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By Tony Poland, LegalMatters Staff • Racialized and immigrant communities often face barriers preventing them from receiving the mental health care they deserve and the stresses of the past year have exacerbated a troubling issue, says Toronto and Markham-area disability lawyer Rupa Karyampudi.
Karyampudi, a partner at MK Disability Lawyers, says there are many people suffering from mental health issues who are entitled to insurance benefits but don’t know how to access them or they may not have a clear grasp of their legal entitlements.
Even those with a legitimate claim can be frustrated by the process and simply give up, she says, unaware that they can challenge an insurance company’s denial. For some, seeking legal advice may not be seen as a viable option.
“I definitely see why people might be hesitant. If you are already dealing with mental health you might think litigation is going to add stress and anxiety. We try to reduce that stress as much as possible,” Karyampudi tells LegalMattersCanada.ca. “We tell our clients that we will take care of dealing with the insurance company while they take care of their health.
Reduce anxiety
“Getting a settlement is important because If they have money coming in at the end of the day, that’s going to reduce their anxiety. Much of that stress stems from financial problems if they’re not getting paid by the insurance company.”
For someone new to the country, navigating Canada’s healthcare system can be a daunting task, she explains.
“Even highly educated people who have lived in Canada for a long time can find it confounding,” says Karyampudi, who teaches social justice law at the University of Ottawa. “Layer on top of that a mental health issue and you can imagine how really difficult it can be to access the necessary resources and be an advocate for yourself. It can be extremely arduous.”
She says the coronavirus pandemic has made the past year especially challenging,
“The second wave of the pandemic has intensified feelings of stress and anxiety, causing alarming levels of despair, suicidal thoughts and hopelessness in the Canadian population,” according to a nationwide monitoring survey on the mental health impacts of COVID-19 released in December by the Canadian Mental Health Association.
Emerging issues
Emerging racial issues have also contributed to a deterioration in mental health, Karyampudi notes. CTV reports Asian communities in Canada have witnessed a rise in hate crimes and racist incidents during the pandemic.
The Black Lives Matter movement also drew attention to racial inequalities.
“Black Lives Matter and the news coverage surrounding it demonstrated there is a high level of anxiety,” she says. “We have been experiencing an increase in mental health issues and claims.”
Karyampudi says issues of social injustice can have a lasting and debilitating effect on the mental health of those within racialized and immigrant communities.
“There are different factors that make some people more vulnerable to certain health outcomes and one of them is racism,” she says. “Many people experiencing racism or discrimination through microaggressions are more prone to mental health issues.”
Despite the increased likelihood for mental health issues among racialized populations, “it doesn’t always translate into an increased number of claims for many reasons,” says Karyampudi.
‘Problems are stigmatized’
“In many of these racialized immigrant communities, mental health problems are stigmatized and there is lack of awareness,” she says. “In terms of treatment, it can difficult to find culturally appropriate care. If there is a cultural or language barrier a doctor might not even understand the problem.”
Karyampudi says if a patient can’t explain their problem, they can become frustrated and fail to seek assistance.
What may be the appropriate treatment for most, such as group therapy, might go against a certain patient’s culture, leading them to refuse help, she adds.
“You might be uncomfortable speaking to people in a group because they might not understand your experiences,” says Karyampudi. “That can complicate things in claims adjudication because in many disability policies there is a provision that says the insurance company can terminate your claim if you not receiving appropriate treatment.”
She says mental health issues are often ignored in racialized or immigrant communities because people are afraid of being further stereotyped.
People will also try to convince themselves they are just having a bad day or week and set feelings of depression and anxiety aside, says Karyampudi.
Talk to a doctor
“Many Canadians feel that way,” she says. “Some don’t know a mental health issue is a medical issue and they should be talking to their doctor. Talking to a doctor is important. That way the issue is documented if there is litigation.”
Karyampudi says many people are reluctant to seek legal advice when they are filing a claim because they believe they can handle it themselves, not realizing there is a limitation period imposed by the insurance provider.
She says some cultures have a mistrust of authority figures and may be hesitant to consult with a lawyer but it is essential to seek advice when encountering a hurdle that seems insurmountable.
“You want a lawyer who is culturally sensitive and aware of the issues. Our firm strives to be aware of issues impacting racialized and immigrant communities,” says Karyampudi, adding she can help direct people to the right resources.
She says there is now “more awareness now of implicit and systemic bias” and a growing emphasis on finding ways to treat mental health issues among racialized and immigrant communities. Still, more needs to be done.
‘Increasing awareness’
“There is an increasing awareness and many insurance companies made statements in the past year about committing to increased equity and inclusion for their employees. But that should also translate to their claims processes as well,” Karyampudi says. “Claims adjusters need to be aware that they’re making assumptions about their clients.”
She says making claimant data more available would also help.
“We don’t know what the data is in terms of what percentage of claims are denied for racialized people. We cannot say unequivocally there are systemic biases. We all have our own experiences but it is very anecdotal,” Karyampudi says. “However, if insurance companies are truly committed to equity and ending discrimination there needs to be more transparency with the data.
“Mental health has really been impacted by the events of this past year, but I am encouraged by the increased awareness about the issue and also by the growing awareness about implicit and systemic bias,” she adds.
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