“Dual Pandemics”: Intersecting Influences of Anti-Black Racism and the COVID-19 Pandemic on the Mental Health of Black Youth

Abstract

Background

The intersection of the COVID-19 pandemic with systemic anti-Black racism in the form of police violence and the subsequent Black Lives Matter movement has created an especially critical juncture to examine the mental health of Black youth.

Purpose

The purpose of this study was to understand the intersecting impacts of anti-Black racism and the COVID-19 pandemic on the mental health of Black youth.

Methods

A youth-engaged research approach and intersectionality framework were utilized. Semi-structured interviews with Black youth across Canada (ages 16 to 30, n = 48) were conducted online via Zoom and analyzed using thematic analysis. Fourteen Black youth were hired to form a Black youth advisory committee, who guided the research process.

Results

The “dual pandemics” of the COVID-19 pandemic alongside highly publicized incidents of racism and the subsequent Black Lives Matter movement negatively impacted participants’ mental health. Four main themes emerged: (1) ongoing exposure to acts of anti-Black racism (2) compounding effect of racism on mental health; (3) high stress levels and fear; and (4) anger and emotional fatigue from lack of shared, long-term solutions.

Conclusion

The simultaneous occurrence of the COVID-19 pandemic and instances of systemic anti-Black racism in the form of police violence presented “dual pandemics” for the Black community, profoundly impacting the mental health of Black youth and adding urgency and impetus to its prioritization. Results of this study indicate that it is critical to explore each event individually as well as the combined impact on the mental health of Black youth, particularly from a racial perspective.

Keywords

Mental health black youth intersectionality COVID-19 anti-Black racism police brutality

Introduction

Racism and discrimination at the individual or group level can critically impact mental health amongst racialized groups (Williams et al., 2022). This is true within the Black community, where extensive research has linked experiences of racism to diminished mental wellness (Cooper et al., 2008; Watson-Singleton et al., 2021). For Black youth in particular, their emotions can be shaped by their experiences of racism and oppression (Lozada et al., 2022), and these direct and indirect experiences of anti-Black racism when engaging with systems and institutions are known causes of depression, trauma, and other adverse mental health outcomes (Cooper et al. 2008; Witherspoon et al., 2022). In May 2020, the murder of George Floyd by a police officer became a pivotal event symbolizing systemic anti-Black racism, igniting the largest racial justice protests in the United States since the Civil Rights Movement (Burch et al., 2021). Global action against anti-Black racism, largely represented by the Black Lives Matter (BLM) movement, extended far beyond American borders as demonstrations protesting the deaths of George Floyd and other Black lives lost to institutionalized violence took place around the world. These instances of systemic anti-Black racism have had mental health consequences across the Black community (Alang et al., 2022; Bor et al., 2018). The current socio-political context of highly publicized instances of racial injustice as well as the anti-Black racism response, largely represented by the BLM movement, have the potential to significantly impact the mental health of Black youth. However, little is known about how Black youth perceive and have been affected by these events (Smith-Bynum, 2022).

In March 2020, shortly prior to the murder of George Floyd, the World Health Organization declared the SARS-CoV-2 (COVID-19) strain a global pandemic. Along with numerous other countries, Canada's Public Health Agency instituted nationwide public health measures including physical distancing, the mandatory closure of schools and nonessential businesses, and gathering size restrictions to reduce the virus's transmission (Government of Canada, 2022). Restrictive population-based measures detrimentally impacted individuals’ mental health and well-being, particularly amongst youth (Cost et al., 2022; Hawke et al., 2021). Studies from the United States and Canada indicate that Black communities experienced significant psychological distress during COVID-19 (Banks, 2022; Craig et al., 2023; Czeisler et al., 2020), in part due to indicators of longstanding racial inequality that were exacerbated by the pandemic (Layne et al., 2023; McKenzie, 2021). For instance, as members of Black communities often experience socio-economic insecurity, worry around contracting the virus and subsequently being required to take time away from work was especially pronounced and profound (Ahmed et al., 2021). However, there is little evidence to date of the impact of the pandemic, including the public health measures, on the mental health of Black youth in particular. Addressing the mental health needs of Black youth during the COVID-19 pandemic is particularly important as this group already experiences poorer mental health outcomes (Anderson et al., 2015; van der Ven et al., 2012).

