Promoting Health Equity: Mental Health of Black Canadians Fund Community Report (2018-2024) : Report

Executive summary

Black people in Canada face significant social and economic challenges that have negative effects on their mental health. The Public Health Agency of Canada (PHAC)'s Promoting Health Equity: Mental Health of Black Canadians (MHBC) Fund supports Black-led, community-based projects that promote positive mental health. These projects aim to increase equity and address the factors that affect mental health, with a focus on anti-Black racism.

This report reflects the voices and mental health experiences of Black communities in Canada, using insights from:

• MHBC Working Group members
• the 15 projects funded by the MHBC Fund between 2018 and 2024

Funding recipients identified the 3 most important criteria for improving accessibility, mental health and wellness:

1. Sustainability
2. Access to mental health services from an organization with a similar cultural and racial identity
3. Projects with a cultural focus were also essential for developing trust with their participants

The MHBC Fund has significantly enhanced the visibility of Black voices, creating change and opportunities for Black-led programming. It has helped to carry out mental health awareness initiatives that built relationships and raised awareness across Black communities by:

• delivering Black-led national conferences and community events
• creating Black-led, Black-focused, and Black-serving online networks

This has led to a rise in awareness of anti-Black racism and intersectional community-based initiatives.

Addressing mental health needs for Black communities in Canada, "which have been ignored and marginalized for several years"^{Footnote 1}, extends beyond the MHBC Fund. This report recognizes the significance of collective endeavors to promote positive mental health across Black communities in Canada. The partnerships established through the MHBC Fund continue to play a role in shaping its current and future work.

Empowering Black communities

The issue of mental health in Black communities is complex, and the report cannot fully capture the experiences of mental health among these communities. However, it does capture the urgency and attention needed to address their mental health needs.

The Promoting Health Equity: Mental Health of Black Canadians Fund (MHBC) supports Black-led, community-based mental health initiatives that aim to increase equity and address the underlying determinants of mental health, with a focus on anti-Black racism. This includes developing tools and resources that:

• can promote positive mental health
• are culturally relevant and decolonized
• respect individuals, family and community values and practices

The report highlights the impact of systemic inequities on the mental health of Black communities in Canada. It acknowledges the relationship between social determinants of health, particularly anti-Black racism and mental health outcomes. Mental health difficulties remain pervasive, and factors that act as a barrier to positive mental health will continue to severely impact Black communities. This is why funding initiatives that promote positive mental health in Black communities are crucial.

The MHBC Fund is the first federal program of its kind to target the unique mental health needs of Black communities in Canada. While the Fund aims to address this, the mental health needs of Black communities go beyond this program. This report acknowledges the importance of collaborative and collective efforts to help strengthen Black communities' actions towards positive mental health. It is critical that partnerships continue to expand on the work that the Fund has begun.

This report reflects the positive impact of what the Fund, and other mental health supports, can do for Black communities in Canada. It explains the impacts of community-based and community-led mental health initiatives and how effectively they support positive mental health outcomes. The report also presents different approaches that promote equity and address the underlying social determinants of mental health within the diverse Black communities across Canada.

Testimonials

These compelling quotes, shared by MHBC Fund project participants, illustrate the impact this Fund had on Black communities^{Footnote 2}.

Background

Recognizing the unique challenges faced by Black people in Canada, including anti-Black racism and its impacts on mental health, the Public Health Agency of Canada (PHAC) launched the MHBC Fund in 2018.^{Footnote 3} This 5-year, $10 million investment^{Footnote 4} supported initiatives that aimed to increase health equity and address mental health and its determinants for Black people in Canada. Between 2018 and 2024, this investment supported 23 community-based projects across Canada.

The MHBC Fund created 2 funding streams: the incubator stream and the implementation stream.

Through the incubator stream, 8 projects received short-term funding between 2019 to 2020. They supported capacity-building activities that helped design, develop, implement and evaluate projects that promote mental health and address its determinants for Black communities in Canada.

Through the implementation stream, 15 projects received funding between 2018 and 2024. They implemented, delivered and evaluated culturally focused, multi-year projects that promoted mental health and addressed its determinants for Black communities in Canada^{Footnote 5}. This included:

• 8 projects funded through Phase I
• 3 projects funded through the incubator stream that received additional funding to carry on to Phase II
• 3 projects funded through a sub-stream that focused on addressing the unique needs of Black 2SLGBTQIA+ populations

The implementation stream also funded a project through its Knowledge Mobilization Network sub-stream. This project supported knowledge mobilization and capacity building across all funded projects and within the broader community of Black practitioners, researchers, and organizations, and the people they serve.

In 2021, Budget 2021 allocated $100 million over 3 years to the Supporting the Mental Health of Those Most Affected by the COVID–19 Pandemic Fund. The Fund promoted mental health and prevented mental illness among populations disproportionately affected by the pandemic. This investment provided $4M to the MHBC Fund to support 9 more projects from previous applicants.

