Equity-Oriented Care: A Path to Improving Access to Adolescent Mental Health and Substance Use Services?

Despite ostensibly universal access to health care, many adolescents in countries such as Canada lack access to much-needed mental health and substance use services. There are many complex and interrelated factors that contribute to people's lack of access to health care services despite living in jurisdictions with universal health care. For example, health inequities shaped by intersecting forms of stigma and discrimination play a significant role in shaping approaches to health care delivery and adolescent access to health care. The idea of intersecting forms of stigma and discrimination draws on the works of Crenshaw (1989), Collins (2022), and others, who identified that various parts of a person's identity, such as their race, gender, sex, and sexual orientation, may confer privilege, advantage, disadvantage, or oppression depending on a person's context. Health inequities have been shown to impact physical health, mental health, self-reported perceptions of health status, and access to health care services (Canada, 2020). Acknowledging these realities, that socially constructed inequities influence health and health care access, is essential for health care providers, policymakers, and researchers to explicitly explore and address, given the insidious and often invisibilized nature of factors that both constitute and contribute to health inequities. In this paper, we present equity-oriented care as a potential path for improving access to adolescent mental health and substance use services.