The intersection of COVID-19 with recent instances of systemic anti-Black racism has created “dual pandemics” (Layne et al., 2023, p. 1) confronting the Black community, and thus precipitated an especially critical juncture to examine the mental health of Black youth. For the purposes of this study, systemic racism refers to processes, laws, policies, and deep-rooted practices and beliefs that “produce, condone, and perpetuate widespread unfair treatment and oppression of people of color” (Braveman et al., 2022, p. 171). Although this study originally intended to focus solely on the mental health impacts of COVID-19 on Black youth, the racial events occurring at the time of this study could not be separated from discussions of mental health with participants. Given the overlap of these social contexts and their salience to participants, we chose to broaden the study focus to include both COVID-19 and recent instances of anti-Black racism, and examine the ways in which they intersected to influence mental health wellbeing of Black youth. Here, we use ‘anti-Black racism’ to refer to the systemic anti-Black racism characterized by police violence. Our discussion of anti-Black racism also includes the global socio-political response it triggered via the BLM movement. This study critically contributes to the gap in knowledge on the mental health of Black youth, specifically in the context of COVID-19 and anti-Black racism.

Methodology

We used a youth-engaged approach to research (Hawke et al., 2018) where youth were seen as experts and contributing partners. This approach added a youth lens to this study, where decisions on research activities including planning, data collection, and analysis reflected youth's perspectives and lived experiences. Youth engagement in the research process facilitated the exchange of knowledge between youth and academic research team members as they collaboratively negotiated meanings that acknowledged multiple realities and facilitated the co-construction of knowledge (Lindquist-Grantz & Abraczinskas, 2020; Ozer, 2017).

Theoretical framework

This study drew on intersectionality theory, which explores multiple forms of social oppression at systemic, interpersonal, and individual levels (Bauer, 2014; Hankivsky et al., 2010). Drawing on intersectionality theory, we explored the interaction of race and socio-political contexts on the mental health of Black youths. Intersectionality theory acknowledges the varied histories and impacts of social, economic, and political marginalization across and within subjugated groups (Crenshaw, 1991). Applying intersectionality theory proposes that the convergence of various forms of oppression, such as health-related and racial oppression, results in distinct vulnerabilities impacting the mental health of Black youth (Smith-Bynum, 2022). Thus, applying intersectionality theory to this study deepens our understanding of the interconnected vulnerabilities Black youth experience, particularly during a pandemic in socio-politically charged circumstances, while simultaneously recognizing their strengths and capacity for resilience.

Research assistants and black youth advisory committee

Six research assistants with varying academic and social backgrounds were recruited to facilitate this project . Research assistants received training in youth-engaged research, intersectionality, and mental health approaches. Training also included an overview of reflexivity, ethical protocols, qualitative interviewing, and analysis. The role of the research assistants was to revise the existing interview guide, conduct interviews, and assist in manuscript writing.

In alignment with youth-engaged research, 14 Black youth were hired to form a Black youth advisory committee. Each member of the advisory committee came with diverse experiences working within the community sector. The Black youth advisory committee met semi-monthly to learn about the research process, share their knowledge and experiences, and collaboratively implement the research activities. For instance, the youth advisory committee was instrumental in deciding to expand the study focus to investigate the intersecting impact of the COVID-19 pandemic and anti-Black racism on the lives of Black youths. They also played a lead role in developing the interview guide together with the research team.

Positionality and reflexivity

In qualitative research, ongoing reflection contributes to unveiling assumptions, minimizing bias, and enhancing rigour across the research process (Lynch, 2000; Wilson et al., 2022). Using an intersectional lens enabled us to reflect on issues of power and our positionalities particularly when interviewing Black youth on issues of mental health. Given the added psychological burden of both the COVID-19 pandemic and instances of anti-Black racism, practicing reflexivity through discussion and memoing was crucial for the research team.

Recruitment

Ethical approval was received from the institutional Research Ethics Board (REB 1 Committee Protocol: Pro00116630). Snowball sampling was used to recruit 48 youth aged 16–30 (mean age = 22) who self-identified as Black and lived in Canada. Participants were recruited through existing databases, Black service providing agencies, and social media. All interested participants were eligible, and completed a consent form and sociodemographic questionnaire. In total, 25 participants identified as male and 23 as female. Most provinces and territories were represented apart from Saskatchewan, New Brunswick, Prince Edward Island, Northwest Territories, and Yukon Territory. The majority of participants identified as Christian (n = 36), four as Muslim and six as non-religious or other. All participants experienced the COVID-19 pandemic in Canada and were aware of the acts of anti-Black racism that had recently taken place at the time, particularly the killing of George Floyd. Participants of this study did not report direct personal experiences of police brutality, conflict with the law, or issues of injustice firsthand. As such, our study reflects participants perceptions and experiences as Black community members who vicariously and indirectly were affected by these events.