Learn more:

• The incubator stream
• The implementation stream
• The Black LGBTQI+ Canadians sub-stream
• The Knowledge Mobilization Network sub-stream
• The Supporting the Mental Health of Those Most Affected by the COVID–19 Pandemic Fund

Objectives

The MHBC Fund aims to support community-based projects across Canada to develop more culturally-focused knowledge, capacity, and programs to improve mental health of Black communities in Canada. The objectives of the MHBC Fund are to increase:

• understanding of the unique barriers to and social determinants of mental health of Black people in Canada
• knowledge of effective, culturally-focused approaches and programs for improving mental health and addressing key social determinants for mental health of Black people in Canada
  • this includes a focus on youth, their families and community environments
• capacity within Black people in Canada to address barriers to mental health

Funding approach

Meaningful engagement and co-development with Black communities in Canada is a cornerstone of PHAC's approach to this program and for promoting health equity. When setting up the MHBC Fund, PHAC established the Mental Health of Black Canadians Working Group (MHBC Working Group). This group was comprised of 11 Black mental health practitioners, researchers, academics, and those with lived experience, all from within Canada^{Footnote 6}. Members have a range of experience and expertise with mental health and its intersections with anti-Black racism, and other social and economic issues facing Black communities.

This interdisciplinary group provided:

• strategic advice and recommendations on project funding through a co-development, decolonized approach
• guidance on capacity building activities
• knowledge mobilization support
• advice on strengthening evidence of mental health and its determinants for Black communities in Canada

Program principles

The MHBC Fund is guided by the following fundamental principles, wherein anti-Black racism is considered an over-arching principle:

• Anti-Black Racism
• Leadership by Black Canadians
• Evidence-based
• The Social Determinants of Health Approach
• Health equity lens
• Cultural competence and safety
• Partnerships and Collaboration

All projects funded under the MHBC Fund^{Footnote 7} were required to integrate these principles into their funding proposals and to report how they were implemented.

Learn more:

• Funded projects
• Objectives and principles of the Promoting Health Equity: Mental Health of Black Canadians Fund

Methods

This report reflects data and findings from the 15 implementation stream projects supported by the MHBC Fund. These projects had a specific focus on delivering and evaluating culturally appropriate mental health promotion interventions developed by and for Black communities across Canada. By narrowing the scope to this stream, PHAC aim to provide a focused analysis of projects actively engaging with Black populations. This approach ensures that the findings presented:

• are grounded in project activities and outcomes
• help to generate evidence on effective, community-led mental health strategies

Projects related to knowledge development, capacity building, or other ancillary streams have been excluded from this analysis to maintain clarity and thematic coherence.

This report shares a summary of results achieved and impacts of the 15 projects. It includes recommendations and areas for action reported by funding recipients to advance health equity and address the determinants of mental health for diverse Black communities across Canada.

PHAC used data and information from MHBC projects' annual, final, and evaluation reports from 2018 to 2024, as well as insights from working group members. The report examines data both quantitatively and qualitatively.

The quantitative approach focused on 5 key performance indicators. It facilitated understanding of who was reached through MHBC funded projects and the positive outcomes that were experienced.

Qualitative approaches included an inductive thematic approach^{Footnote 8} in NVivo and literature reviews. These approaches included diverse perspectives in better understanding experiences of mental health among Black people in Canada. PHAC also identified experiences, feedback and testimonials from project staff and participants in project reports.

This report complements the work of TAIBU Community Health Centre's as part of their Amandla Olwazi – The Power of Knowledge project, funded under the MHBC Fund's Knowledge Mobilization Network.

Project spotlights

Anti-Racist Mental Health Care

Mental Health of Black Communities in the National Capital Region: Assessment, Prevention and Intervention Tools was led by Dr. Jude-Mary Cénat's research team at The University of Ottawa. In a publication about their project, the organization described it as “the first Canadian study on the prevalence and risk and protective factors associated with depressive symptoms among individuals from Black communities, exploring both the predictive roles of everyday racial discrimination and social support”^{Footnote 9}. About 850 Black people between the ages of 15 and 40 took part in the first cycle of a longitudinal survey. As of March 2024, several scientific publications resulted from this longitudinal study and more are expected.

Survey results outlined that among respondents:

• racial discrimination is the most important predictive factor for mental health issues, including:
  • PTSD
  • depression
  • anxiety
  • psychosomatic symptoms
  • suicidal ideation and behaviour
  • poor self-esteem
• a majority face racial discrimination several times per month or almost on daily basis
• most racial discrimination is experienced in high school and university
• mental health is experienced differently according to identity factors, such as:
  • country of origin
  • gender
  • employment status

Dr. Cénat and his research team also developed several training modules as part of their project. The modules responded to an urgent need to provide education and awareness on anti-Black racism in Canada, especially in the context of the murder of George Floyd. As of April 2024, more than 100,000 members of the public have taken part in this training.

In addition, over 10,000 mental health professionals took the training "How to provide antiracist mental health care". This module taught mental health professionals about the needs of people from Black communities and how to provide anti-racist mental health care. Training evaluations suggest that 96% of participants increased their knowledge. The training is recognized internationally and is accredited by the American and the Canadian Psychological Associations.

Dr. Cénat's project also directly engaged Black youth and Black communities within the National Capital Region to discuss mental health during and after the COVID pandemic. Notable initiatives included:

• Chatting in the City: A podcast that opened the conversation about Black mental health and heard from Black youth.
• My Mental Health, My Country and I: A conference organized during Black Mental Health Week in 2022 and 2023. It sparked dialogue about mental health issues experienced by Black youth, and discussions around social, community and political participation. A high school participant spoke candidly about the challenges rooted in a history of discrimination and inequality that he and his peers face:

  "Every day, I hear my parents say that I have to work twice as hard to have the same opportunities as my white classmates and friends. And sometimes, I'm just exhausted. . . . We're all here today to ask the adults in our schools to remove racial barriers and obstacles. We're here because we believe Canada can do better."

