Defunding Police Isn't Enough. There's Systemic Racism in Healthcare Too

Earlier this month, emergency room doctors and nurses in British Columbia were allegedly caught guessing the blood-alcohol levels of Indigenous patients as closely as possible without going over. Apparently the “game,” called “The Price Is Right,” wasn’t a one-off; Métis Nation British Columbia says it’s “widespread and very pervasive,” reported the CBC.

The news broke the same week Black Lives Matter Toronto published a list of concrete steps for defunding the police, a call repeated worldwide after the killing of George Floyd in Minnesota. The aim is to reallocate funds from all levels of police services to systems of care such as social work, mental health supports, and addiction specialists in an effort to stop police violence that disproportionately kills Black and Indigenous peoples and people of colour.

By increasing funding for a wide range of healthcare and support workers, the argument goes, people trained in crisis de-escalation, including mental health and addiction, will be able to take charge when someone in distress calls 911.

But what happens next? Like in the B.C. example, healthcare and support systems also have a legacy of systemic racism.

"There is something seriously wrong here besides ‘The Price is Right.’ ‘The Price is Right’ is just one game," Métis Nation British Columbia CEO Daniel Fontaine told the CBC.

Systemic racism is evident in healthcare, according to a 2018 HealthcareCAN report. Indigenous patients regularly reported longer wait times, being turned away, or racial slurs being used against them by healthcare staff. They were also under-represented in kidney transplants, despite being more likely than white people to suffer from kidney disease.

“If we fund ‘same old, same old,’ we’re taking from one racist system (police) and putting it into another,” said Aseefa Sarang, the executive director of Across Boundaries, a mental health support services network for racialized people.

The only way to ensure meaningful change is to tackle racism in mental health, foster care, addictions support, and medical care, among others, experts who support defunding police told VICE.

Last weekend, Peel Regional Police in Ontario shot and killed 62-year-old father of four, Ejaz Choudry, while he was having a schizophrenic episode. He was at least the fifth person to die in Canada during a mental health call or wellness check by police since April. All five were Black, Indigenous, or people of colour.

Choudry’s family first contacted a non-emergency line for support before police showed up.

“Since he had a knife the social service uncritically and without an anti-racist and anti-oppressive lens followed protocol and called the police,” Sarah Maiter, a professor with York University’s school of social work, told VICE. “The end result of this was the killing of a man suffering with schizophrenia.”

Many social workers have been “uncritical agents of social control,” Maiter said.

Black, Indigenous, and people of colour also face barriers when attempting to access meaningful mental healthcare or addictions services, Sarang said.

Sarang supports defunding the police, but “once we do get to that point, hopefully we make sure reallocated funds are put into systems of care equitably,” she said.

It is well documented that racialized people have a harder time accessing quality mental healthcare. Studies show several barriers affect access to mental health care, including too few racialized counsellors, high costs associated with therapy, and fear of authorities who are perceived as racist or culturally insensitive.

“We need to include community members in decision-making, so we make sure we’re meeting their needs going forward,” Sarang said.

The industry can take many steps to make mental healthcare more equitable, including hiring diverse experts, Sarang said.

When Across Boundaries realized racialized LGBTQ people weren’t being served by the organization, three new hires, all of whom identify as racialized and queer or trans, came on to help develop programming that supports people who are both racialized and part of the LGBTQ community, Sarang said.

“It’s about creating a safe space to have conversations they're not comfortable having in other places,” Sarang said. “Creating opportunities for people to speak with people who understand them because of the same lived experiences.”

White allies, especially those who already have decision-making powers, have a role too, Sarang said. “We need social workers and mental healthcare workers with anti-oppression and anti-racism training.”

According to Statistics Canada, 52.2 percent of children in the foster care system are Indigenous, despite only accounting for 7.7 percent of the population.

Mary Burton, an Indigenous woman living in Winnipeg, Manitoba, was taken from her family as a child and, while she said it’s good she was removed from a dangerous situation initially, the foster care system kept her away from her family for too long. She experienced racism throughout, she said.

“For eight years I was put into situations where I was treated less than human,” Burton said. “I was told I was going to become one of those girls that end up being drunk and pregnant on Main Street.”

As an adult, Burton said she had to fight Child Family Services for custody of her own kids and grandkids. Her experience taught Burton how to engage with social workers and CFS, so she, along with Michael Redhead Champagne, started Fearless R2W, a volunteer-run, community-based outreach group in Winnipeg that supports families navigating the system.

Champagne shared multiple stories of CFS workers who unfairly stereotype Indigenous parents. He believes in defunding the police, he said, but wants to see systems of care tackle racism too.

“If you’re going to defund the police and redirect resources, look at the fact that systems like the foster care system are about family separation. Resources should go towards family reunification,” Champagne said. “Whether we’re addressing health, mental health, addiction, or other, we shouldn’t punish people when they make mistakes.”

Several healthcare professionals in Canada came out to share their own experiences with racism in the system following the news of the racist “Price Is Right” game.

Danielle Bourque-Bearskin is an Ontario-based nurse who studied inequities in the healthcare system as part of her masters degree. “I’m a huge supporter of abolishing the RCMP and defunding police,” she told VICE. “But I hold that with reservation if we’re reallocating funds in a way that replicates harm in colonial systems (like healthcare) that still haven’t acknowledged their own systemic racism.”

Nurses have played instrumental roles in furthering colonialism and violence targeting Indigenous peoples, particularly when it comes to the foster care system, residential schools, missing and murdered Indigenous women and girls, and the less well known practice of forced sterilization of Indigenous women, Bourque-Bearskin said.

She has seen firsthand how Indigenous patients are stereotyped and treated poorly, so it’s no wonder Black and Indigenous peoples are less likely to seek care when they need it, she said.

The only way to eradicate systemic racism in healthcare is for professionals to acknowledge racism exists—otherwise calls to defund the police won’t have the desired effect.

Racism “is not an Indigenous or a Black problem here in Canada—it’s a Canadian problem,” Bourque-Bearskin said. “We have racism and Canada has done a poor job of acknowledging it. It’s mind-boggling.”

More Black, Indigenous, and people of colour need to be hired into leadership positions, because their lived experience will help inform the work environments, she said.

In 2017, the Toronto Star reported the limited availability of racial diversity data among physicians, and noted that of the 39 health ministers that had served in Canada by that time, only one was Indigenous and one was racialized. A 2015 Canadian Medical Association Journal editorial found that even with incomplete data, it’s clear Black people were drastically under-represented in medical schools across Canada.

“Indigenous representation and leadership in decision-making allow for a trickle-down effect,” Bourque-Bearskin said. “We’re at a very grassroots level right now, but going from the ground up will only do so much. Change needs to come from the top down as well for full systemic change to occur in healthcare.”

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