Data collection

Recruitment and data collection occurred concurrently until data saturation was achieved. Research assistants conducted 48 semi-structured, virtual interviews via Zoom, each lasting approximately 60 min. During the interview, participants were able to speak in English or French. The interview guide was created by the principal investigators and revised by research assistants and the youth advisory committee to incorporate relevant social, political and cultural questions. Interview questions discussed participants’ experiences and perceptions of anti-Black racism and police brutality, the BLM movement, and COVID-19 on mental health.

Data analysis

Thematic analysis driven by grounded theory with NVivo 12 software was utilized to highlight and define recurring themes in the interview data and interpret the results (Braun & Clarke, 2006). Thematic analysis is a method for identifying, analyzing, and reporting patterns within a dataset (Braun & Clarke, 2006). We chose thematic analysis as our primary methodological approach due to its suitability for identifying and interpreting patterns within qualitative data (Braun & Clarke, 2006). Thematic analysis allowed us to explore the rich narratives provided by our participants and uncover recurring themes that emerged across the interviews.

Data collection and data analysis occurred concurrently. The research assistants met weekly with a postdoctoral fellow to reflect on data gathered and propose strategies to inform the research process and enhance quality. The postdoctoral fellow and research assistants read multiple manuscripts and co-developed a framework for coding the data. The coding framework developed by each member of the team was compared to develop an agreed upon coding framework.

Analysis occurred through the use of Nvivo data analysis software and involved coding the data. As data was coded, the codes were expanded collapsed or refined. We used open coding and kept memos to track our thought process and reflexively engage in the data. We then used axial coding to aggregate codes into categories. We compared codes and defined several ideas within our data (selective coding). These codes were then translated into themes. The final step involved writing the results based on the thematic analysis of the data.

To ensure rigor in our study, several measures were implemented. We ensured intercoder reliability. Regular meetings were held between the postdoctoral fellow and the research assistant to discuss coding discrepancies and ensure consistency in interpretation. We also implemented peer debriefing. The analysis process was periodically reviewed by other members of the research team to provide additional insights and validate emerging themes. We met regularly to debrief about our emerging ideas. We also exercised reflexivity. The researchers continuously reflected on their own biases and assumptions throughout the analysis process, striving for impartiality and transparency in interpretation.

Results

Interviews were conducted with 48 Black youth from across Canada. The findings from this study were organized into the following four themes: (1) ongoing exposure to acts of anti-Black racism (2) compounding effect of racism on mental health; (3) high stress levels and fear; and (4) anger and emotional fatigue from lack of shared, long-term solutions.

Ongoing exposure to acts of anti-black racism

As the public reacted to recent instances of anti-Black racism in the form of racial violence, particularly the killing of George Floyd, social media and news sources continually displayed video, commentary, and other visual and audio reminders. Participants spoke honestly about the grief, trauma, and sadness they experienced and re-experienced as they were repeatedly confronted by and reminded of his death in the media, online, and in discussion. Participants shared that both the actual instances of racial violence, such as the killing of George Floyd, as well as the re-portrayal of these instances in the media, were emotionally and psychologically troubling.

I can think about stress as it relates to… anti-black racism and police brutality and racial violence. I think for a lot of black folks during that time seeing all that stuff and being bombarded constantly on pretty much the only platforms that you’re engaging with because physical social interactions are gone. ( Male, 23, born in Jamaica)

As mentioned, participants’ perceived overexposure to images and discussion of racial violence was compounded by greater online presence due to pandemic-related circumstances, subsequently magnifying the traumatic impacts they experienced. These impacts were extensive and longer term in some cases, including fear of being a victim of similar racial violence:

I haven't thought about George Floyd per se in a while. Now you just said it… That vivid image from the video [of George Floyd's murder] is still there. And that to me is a sign of trauma. But one may say, why are you traumatized if it doesn't happen to you? I think a lot of minorities, especially racial minorities, internalize that. That could really be me. I think that is the cause of trauma as well. (Male, 24, born in Rwanda)

Compounding effect of racism on mental health

As youth whose studies, social interactions, and employment were eminently shaped by the pandemic and subsequent public health measures, participants perceived that their mental health diminished as the pandemic continued. In addition to the mental health challenges presented by the pandemic, Black youth experienced the added mental burden of systemic racism. Participants felt that racism, primarily exemplified through the killing of George Floyd, worsened their emotional state during the pandemic: “The pandemic and the racism that was going on really had a bad effect” (Male, 22, born in Canada). As Black youth, navigating the mental health challenges of the pandemic were complicated by simultaneously confronting highly publicized instances of systemic racism. For example, as one youth noted: “In the midst of the pandemic, people still have to face racism and all of that. That really made me really angry, because people are battling with the pandemic, and you have the killing – an innocent Black man” (Male, 22, born in Canada). Participants felt that the conscious and unconscious obligation as Black youth to bear the mental load of both the pandemic and the current racial events on a regular, ongoing basis had detrimental consequences over time. According to a university-age participant,