• The National Conference on Black Community Mental Health: A conference that brought together community leaders and experts to share research and knowledge on Black mental health in October 2022. While the MHBC project ended in March 2024, a second conference was held in October 2024.

Learn more:

• How to provide antiracist mental health care
• Chatting in the City
• My Mental Health, My Country and I
• The National Conference on Black Community Mental Health

Restorative Justice Framework

21 Black men from the borough of Montreal-North participated in Justice Hoodistique, a restorative justice program by Hoodstock. This program aimed to constructively reintegrate into society Black people aged 18 to 64, who have been accused of a crime and have accepted responsibility for it. This project strengthened community ties and promoted personal accountability.

The project involved families and close acquaintances of both the accused and victims in psychosocial counselling, 2 healing retreats, the creation of a hoodistic circle, and mediation. Its core values were wellbeing, non-judgment, community, compassion and humanity. Using these values as a guide, the project helped participants rebuild their self-esteem and rehabilitate their self-image. The evaluation of the project, conducted in close collaboration with the SHERPA University Institute, highlighted many benefits of the project on participants and the community.

The healing retreats created a safe environment for self-reflection and experience sharing, especially through the warm welcome of the program staff and the kasàlà^{Footnote 11} workshop.

Some victims have agreed to actively participate in the mediation process. A project facilitator recounted how the project can touch the heart of victims and generate empathy.

Between the beginning and the end of the project, participants changed their practices to improve their mental health. Over the course of the project, they reported:

• to have stopped using alcohol or drugs
• consulting a psychotherapist or mental health professional (instead of doing nothing as stated at the beginning of the project)
• taking part in activities that makes them happy at the end of the project in a greater proportion
• an improvement in their mental health, especially for those who consider their health to be excellent, from 41% to 59%

After the project, one participant expressed the desire to give back to younger people and contribute to crime prevention in the community:

In the long term, Hoodstock hopes to include minors (12 to 17 years old) in their restorative justice program, and extend the reach to Greater Montreal and other Canadian cities.

Learn more:

• Hoodstock
• Justice Hoodistique

From Stress to Strength: Enhancing Black Youth Mental Health Through Physical Activity

The Aspire for Higher (A4H) Youth Mental Wellness Program is a culturally responsive initiative based in the Greater Toronto Area. It addressed the mental health challenges facing Black youth by integrating basketball into a holistic wellness curriculum. The program was developed in recognition of the social, emotional and systemic barriers Black youth face when accessing mental health support. It used basketball as an engagement strategy and a therapeutic tool, creating a safe and affirming space for youth to explore mental wellness, strengthen their coping skills, and build self-confidence.

From April 2021 to March 2024, the Youth Mental Wellness Program project successfully reached 423 youth between the ages of 11 and 16, including 194 Black-identifying participants. The program also trained 23 Black facilitators, ensuring the delivery of content was culturally aligned and relatable. Programming was delivered both in and out of school, allowing for greater flexibility and access. Youth attended weekly sessions that combined basketball training with discussions on mental health, emotional well-being and Black identity.

Basketball played a critical role in the success of the program. It was chosen not just for its popularity, but because it holds cultural and emotional significance within Black communities. Basketball resonates with Black youth as a familiar and accessible form of self-expression, a symbol of aspiration, and a source of community pride. It creates a natural environment for building trust, teamwork, and discipline: qualities that align closely with mental wellness^{Footnote 12}.

In the context of A4H, basketball was more than recreation. It allowed youth to safely explore difficult topics like stress, discrimination and emotional vulnerability. By embedding mental health education into the structure of physical activity, the program was able to reduce stigma and make wellness discussions more approachable.

Evaluation findings demonstrate that the Youth Mental Wellness Program had a measurable, positive impact on participants. Black-identifying youth reported improvements in both mental and physical health, with 87% saying their mental health had improved by the end of the program. Participants described feeling better able to cope with stress, more physically fit, and more emotionally resilient (Figure 1). In addition to mental health benefits, youth also gained knowledge about Black history, cultural pride, and the impact of systemic racism on their lives. These elements helped to foster a stronger sense of identity and personal empowerment.

Over 90% of Black-identifying participants agreed that the program was relevant to their experiences, and 96% said they would recommend it to their peers. Youth expressed particular appreciation for the safe, open space A4H created where they could engage in meaningful discussions, ask questions, and feel seen and understood. The combination of physical activity and culturally relevant mental health education created a unique environment that resonated deeply with participants. Facilitators, many of whom were also Black, served as trusted mentors and role models. This further reinforced the program's values of leadership, authenticity and community care.

A4H has demonstrated that culturally grounded, sport-based programs can be a powerful tool for improving mental health outcomes among Black youth. By leveraging the popularity and significance of basketball, A4H created an environment where youth could learn, heal, and grow in ways that were engaging, affirming, and impactful. The program not only helped participants strengthen their mental and emotional well-being but also contributed to their physical health, identity development, and community connection.

