Difference between revisions of "Settlement and Mental Health"

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<div class="portalintro"> [[Image:arrows.jpg|link=]] Settlement workers need to have knowledge about the labour market and employment resources in order to connect newcomers with appropriate services.</div>
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<div class="portalintro">[[Image:head.jpg|link=]]Settlement workers need to have knowledge of mental health, enhanced capacity to detect early signs of mental health issues in immigrants and refugees who face migration stressors and risks of developing mental illness, and strengthened ability to connect those at risk to the appropriate services.</div>
  
 
==Quick Facts==
 
==Quick Facts==
 
<div class="newtoc">__TOC__</div>
 
<div class="newtoc">__TOC__</div>
  
* [http://www.onestep.ca/index.php?option=com_content&view=article&id=2&Itemid=2 ONESTEP has 100 non-profit member agencies delivering training and employment programs in 50 communities across Ontario] - Ontario Network of Employment Skills Training Projects (ONESTEP)
+
===Mental Health in Canada===
* [http://ocasi.org/downloads/MOH_ExecutiveSummary_ENG.pdf 61.8% of newcomers surveyed in Ontario said finding employment was their biggest settlement and integration challenge] - Making Ontario Home (MOH) - '''2012'''
+
 
*[http://ocasi.org/downloads/MOH_ExecutiveSummary_ENG.pdf Newcomers in smaller towns reported more success finding jobs] - Making Ontario Home (MOH) - '''2012'''
+
* One in five Canadian lives with a mental health illness each year. [http://www.mentalhealthcommission.ca/SiteCollectionDocuments/January_2013/Case_for_Investment/Investing_in_Mental_Health_FINAL_ENG.pdf Mental Health Commission of Canada (MHCC)]
* [http://www.statcan.gc.ca/daily-quotidien/121214/dq121214b-eng.htm Employment rate for immigrants aged 25 to 54 at 75.6% compared with 82.9% for Canadian-born] - Statistics Canada - '''2011'''
+
* Immigrants and refugees experience stresses associated with immigration and resettlement that may place them at increased risk of developing mental health problems. [http://www.ontario.cmha.ca/about_mental_health.asp?cID=23054  Canadian Mental Health Association (CMHA) Ontario]
* [http://www.tcu.gov.on.ca/eng/employmentontario/training/certification.html About 20 of more than 140 trades have mandatory certification] - Ministry of Training, Colleges and Universities
+
* Canadian newcomer mental health has been described in [http://www.toronto.ca/health/map/newcomer.htm The Global City: Newcomer Health in 2011]:
* [http://www.ontarioimmigration.ca/en/working/OI_HOW_WORK_PROF_PROFS.html About 40 professions in Ontario are regulated] - Ontario Immigration
+
: 1. Most newcomers arrive in better health, including mental health, than Canadian-born residents.
* [http://www.networksforimmigrants.ca/about-us/facts-stats 70+ professional immigrant networks (PINs) operate in the Greater Toronto Area with 30,000+ immigrants connected to these networks] - Toronto Region Immigrant Employment Council (TRIEC) - '''2009'''
+
: 2. Overall, newcomers lose their health advantage and their health declines over time.
* [http://www.tcu.gov.on.ca/eng/employmentontario/ Information about employment, education and training in 25 languages] - Employment Ontario
+
: 3. Newcomers have diverse health needs. Certain newcomer sub-populations are at higher risk for specific mental health issues, including women, low income newcomers, some racialized newcomers and refugees.
* [[Training_for_Employment_Support_Services/Video | How to use the Employment Ontario (EO) website to find a service provider in your area (video)]] - OCASI - Ontario Council of Agencies Serving Immigrants
+
: 4. Settlement is a health issue.
* [http://wiki.settlementatwork.org/w/uploads/EO_Services.ppt Overview of Employment Ontario Programs and Services (PDF)] - Ministry of Training, Colleges and Universities
+
: 5. Newcomers experience multiple barriers to accessing necessary services. This includes access for mental healthcare and services for newcomers to specialists, counselling and therapy, and education and prevention programs.
 +
: 6. Newcomers' health knowledge and positive behaviours should be acknowledged and promoted.
 +
 