It's overwhelming, especially being in a program such as sociology where we’re talking about race and racism, and then everyone's studying the impact of COVID-19 in these programs. So it's like constantly being bombarded with [these issues] and not having that break from [them]… It just overall tears you down, without realizing how much it's chipping at you. (Female, 23, born in Canada)

High stress levels and fear

As Black youth, participants experienced greater stress and anxiety as they grappled emotionally and psychologically with both the pandemic and an environment of heightened anti-Black racism. The overlap of worry around illness from COVID-19 as well as racial violence against other Black individuals had mental health impacts. The time following George Floyd's death “created a lot of stress for Black youth” (Female, 16, born in Italy) particularly due to heightened anxiety of police-instigated racial violence, while simultaneously, fear of serious illness from COVID meant that for some participants, “during the pandemic my stress was probably the highest it's ever been” (Female, 20, born in Ghana). Another participant explained further:

I think [COVID-19 and racial violence] could cause stress in multiple ways. One would be the amount of violence that we’re exposed to, whether it be online or in our daily lives. We’d have the George Floyd protest that was happening at the exact same time as COVID-19. So, kids were seeing other people being murdered by police, and that was happening at the exact same time that you’re also supposed to be worried about your family [due to COVID-19]. So I think it impacted everyone's mental health. (Female, 23, born in Canada)

Contextual factors related to the pandemic served to compound participants’ stress around becoming a target of police violence. Participants shared that it was difficult to balance both the limitations imposed by the pandemic such as the closing of public spaces, and their fear of attracting attention from police or others when outside of their homes:

That [situation] could produce high stress levels in Black folks because the pandemic is one thing and the health concerns but now, there's this fear of I might go outside and someone might shoot me for no reason, or someone might see me and commit a hate crime because I’m just running down the street trying to get some exercise [because fitness centres are closed]. (Male, 23, born in Jamaica)

Pandemic-related public health measures restricting in-person connection with their networks and peers made participants feel isolated, adding to their stress and anxiety. Participants found that alternative, online forms of connection did little to alleviate these feelings or in some cases, were more detrimental to their mental health.

Anger and emotional fatigue from lack of shared, long-term solutions

Several participants discussed the mental health impacts of the public reaction to anti-Black racism. Some youth felt that the Black community was negatively affected by bearing the burden of response to anti-Black racism: “I think frustration, anger, tiredness. Because I think the problem is a lot of times issues that come up, we, Black people themselves, feel like that's their issue and that is for them to bear” (Female, 19, born in United Kingdom). Participants felt that as non-victims, other racial groups abdicated responsibility in addressing anti-Black racism, which also caused frustration:

You don’t realize how other races don’t see a need to actually support or actually do something [about anti-Black racism]. So a lot of times there's frustration because it's like, why is it always asked [of us] when these issues are not even our issues, technically. (Female, 19, born in United Kingdom)

Initiatives that were undertaken to support the Black community were often formally or informally associated with the Black Lives Matter movement. Despite the movement's intention to inspire positive social and systemic change, the initiatives to achieve this were at times perceived as short-lived, tokenistic, and insufficient to address the magnitude and prevalence of anti-Black racism, particularly initiatives shared and propagated via social media. For instance, while posting black squares on social media was a way to show solidarity with the Black Lives Matter movement, some participants felt that this action was inadequate in proportion to the issue: “People aren’t going to have black squares forever. It's going to be very fleeting and I never think of the Black plight or issue as a fleeting plight or issue” (Male, 22, born in Canada). Although the Black Lives Matter movement propelled anti-racism to the centre of social discourse, Black youth felt that oftentimes, the scope of issues was oversimplified, reducing longstanding systemic and societal injustices to advocating for Black enterprise.

It was a profound moment to engage in these critical dialogues about not only what is the condition of Black life but also think about how do we create a better society, how do we move forward? And then to see the discourse to be, “we just need to support Black businesses and fund Black organizations more”. It was just like, well the moment is wasted. (Male, 23, born in Jamaica)

Consequently, participants doubted the BLM movement's longevity and long-term impact: “[The movement] just put a band aid on a huge hole… Racism is always going to find a new way to show up… because we can’t even really be united or one voice” (Female, 24, Born in Trinidad and Tobago).