As the Youth Mental Wellness Program continues to evolve, its model offers valuable insights for future youth wellness interventions. The success of the program reinforces the importance of culturally relevant programming, early intervention, and creating safe spaces where Black youth can thrive. With continued support and expansion, initiatives like A4H Youth Mental Wellness Program can transform how mental health support is delivered in Black communities and is centered on the belief that healing is possible.

Figure 1: Mean ratings for mental health-related items on the pre-survey and post-survey

Figure 1: Text description

Metric	Pre-survey	Post-survey
Physically fit and healthy*	3.92	4.31
Able to cope when life gets hard*	3.72	4.13
Comfortable talking about mental health	3.65	4.02
Know how to take better care of mental health	3.92	4.04
Usually feel I belong in my community/social groups	3.85	4.00
Mental Health Rating*	3.58	4.02

Figure 1: Notes

• Figure 1 displays the means for the items that appeared on both the pre-survey and post-survey, with means ranging from 1 to 5, with higher means indicating greater endorsement of the item.
• * Significant difference in scores on the pre- and post-survey.

Learn more:

• Aspire for Higher

Self-care for Black Women

Women's Health In Women's Hands is a community health centre for racialized women living in Toronto and surrounding municipalities. The health care team involved skilled professionals who specialize in the health and wellness needs of racialized women and prioritize those from African, Caribbean, Latin American and South Asian communities.

Their Empowered African, Caribbean, and Black (ACB) Women's Wellness Gathering project was funded from 2020 to 2024. This peer-led mental health intervention had a long-term goal of improving the mental health of ACB women and gender diverse participants that are 16 years and older. This project reached 481 ACB participants and included:

• successful series of community workshops
• collecting digital stories from peers
• creating a podcast series
• virtual talking circles with external guest facilitators
• submitting a book chapter to the University of Ottawa
• presenting at the University of Ottawa's Vulnerability, Trauma, Resilience and Culture Research Laboratory (V-TRaC) conference, about their book chapter called "Empowered ACB Women Wellness project"
• hosting an in-person event for participants to:
  • share the project overview and learnings
  • build community connection

The project recruited 36 ACB peer leaders and 9 advisory committee members. ACB women who participated in the project reported:

• improved knowledge of what affects their own mental health
• better understanding of the mental health needs of ACB women
• intending to use acquired knowledge in their professional activities regarding positive mental health and its determinants affecting Black people in Canada
• increased accessibility to resources that support positive mental health

In reference to skills and abilities that support positive mental health, one participant shared:

Some of the peer facilitators also expressed having gained confidence in facilitation skills. One stated:

Learn more:

• Women's Health in Women's Hands

Voices in Colour: Narrative-Based Mental Health Interventions for Black 2SLGBTQIA+ Youth

The Ecosystems of Healing project was led by The Youth Project and implemented from 2021 to 2024. It focused on promoting mental wellness and community resilience among African Nova Scotian and Black 2SLGBTQIA+ youth. The project was created in response to the systemic marginalization of Black 2SLGBTQIA+ people and the barriers to mental health resources they face, as well as over-consultation of these communities. The project centered creative expression, culturally focused interventions, and cultivating safe spaces.

The program engaged 440 participants in artistic, mentorship, and relationship-building activities across identity, age and experience. Activities included:

• multidisciplinary arts workshops
• a fashion show exploring intersectional identity (The Myth of the Monolith)
• community retreats
• culturally grounded events such as the "Beyoncé Sing-A-Long"

These activities allowed participants to process emotions, develop creative skill sets and build affirming peer networks. Facilitators removed barriers to participation by providing food, transportation and setting non-punitive attendance policies.

A significant outcome of the project was the development of new models for culturally focused mentorship and youth outreach, especially tailored to the needs of Black queer and trans youth. Project mentors and participants reported enhanced emotional regulation, increased confidence, and a stronger sense of community. They told us that having intentionally curated, closed spaces where Black 2SLGBTQIA+ youth could freely express themselves as transformative.

The project was also recognized at a municipal and provincial level. Notably, The Myth of the Monolith was honored in the Nova Scotia Legislature, an unprecedented moment of visibility for artistic programming led by Black queer and trans youth. Working with local artists, organizations and regional facilitators extended the project's reach into urban and rural communities.

Ecosystems of Healing was successful in creating community-led mental health interventions that are culturally and contextually meaningful. Participants overwhelmingly expressed a desire for extended and expanded programming. The project offers a compelling model for future youth mental health work that centers care, cultural focus and community trust.

Learn more:

• The Youth Project

Healing in Motion: ArTeMo and the Art of Afrocentric Mental Health

The ArTeMo project, spearheaded by the Africa Centre in Alberta, aimed to develop and test culturally informed interventions that:

• connect Black youth to their culture
• create a sense of belonging and identity
• enhance empowerment

The project also intended to increase cultural competency among organizations that provide services to at-risk Black youth.

From 2019 to 2022, the project hosted a variety of activities for Black youth and their families including:

• rap, paint, and poetry events
• engagement forums
• conversation cafes
• mentorship and employment support
• annual conferences

At the same time, institutional stakeholders like health and education service providers took part in training designed to reduce anti-Black bias and increase knowledge of mental health and its determinants.

