One of the first patients Kwame McKenzie treated as a psychiatrist in London, England, was a young Black man diagnosed with schizophrenia. Dr. McKenzie, then years away from becoming the director of health equity at Toronto’s Centre for Addiction and Mental Health (CAMH), remembers the father, an African-Caribbean immigrant, trying not to cry while asking questions. Had they done something wrong to make their child so ill? This was their second son now suffering from psychosis, the father explained. How could they stop it from happening to their other children? Dr. McKenzie didn’t have a good answer. He resolved to find one.
That search led him to dig deeper into a curious, and alarming, pattern: In a number of Western countries, including Canada, migrants from Africa and the Caribbean – and their children – are more likely to be diagnosed with schizophrenia than either their native-born white peers or immigrants from other parts of the world. Study after study has pointed to one significant risk factor: skin colour.
Schizophrenia, a disorder characterized by often debilitating hallucinations and delusions, is one of the most severe mental illnesses and among the hardest to treat. It is relatively rare – affecting about one per cent of the population – but its burden on patients, their families and the health care system is huge, especially since the illness most often emerges in the late teens and early 20s. People with schizophrenia die, on average, 15 years earlier than the general population. They’re also more likely to end up homeless and unemployed, and to spend more time in hospital or the criminal justice system. Despite public perception, they are more often victims of violence and tragedy than perpetrators of it. (One example: In Montreal, people with schizophrenia comprise 0.6 per cent of the population, but they represented 25 per cent of those who died in the city’s 2018 heatwave.)