not offer significant relief from racial discrimination itself (Kogan, 2022). Various coping strategies employed by racialized individuals to manage the stress associated with racism may offer some relief. Commonly used strategies include seeking social support, engaging in religious/spiritual practices, and problem-focused coping (Jacob, 2023). Nonetheless, while these strategies offer short-term relief, they often do not address the root causes of stress and trauma (Jacob, 2023). These individual efforts are not enough to disrupt systemic and institutionalized racism. Structural changes within institutions and communities are necessary to foster more supportive environments for racialized and marginalized groups.

Positive mental health outcomes and wellness may be achieved through EDID. EDID frameworks play a crucial role in restructuring environments in ways that may act as protective factors against racism. While it is impossible to eradicate discrimination entirely, EDID initiatives can reduce frequency and impact by fostering more inclusive and equitable environments. Functional and effective coping strategies combined with systemic changes offer a more comprehensive approach to improving mental health outcomes.

An example of this is the work done by the Centre for Addiction and Mental Health (CAMH) in Toronto. CAMH has implemented a number of EDID initiatives, such as the Office of Health Equity, which aims to address health disparities and promote equity within the institution and the broader community. Their efforts include training staff on cultural competency, developing community partnerships to better serve diverse populations, and conducting research on the mental health impacts of racism and discrimination. Another example is the creation of the National Centre for Truth and Reconciliation (NCTR) in Winnipeg. The NCTR supports mental health and well-being through its commitment to preserving the history and legacy of residential schools and promoting reconciliation. By acknowledging the historical injustices faced by Indigenous Peoples and providing a platform for their stories to be heard, the NCTR helps to foster a sense of community and healing, which are essential for mental well-being.

The University of British Columbia’s (UBC) Inclusion Action Plan is another instance where EDID initiatives have been successfully implemented. UBC has committed to creating an inclusive campus by addressing systemic barriers, fostering a culture of inclusion, and implementing strategies to support the mental health and well-being of its diverse student body. This includes providing mental health resources that are culturally sensitive and accessible to all students.

 Trauma and Indigenous Communities

Indigenous communities in Canada have faced centuries of trauma due to colonialism, systemic racism, and ongoing discrimination. The residential school system, in particular, has left a legacy of intergenerational trauma that continues to affect the mental health and well-being of Indigenous Peoples. Survivors of residential schools and their descendants often experience higher rates of PTSD, anxiety, depression, and substance use disorders. The Truth and Reconciliation Commission of Canada has documented these impacts extensively, emphasizing the need for culturally appropriate mental health services and supports that acknowledge and address this historical trauma. Initiatives like the First Nations Mental Wellness Continuum Framework aim to provide a holistic approach to mental wellness that incorporates traditional healing practices and community-based support, recognizing the importance of cultural identity and connection to the land in the healing process.

An example in the work of Niel Arya et al. (2018) highlights how Canada’s colonial history and systemic racism continue to affect the mental and physical health of Indigenous peoples—generational trauma and mistrust of healthcare systems are exacerbated by these challenges. Acknowledging the shortcomings of the existing systems and organizations and emphasizing the need for structural reforms in healthcare are crucial for advocating for culturally safe care frameworks that address historical injustices and power imbalances (Arya, 2018).

Addressing the mental health impacts of racism requires a multifaceted approach. While individual coping strategies are useful, they must be complemented by structural changes to reduce the prevalence and impact of racial discrimination. EDID frameworks offer a way to create more equitable and inclusive environments, potentially alleviating some of the mental health challenges associated with racism. As we strive for systemic change, it is crucial to understand and address both the individual and structural elements of racism to improve the overall well-being of marginalized communities.

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