Overall, the project reached 2,117 participants aged 6 to 65 years, online and in-person. The project worked with organizations such as 3 public schools in Edmonton, and the Alberta Black Therapists Network to deliver its programs. The Sexual Assault Centre of Edmonton also helped to create anti-Black racism tools and mental health education resources.

The project's outcomes demonstrate significant achievements:

• Africa Centre launched Western Canada's first free Black focused counselling clinic
• Over 90% of participants who completed post-event surveys reported learning new mental health skills

For example, one youth participant reported applying the self-compassion skills acquired during the paint nights:

• Conversation cafes and school-based guest facilitation sessions fostered safe, supportive environments that openly address racism and mental health
• 81% of conference attendees felt they have stronger social supports for mental health after attending the conference
• 77% of conference attendees acknowledged the conference helped decrease mental health stigma
• The mentorship program connected mentees with mental health mentors, resulting in tangible success stories including 2 mentees securing full-time employment
• 45 staff members received training to enhance support for 2SLGBTQIA+ youth, addressing intersectional needs within the community

The ArTeMo project shows how holistic, intergenerational and integrative mental health interventions can improve the psychological, emotional and social well-being of Black youth. Project learnings are being integrated into Africa Centre's counselling clinic to develop a more comprehensive mental health program.

Learn more:

• The Africa Centre
• The ArTeMo project (PDF, 3.1 MB)

MHBC Fund Knowledge Mobilization Network

The MHBC Fund's Knowledge Mobilization Network sub-stream funded the TAIBU Community Health Centre's Amandla Olwazi – The Power of Knowledge project. This project aimed to help share evidence and insights, and strengthen networks within and between Black communities.

Amandla Olwazi developed a website called the Black Wellness Network to support the program's knowledge mobilization initiative. This website mobilizes resources such as:

• more information on MHBC Fund projects
• the Project Stories Series and the MHBC Infographic Series, which were co-developed by PHAC and the TAIBU Community Health Centre
• centralized information and resources related to the mental health of Black communities

The project was guided by an advisory committee made up of staff and volunteers from MHBC Fund projects, as well as members of the research community and diverse Black communities. It was rooted in Afrocentric values and principles, and focused on connecting and exchanging knowledge between researchers, professionals, the public, and individuals seeking mental health supports. These exchanges were made through the Black Wellness Network website and during their annual ACT Now! conference held in March 2023 and March 2024.

The conferences aimed to bring together Black leaders, elders and youth, as well as academics, advocates and mental health professionals to address multifaceted mental health issues affecting Black communities. These exchanges fostered novel insights, resources and tools pertaining to the mental wellbeing of Black people across Canada. The conferences encouraged awareness and deeper comprehension of anti-Black racism and strengthening the fabric of communities.

In 2023, over 270 individuals attended the ACT Now! conference. The most represented sectors were^{Footnote 13}:

• mental health services (43%)
• community health (40%)
• grassroots organizations (32%)

In 2024, over 300 participants attended the ACT Now! conference, which included 260 in-person attendees and over 100 online attendees. The most represented sectors were^{Footnote 14}:

• mental health services (33%)
• community health (18%)
• social services (15%)
• primary care (7%)

95% of conference attendees reported applying or using acquired knowledge in their daily life. 89% of conference attendees demonstrated using or intending to use acquired knowledge in their professional mental health activities.

This project's activities played a significant role in knowledge mobilization by supporting:

• increased understanding of the unique mental health experiences of Black people in Canada
• the development of various knowledge mobilization products

MHBC Fund projects also led the development of their own knowledge mobilization products, such as training, reports, peer-reviewed articles, and toolkits^{Footnote 15} to encourage positive mental health change.

Learn more:

• Black Wellness Network
• MHBC project resources (Black Wellness Network)

Knowledge to equip and empower Black communities

The MHBC Fund supported several grassroot initiatives and community organizations across Canada that worked towards promoting mental health in Black communities. These initiatives often addressed barriers to care by focusing on awareness-raising, education and empowerment. Projects promoted positive mental health, built strength and confidence, decreased trauma, and expanded knowledge of supports and services for Black people in Canada.

PHAC reviewed MHBC funded project reports and relevant literature to identify 4 key recurring themes:

• Addressing anti-Black racism as a social determinant of health
• Access to culturally appropriate mental health supports and services
• Adopting a decolonized approach
• Approaches toward health equity

These themes are central for fostering positive mental health within Black communities across Canada.

Addressing anti-Black racism as a social determinant of health

Health disparities are often a consequence of systemic inequities, and are closely intertwined with the pervasive effects of anti-Black racism. In response to these challenges, the MHBC Fund supported initiatives which aimed to improve mental health outcomes for Black communities. These projects were specifically designed to:

• address the inequities faced by these communities
• enhance awareness of mental health issues
• address the specific barriers that impede access to optimal mental health care

Funding recipients expressed that Black communities in Canada have suffered negative effects and harms as a result of anti-Black Racism in areas such as health, income and access to resources. Black communities in Canada face disparities in health outcomes and determinants of health arising from differential care, access and exposure to opportunities based on race^{Footnote 16 Footnote 17 Footnote 18}. Organizations also partnered with supplementary providers such as scholars, advocates, professionals and community members.