Discussion

The simultaneous occurrence of the Covid-19 pandemic and instances of systemic anti-Black racism in the form of police violence presented “dual pandemics” (Layne et al., 2023, p. 1) for the Black community, profoundly impacting Black youth mental health. Participants of this study experienced trauma as well as heightened stress and anxiety as they grappled with the realities of the pandemic while navigating the experience of being Black youth during a racially-charged time. The intersection of these events with their identity as Black individuals and as youth made participants more vulnerable to poor mental health outcomes. Evans and Francis (2020) discussed instances where Black youth experienced racial profiling and criminalization more frequently than their white counterparts during the pandemic. Stemming from fear of similar outcomes, Black youth in this study were hesitant to be seen outdoors during the pandemic (such as when exercising), and experienced greater anxiety and isolation. Further, Gibson et al. (2022) report that sociocultural awareness is heightened during adolescence, such that highly publicized instances of racism are both salient and potentially problematic for youth development. Given that the pandemic is known to have increased anxiety, stress, and depression most significantly amongst youth and young adults (Nwachukwu et al., 2020), the overlap of the Covid-19 pandemic and recent instances of anti-Black racism is especially worrying in terms of its effect on mental health for Black youth. More research is needed to understand the latent and possible long-term effects of the dual pandemics on mental wellness amongst Black youth as a unique demographic group at the juncture of multiple intersecting identities.

Notably, although youth in this study were not direct targets of anti-Black racism in the form of police violence, their mental wellness was significantly impacted by instances of racism against others with a shared identity as Black. Participants spoke about the effect of continually being exposed to video, images, and commentary of police violence, particularly the killing of George Floyd, in the media and online spaces. A recent study found that compared with other racial groups, Black youth more frequently spend time on social media sites (Rideout & Robb, 2019). The nature of social media spaces, where current events are often presented and discussed, creates an environment where Black youth are likely to be confronted with acts of racism and violence (Witherspoon et al., 2022). Coupled with the sharp increase in social media use amongst youth during the COVID-19 pandemic (Statista, 2020), during this period, Black youth were likely to be exposed to racism and acts of violence against other individuals with a shared identity as Black. The transmission of trauma occurs through direct as well as vicarious exposure to acts of systemic racism, as individuals witness others with a shared identity experiencing discrimination (Pryce et al., 2021). As such, Black youth may be especially vulnerable to adverse mental health outcomes of acts of systemic racism perpetrated against others in the Black community. In the context of the “dual pandemics”, the vicarious effects of systemic racism on Black youth is particularly concerning.

While managing the personal, direct impacts of the COVID-19 pandemic and anti-Back racism, participants described the double burden of also navigating the public response. Although the Black Lives Matter movement was intended to inspire solidarity and collective action against anti-Black racism, public engagement from non-Black racial groups in the Black Lives Matter movement can be perceived as tokenistic and short-lived, especially in the virtual realm (Kalina, 2020). Participants of this study felt that posting black squares on social media in support of the Black Lives Matter movement was “fleeting” and therefore inadequate given the scope and pervasiveness of anti-Black racism. Posting black squares, then, can demonstrate ‘performative allyship’, if non-Black individuals profess verbal support but do not invest time or energy towards substantive, sustained action to limiting anti-Black racism (Kalina, 2020; Wellman, 2022). The Black Lives Matter movement attracted widespread public engagement, yet much of it took place -and remained- in the online context via social media and other virtual platforms (Mundt et al., 2018; Wellman, 2022), thereby limiting the impact of allyship against anti-Black racism to “hashtag activism” (Wellman, 2022). Participants of this study pointed out the disjuncture between the real issues of inequality facing the Black community and the public's commitment to “actually support[ing]” or “actually do[ing]”. Black youth felt frustrated and disillusioned by these instances of minimal engagement in the face of maximal consequences for the Black community. Findings from this study suggest that such misdirected, short-lived, or tokenistic responses, however well-intentioned, can serve to exacerbate the mental load that Black individuals carry as they balance both experiences of inequality and their expectations for meaningful change. When movements and campaigns fall vastly short of addressing deeply-rooted systemic racism, the impact on mental health may be even greater. Performative allyship, then, can become another mental health burden for marginalized groups to bear (Kutlaca & Radke, 2023), in this case, Black youth.

