“Without Them I Wouldn’t Be Here”: Parenting Practices and Access to Mental Health and Substance Use Care Among Immigrant and Refugee Youth of African Descent in Nova Scotia

This study explores how parenting practices influence access to mental health and substance use (MHSU) care among African immigrant and refugee youth in Nova Scotia. Based on qualitative interviews and focus groups with youth aged 18–25 who had accessed or attempted to access MHSU services, this study centers youth narratives on parental roles in navigating culturally unfamiliar health systems. Data were analyzed thematically by the research team, with input from advisory committee members of African descent, using a collaborative and manual approach grounded in Afrocentric and Ubuntu principles of relationality, collective meaning-making, and respect for participant voice. Despite stigma, and acculturative stress, findings reveal that African parents often act as vigilant protectors, cultural anchors, and decisive actors in recognizing and responding to youth substance use. Participants described their parents as watchful, strict, and deeply invested in their well-being, sometimes even “saving” them by initiating care when peers or institutions failed to do so. Parental nudging, family-based intervention, and cultural values of collective responsibility were central to accessing MHSU services. This study emphasizes the need for culturally responsive and family-inclusive healthcare delivery by highlighting gaps in care systems where parental involvement was excluded or where African family dynamics that shape help-seeking and support were misunderstood.