Feedback from funding recipients indicated the importance of addressing anti-Black racism. The mental health of Black people is profoundly affected by institutional racism and racial prejudice^{Footnote 19}. Knowing this, funding recipients developed diverse approaches to address anti-Black racism, including:

• revising, practicing and developing strategies to counteract anti-Black racism
• understanding how gender and sexuality are impacted by anti-Black racism
• perspectives on how the mental health of Black youth is affected by anti-Black racism
• educating and training participants on navigating anti-Black racism in structured systems
• leading from an Afrocentric and Ubuntu lens to combat anti-Black racism

Funding recipients expressed that anti-Black racism is a major factor influencing mental health and wellness in Black communities. MHBC Fund projects identified the need to address anti-Black racism and aimed to educate the community on this point.

According to one project, understanding the "barriers and challenges faced by Black youth and families that are rooted in and upheld by systemic violence and anti-Black racism [is crucial]."

Project findings supported funding recipients by making recommendations for professionals, service providers and the general public. MHBC Fund projects have reframed assessment tools and developed toolkits and certificates to educate program participants, professionals and service providers on anti-Black racism.

Access to culturally appropriate mental health supports and services

Funding recipients worked with partners to offer culturally sensitive and relevant mental health services and interventions. Project interventions used traditional healing practices and community-based approaches that recognize the importance of addressing systemic inequities to address stigma, discrimination and anti-Black racism.

MHBC Fund projects enhanced equitable access to care and support for Black people in Canada through:

• collaboration with partners
• using a health equity framework
• a focus on cultural competency and safety

These principles acknowledge the necessity of challenging systematic injustices and delivering treatment that honors the cultural and social circumstances of Black communities in Canada.

Funding recipients partnered with Black community organizations and leaders to design and implement mental health interventions and to increase access to support. Community feedback was crucial for guaranteeing cultural competency and safety. Projects prioritized equitable access to opportunities and resources, and focused on attaining health equity by:

• providing training programs and toolkits
• adapting resilience tools to support and protect the cultural norms of certain populations

Guaranteeing safe, accessible and equitable healthcare for Black communities in Canada recognizes anti-Black racism and its effects on the health and wellbeing of Black people in Canada. Project participants were offered a secure environment and culturally customized services for learning and development.

Adopting a decolonized approach

The stigma associated with mental health has arisen from historical, research, practical and policy shortcomings that have inadequately addressed the unique aspects of suffering within Black communities^{Footnote 21}. Projects embraced decolonizing frameworks to ensure the ethical, democratic, critical and community-oriented execution of mental health research and practice aimed at transforming mental health promotion for Black communities in Canada.

Despite ongoing efforts to enhance cultural sensitivity in mental health care, Western colonial paradigms remain the predominant basis for research, education and practice in these fields^{Footnote 22}. Funding recipients used Afrocentric research paradigms in their projects to address the lack of culturally pertinent and suitable research on Black mental health in their projects.

MHBC Fund projects that used decolonizing frameworks identified:

• the deficiencies in mental health service provision
• the restoration of wellness approaches as pathways for enhancing Black health services across Canada
• developing methods through which services can implement these transformations

Some projects addressed decolonization by focusing on fundamental concepts of mental health promotion and encompassing structural transformation. They also used Ubuntu principles^{Footnote 23} and culturally relevant mental health services.

Contextualizing Black mental health and wellbeing involves prioritizing Black interests and voices. The discourse surrounding decolonization shows that knowledge is shifting to prioritize and amplify the voices of Black communities. Health and mental health interventions led by Black communities are crucial for transformation.

Approaches toward health equity data

An approach that addresses the social determinants of Black mental health requires community engagement, advocacy, education, targeted interventions and a health equity lens. Funding recipients aimed to create inclusive and culturally sensitive spaces that recognized and addressed these determinants to support the mental wellbeing of Black individuals and communities in Canada. This was essential for ensuring equitable access to mental health services and culturally sensitive care. Projects implemented these principles by continuously assessing their mental health strategies and services, and used health equity metrics to measure progress.

Research conducted by MHBC Fund projects complemented existing mental health promotion tools and improved their workplans to ensure they were culturally appropriate.

Funding recipients that have effectively implemented a health equity perspective in their projects have:

• provided mental health and wellness education to Black communities and Black youth
• made informational materials available to people with different education levels and linguistic backgrounds, such as:
  • peer reviewed articles and presentations
  • toolkits
  • meditation models
  • social networks
• increased general knowledge about mental health care of Black children and youth

Learn more:

• Pathways to Care

Program outcomes

All MHBC Fund projects had to measure outcomes that aligned with the program's logic model, as shown in Figure 2. Each project outcome focused on important elements that supported positive mental health for Black communities across Canada. These included:

• connecting Black people across Canada
• enhancing social settings
• expanding knowledge or developing skills and abilities
• exchanging best practices and lessons learned

Figure 2: Achieving positive mental health: The Program's logic model

Figure 2: Text description

Long-term outcomes:

• The mental health and well-being of target populations is improved
• Innovative programs and interventions to promote positive mental health are identified and shared

Medium-term outcomes:

• Social environments are improved to support positive mental health (policies, access to resources, social support)
• Knowledge about mental health and its determinants is increased
• Skills or abilities that support positive mental health are improved

Short-term outcome:

• Target populations participate in planned project activities

Participation in project activities

From 2018 to 2024, 144,649 project participants took part in MHBC Fund project activities, including:

• 20,086 people being supported by positive mental health programs for Black people in Canada^{Footnote 24}
• 124,563 people taking part in activities that focused on the social environment of Black people in Canada, including:
  • mentors
  • parents
  • health professionals
  • staff
  • religious leaders
  • members of the public

Distribution of participants to positive mental health programs per gender and age group.^{Footnote 25} Since the University of Ottawa project reached the majority of participants (95 %) data is presented with and without this project.