Implications

The “dual pandemics” of Covid-19 and the Black Lives Matter movement have added urgency and impetus to prioritizing the mental health of Black youth. Findings from this study indicate that it is critical to explore each event individually, as well as the combined impact on the mental health of Black youth, particularly from a racial perspective. With a better understanding of the ways in which race and systemic racism have affected Black youth's experiences and mental health during the COVID-19 pandemic, we can work towards developing policies and supports aimed at restoring mental wellness. This study is a first step towards filling this gap in knowledge. More studies on these events, as well as the ways in which they intersect to influence mental health, should be of priority to better understand mental health amongst this group and begin to redress the ongoing psychological effects of systemic racism. Policy and practices that draw on this evidence must follow.

Limitations

Because the original focus of this study was to explore the mental health of Black youth and the Covid-19 pandemic, inclusion criteria for this study did not require lived experiences of anti-Black racism such as police violence. Participants did not report having had these firsthand experiences, which limits the findings to their perceptions and experiences based on others’ direct encounters.

Conclusion

As Covid-19 and anti-Black racism simultaneously presented new socio-political contexts and realities, Black youth were especially burdened with stress, fear, and frustration as they responded to both the realities of the pandemic and their perceptions and emotional responses to systemic racism perpetrated against the Black community. The decline in mental health that participants experienced contributes much-needed insight on the mental health of Black youth, while also emphasizing the need to prioritize Black mental health broadly, and in response to Covid-19 and anti-Black racism in the form of police brutality in particular. As we emerge from both the pandemic and the time of heightened anti-Black racism and subsequent Black Lives Matter movement, the impetus to understand, restore, and promote the mental health of Black youth remains.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Canadian Institutes of Health Research

ORCID iD

Bukola Salami

Author Biographies

Samah Osman was a research assistant at the Faculty of Nursing, University of Alberta.

Olivia Aiello was a postdoctoral fellow at the Faculty of Nursing, University of Alberta.

Khadija Brouillete was a research assistant at the Faculty of Nursing, University of Alberta.

Mischa Taylor was a research coordinator at the Faculty of Nursing, University of Alberta. She currently works in community-based qualitative research at the University of British Columbia. She has been involved in community-based projects exploring newcomers' psychosocial adaptation, youth mental health, and more.

Kwame McKenzie is chief executive officer of Wellesley Institute, Director of Health Equity at Center for Additions and Mental Health, and a full professor of Psychiatry at University of Toronto.

Andre M. N. Renzaho is a distinguished professor of Humanitarian and Development Studies within the School of Medicine at Western Sydney University. His work focuses on global migration and health equity.

Jo Henderson is a registered clinical psychologist in Ontario as well as scientific director and senior scientist of the Margaret and Wallace McCain Centre for Child, Youth and Family at the Centre for Addiction and Mental Health. Their work focuses on developing and testing new models of service delivery in partnership with youth, family members and service providers.

Hayley Hamilton is a senior scientist and the associate director of the Institute for Mental Health Policy Research at the Centre for Addiction and Mental Health (CAMH). She is also an associate professor in the Dalla Lana School of Public Health at the University of Toronto and co-director of the Collaborative Program in Addiction Studies at the University of Toronto.

Bukola Salami was a full professor at the Faculty of Nursing, University of Alberta. She is currently full professor and Tier 1 Canada Research Chair in Black and Racialized Peoples Health at the Department of Community Health Science, University of Alberta. She has expertise in Black people's health.

References

Ahmed

Jamal

Ishak

Nabi

Mustafa

(2021). Racial equity in the fight against COVID-19: A qualitative study examining the importance of collecting race-based data in the Canadian context. Tropical Diseases, Travel Medicine and Vaccines, 7(1), 1–6. https://doi.org/10.1186/s40794-021-00138-2

Alang

VanHook

Judson

Ikiroma

Adkins-Jackson

P. B.

(2022). Police brutality, heightened vigilance, and the mental health of black adults. Psychology of Violence, 12(4), 211. https://doi.org/10.1037/vio0000418

Anderson

K. K.

Cheng

Susser

McKenzie

K. J.

Kurdyak

(2015). Incidence of psychotic disorders among first-generation immigrants and refugees in ontario. Canadian Medical Association Journal, 187(9), E279–E286. https://doi.org/10.1503/cmaj.141420

Banks

(2022). Black adolescent experiences with COVID-19 and mental health services utilization. Journal of Racial and Ethnic Health Disparities, 9(4), 1097–1105. https://doi.org/10.1007/s40615-021-01049-w

Bauer

G. R.

(2014). Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity. Social Science & Medicine, 110, 10–17. https://doi.org/10.1016/j.socscimed.2014.03.022

Bor

Venkataramani

A. S.

Williams

D. R.

Tsai

A. C.

(2018). Police killings and their spillover effects on the mental health of black Americans: A population-based, quasi-experimental study. The Lancet, 392(10144), 302–310. https://doi.org/10.1016/S0140-6736(18)31130-9

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Braveman

P. A.

Arkin

Proctor

Kauh

Holm

(2022). Systemic and structural racism: Definitions, examples, health damages, and approaches to dismantling. Health Affairs, 41(2), 171–178. https://doi.org/10.1377/hlthaff.2021.01394

Burch

Badger

Harmon

Tavernise

(2021, April 21). The death of George Floyd reignited a movement. What happens now? The New York Times. https://www.nytimes.com/2021/04/20/us/george-floyd-protests-police-reform.html

10.

