Advancing Racial Equity, Diversity, and Inclusion in Ontario's Child and Youth Mental Health Sector: Perspectives of Agency Leaders

Public Significance Statement This study identifies current efforts underway to advance racial equity in the child and youth mental health and addictions sector in Ontario. We believe leaders can learn from the early successes and challenges of these agencies outlined in this article to create more innovative and culturally responsive mental health services for all. Systematic challenges in providing culturally responsive mental health and addictions services have produced widespread inequities for racialized service providers, clients, and communities. There is a pressing need for coordinated system-level change. In this article, we present findings from a cross-sectional mixed methods study examining current organizational practices in advancing racial equity in the child and youth mental health and addictions sector in Ontario. To understand current efforts and identify a path forward, we surveyed executive leaders from 102 agencies and conducted case studies with 10 agencies on their practices along five domains: organizational leadership, intersectoral partnerships, workforce diversity and development, client and community engagement, and continuous improvements. Leaders shared a strong desire to advance racial equity and had begun this work to varying degrees. Fifty-one percent of agencies had made a public commitment to racial equity; however, few had developed written plans to support these efforts. Over 60% of agencies had developed relationships with cross-sectoral and community partners to facilitate this work. Seventy-five percent of agencies had offered racial equity training to staff, and some had implemented targeted recruitment efforts for racialized staff. Over 69% of agencies provided translation services and referrals to other agencies, whereas only 39% provided clients the option to request service providers who reflected their cultural identity. Less than 29% of agencies collected and used race-based data routinely to inform their work. Our findings, in particular the domains examined and barriers and facilitators, can inform parallel efforts in related sectors across Canada and internationally.