Program reach

The MHBC Fund invites organizations across sectors to partner with Black communities across Canada in supporting positive mental health initiatives. By engaging community-led, culturally-grounded action, the Fund supports initiatives that strengthen capacity, build evidence, and deliver programs to reduce barriers and address the social determinants of mental health among Black people in Canada. Through the funded Implementation stream projects illustrated on the program map, the MHBC Fund aims to mobilize partnerships, elevate culturally-relevant knowledge, and foster sustainable community-driven change.

Learn more:

• Mental Health—Black Canadians—Funding Map

Increased knowledge of mental health

On average, 82% of project participants reported increasing their knowledge of mental health. Several projects intended to educate and raise awareness of mental health issues among Black communities. Projects delivered training activities, webinars, workshops and education sessions for Black people in Canada and their social networks (such as parents, mentors, health professionals, teachers and service providers).

Participants reported gaining a better understanding of mental health needs and challenges, and the effects of racism, micro-aggressions, and discrimination on their mental health. They felt more able to access information about mental health supports, and were more successful identifying myths and truths about mental health.

Increased skills or ability to support mental health

On average, 78% of participants reported increasing their skills and abilities to support their mental health as a result of taking part in projects. Some projects used arts-based approaches (like painting, rap and poetry) to help participants express their experiences with mental health. Participants found these activities effective in:

• improving their mental health
• enhancing outcomes of cognitive behavioral therapy
• helping to develop coping mechanisms

Project participants also felt more confident in supporting the mental health of people around them, as well as taking action to improve their own mental health. For example, by seeking support, finding resources, and improving their ability to believe in themselves.

Improvements of social environments

On average, 57% of project participants reported improvements in social environments. A majority of the 15 projects funded under the implementation stream reported stronger social supports as a result of their project (such as someone to talk to or to help them). At the community level, this meant:

• establishing effective referral networks
• developing trust
• identifying community needs
• fostering partnerships between:
  • mental health organizations
  • grassroots organizations
  • leaders in the community
  • pertinent stakeholders

6 funding recipients reported participants having better access to resources, and 2 projects reported reduced mental health stigma as result of their projects.

Improving social environments is important because the community plays a large role in mental health outcomes. Community environments can create fear, grief and trauma for its members, and can cause communities to separate and no longer occupy the space they should. As a result, strengthening communities and bringing community members together is critical to improving and maintaining positive mental health outcomes.

Overall, MHBC Fund projects truly strengthened the fabric of Black communities and enabled positive responses to mental health challenges.

Improved mental health

On average, 68% of project participants reported improvements in their mental health. It's essential for community members to work together to understand what affects their access to mental health supports. This collaboration ultimately leads to a strong sense of belonging and improved perceived mental health.

Worldwide events impacting MHBC Fund projects

Several events impacted the mental health outcomes of Black communities in Canada during the implementation of MHBC funded projects. The most frequently reported were:

• the COVID-19 pandemic
• the murder of George Floyd
• the Black Lives Matter movement

The COVID-19 pandemic deepened socioeconomic disparities in Black communities across Canada, which led to continued lasting negative impacts. The trauma of the murder of George Floyd had a significant impact on mental health experiences and continues to do so.

These events showed the need for initiatives like the MHBC Fund that help Black communities support their own positive mental health.

The COVID-19 pandemic

The COVID-19 pandemic disproportionately affected the mental health of Black people in Canada. Structural inequalities, racism, and pre-existing socioeconomic disparities adversely affected Black people in Canada, making them more vulnerable to the negative health effects of the pandemic^{Footnote 26 Footnote 27}.

Projects included efforts to address these effects by establishing mental health resources for Black people, using community links and educating participants on resilience and resistance. Materials and work plans used Afrocentric values, anti-Black racism strategies and Ubuntu principles while following COVID-19 protocols. Adopting a strength-based approach was also essential for prioritizing Black experiences in health discussions and support. COVID-19 caused barriers to project delivery, such as limiting in-person activities. This made it challenging to engage new target demographics and to build trust with them.

The murder of George Floyd and the resurgence of the Black Lives Matter movement

The murder of George Floyd in the United States of America in 2020 had a profound global effect. This brought renewed attention to issues of systemic racism, oppression, and the broader impact on mental health, particularly within Black communities globally. It started conversations about systemic racism across multiple MHBC Fund projects. It prompted thought-provoking discussions about mental health inequities for Black people in Canada, and resulted in the development of educational initiatives. This included topics on anti-racism and gun violence.

Black Lives Matter's global outcry following the murder of George Floyd highlighted the need for mental health supports for Black communities in Canada, as they still experience racism. This has led to a call to identify, recognize and tackle issues of racism and equity in health care institutions, mental health research, and mental health service delivery.