Cooper

S. M.

McLoyd

V. C.

Wood

Hardaway

C. R.

(2008). Racial discrimination and the mental health of African American adolescents. In Quintana

S. M.

McKown

(Eds.), Handbook of race, racism, and the developing child (pp. 278–312). John Wiley & Sons, Inc.

11.

Cost

K. T.

Crosbie

Anagnostou

Birken

C. S.

Charach

Monga

Kelley

Nicolson

Maguire

J. L.

Burton

C. L.

Schachar

R. J.

Arnold

P. D.

Korczak

D. J.

(2022). Mostly worse, occasionally better: Impact of COVID-19 pandemic on the mental health of Canadian children and adolescents. European Child & Adolescent Psychiatry, 31(4), 671–684. https://doi.org/10.1007/s00787-021-01744-3

12.

Craig

S. G.

Ames

M. E.

Bondi

B. C.

Pepler

D. J.

(2023). Canadian adolescents’ mental health and substance use during the COVID-19 pandemic: Associations with COVID-19 stressors. Canadian Journal of Behavioural Science, 55(1), 46–55. https://doi.org/10.1037/cbs0000305

13.

Crenshaw

(1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299. https://doi.org/10.2307/1229039

14.

Czeisler

M. É.

Lane

R. I.

Petrosky

Wiley

J. F.

Christensen

Njai

Weaver

M. D.

Robbins

Facer-Childs

E. R.

Barger

L. K.

Czeisler

C. A.

Howard

M. E.

Rajaratnam

S. M.

(2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020. Morbidity and Mortality Weekly Report, 69(32), 1049. https://doi.org/10.15585/mmwr.mm6932a1

15.

Evans

Francis

(2020). Galvanizing solidarity through chaos: Policing, surveillance and the impact of COVID-19 on black Canadian youth. Child and Youth Services, 41(3), 323–326. https://doi.org/10.1080/0145935X.2020.1841434

16.

Gibson

S. M.

Bouldin

B. M.

Stokes

M. N.

Lozada

F. T.

Hope

E. C.

(2022). Cultural racism and depression in Black adolescents: Examining racial socialization and racial identity as moderators. Journal of Research on Adolescence, 32(1), 41–48. https://doi.org/10.1111/jora.12698

17.

Government of Canada. (2022, August 31). Summary of evidence supporting COVID-19 public health measures. Government of Canada. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/guidance-documents/summary-evidence-supporting-covid-19-public-health-measures.html

18.

Hankivsky

Reid

Cormier

Varcoe

Clark

Benoit

Brotman

(2010). Exploring the promises of intersectionality for advancing women's health research. International Journal for Equity in Health, 9(1), 1–15. https://doi.org/10.1186/1475-9276-9-5

19.

Hawke

L. D.

Relihan

Miller

McCann

Rong

Darnay

Docherty

Chaim

Henderson

J. L.

(2018). Engaging youth in research planning, design and execution: Practical recommendations for researchers. Health Expectations, 21(6), 944–949. https://doi.org/10.1111/hex.12795

20.

Hawke

L. D.

Szatmari

Cleverley

Courtney

Cheung

Voineskos

A. N.

Henderson

(2021). Youth in a pandemic: A longitudinal examination of youth mental health and substance use concerns during COVID-19. BMJ Open, 11(10), e049209. https://doi.org/10.1136/bmjopen-2021-049209

21.

Kalina

(2020). Performative allyship. Technium Social Sciences Journal, 11(1), 478–481. https://doi.org/10.47577/tssj.v11i1.1518

22.

Kutlaca

Radke

H. R.

(2023). Towards an understanding of performative allyship: Definition, antecedents and consequences. Social and Personality Psychology Compass, 17(2), e12724. https://doi.org/10.1111/spc3.12724

23.

Layne

T. M.

Clark

U. S.

Mohamed

N. E.

Miller

S. J.

Sly

J. R.

Kata

H. E.

Astha

Lawrence

S. A.

Hutson

Campbell

K. N.

Benn

E. K.

(2023). Undue burden: Black faculty, COVID-19, and the racial justice movement. Journal of Clinical and Translational Science, 7(1), e14. https://doi.org/10.1017/cts.2022.460

24.