Key learnings

This summary of key learnings uses information from various sources, such as:

• MHBC Fund projects' annual, final and evaluation reports
• learnings from the MHBC Working Group
• the special issue of PHAC's Health Promotion and Chronic Disease Prevention in Canada Journal, Engaging in culturally responsive research and programs for Black communities

Applying an anti-racist and intersectional lens, and enabling community resilience to address the needs of diverse Black people in Canada, requires a foundation of:

• Black representation in mental health programming
• building trust and relationships within Black communities
• including people with lived experiences

It was essential to embed equity considerations throughout the funding process, including in the design of funding application materials and the review process. This helped to remove barriers and made it easier for communities to access opportunities and resources.

Taking a holistic approach can lead to more effective outcomes. Such an approach should address underlying social, economic and environmental determinants of mental health and how they connect, as well as individual mental health needs. This includes efforts to address socioeconomic disparities, systemic racism and inequalities in mental health.

There are a unique history and pervasive nature of systemic racism against Black people in Canada. Given this history, authentic engagement with the MHBC Working Group and other diverse Black stakeholders:

• enabled a co-development approach
• increased the inclusion of Black peoples' voices
• built trust
• provided Black-led advice to help develop and the implement the MHBC Fund

It is vital to engage with Black-led organizations, mental health professionals, mentors and coaches. This increases knowledge of mental health promotion in Black communities in Canada, and improves awareness and use of the project's programs and services.

A critical step to addressing barriers in mental health is by developing and using the knowledge and expertise of Black communities. Projects held regularly engaged with Black communities and gather input on mental health services, barriers and needs. These partnerships between mental health organizations, community leaders, grassroots organizations and stakeholders helped to identify community needs, build trust and establish effective referral networks.

Programs and services increased their relevancy and responsiveness by:

• recognizing the knowledge and experience of Black communities
• prioritizing community-centered and community-relevant projects that responded to unexpected events and needs
• designing their programs and services with an anti-racist and intersectional lens

Community-led initiatives can address the unique needs and challenges of the local population, using community resources, strengths and cultural values.

Creating sustainable and impactful change requires partnerships and collaboration among stakeholders such as:

• mental health organizations
• community leaders
• researchers
• policy makers

These partnerships drove innovation and advocacy, and helped to develop comprehensive solutions.

Analysis of the data from MHBC annual and final reports and interviews illuminated 3 main themes^{Footnote 28}:

1. Facilitators of successes.
2. Challenges.
3. Lessons learned Recommendations for funders.

Facilitators included honorariums and incentives, participatory action research design, and Black leadership.

Challenges included:

• delays (for obtaining ethics approval and program implementation)
• impacts of the COVID-19 pandemic
• difficulties maintaining partnerships

Finally, lessons learned, and recommendations advised that funders provide:

• longer term and more flexible funding
• more Black representation and leadership within funding organizations
• greater support of cultural competency among mainstream service providers

Community participation helped raise awareness about mental health issues, reducing stigma, and promoting open discussions. By involving members from diverse Black communities, projects could openly address mental health concerns, fostering a supportive environment where people felt comfortable seeking support. Community participation fostered resilience by building social connections, promoting collective problem-solving, and enhancing community support networks. Projects implemented mental health initiatives and strengthened the fabric of the community, enabling it to respond more effectively to mental health challenges.

Facilitating relationships within diverse Black communities increased the awareness, exchange and use of resources, through:

• Black-led national conferences
• community activities
• project networking
• collaborations
• partnerships
• a Black-led, Black-focused and Black serving network

Conclusion

The MHBC Fund has been instrumental in boosting the visibility of Black voices, fostering change, offering Black-led guidance for mental health programs, and drawing attention to the importance of positive mental health MHBC Fund projects were able to make connections, raise awareness, and build relationships within diverse Black communities in Canada by:

• supporting Black-led national conferences and community activities
• developing Black-led, Black-focused, and Black-serving online networks

This, in turn, increased mental health awareness, knowledge exchange, and use of resources.

Increasing the relevance and responsiveness of services offered through the MHBC Fund projects was made possible by acknowledging the diverse knowledge and experiences of Black communities. The MHBC Fund prioritizes community-centered projects that are responsive to pertinent events, needs, and organizations that design their services through an anti-Black racist and intersectional lens.

For two years, Budget 2024 investments to PHAC have supported:

• build on existing work
• support new funding recipients
• create new mental health initiatives with measurable results during the 2-year timeframe

Limitations

To ensure the MHBC Fund's results are transparent, this report includes contextual information and verbatim quotes. However, these findings do not represent all Black communities in Canada. The quantitative results reflect the program outcomes among those who have responded to surveys and consent to participate in the project's evaluation. Consequently, the results may not reflect the experience of all participants reached through the MHBC Fund.

Some participants did not feel comfortable providing sociodemographic information or race-based data. In some cases, no data on race was collected. Disaggregated data would be useful in recognizing and addressing systemic racism, discrimination, and social injustices in mental health outcomes for Black communities in Canada. It would also highlight significant gaps in the availability of race-based data.

Acknowledgements

The Public Health Agency of Canada expresses gratitude to members of the Mental Health of Black Canadians Working Group for their leadership, guidance, reflection, and continued support, including the design and the implementation of the MHBC Fund. The Agency also recognizes the leadership of the MHBC Fund's funding recipients for driving positive community change and enhancing collective efforts to achieve health equity.

References