Lindquist-Grantz

Abraczinskas

(2020). Using youth participatory action research as a health intervention in community settings. Health Promotion Practice, 21(4), 573–581. https://doi.org/10.1177/1524839918818831

25.

Lozada

F. T.

Riley

T. N.

Catherine

Brown

D. W.

(2022). Black emotions matter: Understanding the impact of racial oppression on black youth’s emotional development: Dismantling systems of racism and oppression during adolescence. Journal of Research on Adolescence, 32(1), 13–33. https://doi.org/10.1111/jora.12699

26.

Lynch

(2000). Against reflexivity as an academic virtue and source of privileged knowledge. Theory, Culture & Society, 17(3), 26–54. https://doi.org/10.1177/02632760022051202

27.

McKenzie

(2021). Socio-demographic data collection and equity in COVID-19 in Toronto. EClinicalMedicine, 34, 1–2. https://doi.org/10.1016/j.eclinm.2021.100812

28.

Mundt

Ross

Burnett

C. M.

(2018). Scaling social movements through social media: The case of Black Lives Matter. Social Media + Society, 4(4). https://doi.org/10.1177/2056305118807911

29.

Nwachukwu

Nkire

Shalaby

Hrabok

Vuong

Gusnowski

Surood

Urichuk

Greenshaw

A. J.

Agyapong

V. I.

(2020). COVID-19 pandemic: Age-related differences in measures of stress, anxiety and depression in Canada. International Journal of Environmental Research and Public Health, 17(17), 6366. https://doi.org/10.3390/ijerph17176366

30.

Ozer

E. J.

(2017). Youth-led participatory action research: Overview and potential for enhancing adolescent development. Child Development Perspectives, 11(3), 173–177. https://doi.org/10.1111/cdep.12228

31.

Pryce

D. K.

Olaghere

Brown

R. A.

Davis

V. M.

(2021). A neglected problem: Understanding the effects of personal and vicarious trauma on African Americans’ attitudes toward the police. Criminal Justice and Behavior, 48(10), 1366–1389. https://doi-org.login.ezproxy.library.ualberta.ca/10.1177/00938548211006756

32.

Rideout

Robb

M. B.

(2019). The common sense census: Media use by tweens and teens. Common Sense Media. https://www.commonsensemedia.org/sites/default/files/uploads/research/census_researchreport.pdf

33.

Smith-Bynum

M. A.

(2022). It’s about time black lives matter: The urgency of research on black youth development. Journal of Research on Adolescence, 32(1), 302–306. https://doi.org/10.1111/jora.12735

34.

Statista. (2020). Technologies used by teens in the United States to stay connected to friends and family the no longer see in-person during the coronavirus pandemic in April 2020. Statista. https://www.statista.com/statistics/1115305/technology-used-by-teens-stay-connected-during-coronavirus-pandemic-usa/

35.

van der Ven

Bourque

Joober

Selten

J. P.

Malla

A. K.

(2012). Comparing the clinical presentation of first-episode psychosis across different migrant and ethnic minority groups in Montreal, Quebec. Canadian Journal of Psychiatry, 57(5), 300–308. https://doi.org/10.1177/070674371205700505

36.

Watson-Singleton

N. N.

Mekawi

Wilkins

K. V.

Jatta

I. F.

(2021). Racism’s effect on depressive symptoms: Examining perseverative cognition and Black lives matter activism as moderators. Journal of Counseling Psychology, 68(1), 27–37. https://doi.org/10.1037/cou0000436

37.

Wellman

M. L.

(2022). Black squares for Black lives? Performative allyship as credibility maintenance for social media influencers on Instagram. Social Media + Society, 8(1). https://doi.org/10.1177/20563051221080473

38.

Williams

M. T.

Khanna Roy

MacIntyre

M. P.

Faber

(2022). The traumatizing impact of racism in Canadians of colour. Current Trauma Reports, 8(2), 17–34. https://doi.org/10.1007/s40719-022-00225-5

39.

Wilson

Janes

Williams

(2022). Identity, positionality and reflexivity: Relevance and application to research paramedics. British Paramedic Journal, 7(2), 43–49. https://doi.org/10.29045/14784726.2022.09.7.2.43

40.

Witherspoon

D. P.

Wray-Lake

Halgunseth

L. C.

(2022). Black lives matter! adolescent research incrementally dismantles racism and systems of oppression. Journal of Research on Adolescence, 32(1), 4–12. https://doi.org/10.1111/jora.12736