 +
=== Social Determinants of Health ===
 +
 
 +
* Social factors may have an influence over a life course to increase or decrease someone‟s risk of developing a mental health problem or illness. Some increase vulnerability while others act as factors that precipitate illness. Some prolong illness and still others prevent illness and restore health.
 +
* Vulnerability at specific transitions in life, such as during migration, are due to a significant increase in life stresses at a time when the social safety-net may not be as strong.
 +
* The [http://www.phac-aspc.gc.ca/ph-sp/determinants/index-eng.php#key_determinants Public Health Agency of Canada (PHAC) lists 12 determinants of health]. With the exception of the biology and genetic endowment determinant, the rest of the 11 of these determinants could be considered social determinants of health and may be particularly pertinent to immigrant and refugee groups. In addition, an important determinant of health that is relevant to immigrants and refugees is their migration experience and immigration category. [http://www.toronto.ca/health/map/newcomer.htm The Global City: Newcomer Health in 2011]
 +
 
 +
===Mental Health and Culture===
 +
* Although mental illnesses have similar symptoms across cultures, their manifestations and how people describe and interpret symptoms vary with ethnicity and culture.
 +
* For instance, some ethno-cultural groups are more likely to present emotional problems as physical problems.
 +
* Similarly, stigma within a culture varies according to the cultural and sociological backgrounds of the community.
 +
* There is evidence that ethnic minorities experience mental illness stigma more harshly than majority groups. Due to family-shared shame, and different cultural perceptions of mental illness and its causes, many members of minority groups delay treatment. [http://www.ontario.cmha.ca/about_mental_health.asp?cID=23054 Canadian Mental Health Association (CMHA) Ontario].
  
 
==Concepts, Skills & Terminology==
 
==Concepts, Skills & Terminology==
'''Discover important concepts, definitions and terms relating to settlement and employment.'''
+
<p>'''Discover important concepts, definitions and terms relating to mental health in the settlement sector.'''</p>
===Concepts===
+
===Terminology===
*'''Obstacles to employment for skilled immigrants''' (from [http://triec.ca/about-us/faqs/#ObstaclesToEmployment Toronto Region Immigrant Employment Council (TRIEC)])
+
* The [http://www.who.int/features/qa/62/en/index.html WHO (World Health Organization)] describes mental health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. It is the foundation for well-being of individuals, families and communities.
:Difficulty obtaining Canadian work experience
+
* The WHO defines mental health as “... a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. 
:Employers not able to recognize international education, training and experience
 
:Insufficient information about employment opportunities and requirements
 
:Lack of professional networks
 
:Lack of occupation-specific terminology in English or French
 
:Lack of targeted training programs to bridge gaps in qualifications
 
  
===Skill Set for Settlement Workers===
+
====Resources====
*'''Employment-related Information and Referral (I&R)''' (from [http://learnatwork.ca/course/view.php?id=24 Employment Services - A Training for Settlement Workers])
+
* [http://www.cmhapeel.ca/determinantsofhealth.htm  Canadian Mental Health Association of Peel's terminology and determinants of health]
:Assessing a client’s basic employment needs
+
* [http://www.phac-aspc.gc.ca/ph-sp/determinants/index-eng.php Public Agency of Health Canada terminology]
:Knowing about employment resources and services
 
:Knowing how to keep updated
 
:Referring clients to the appropriate resources in a timely manner
 
:Listening actively and communicating information effectively to clients
 
  
===Terminology===
+
==='''Concepts'''===
*'''Apprenticeship'''
+
Three ideas central to the improvement of health follow from the definition above:  
:A period of supervised training, combining on-the-job training and in-school instruction, that leads to certification in a specific trade
+
* Mental health is an integral part of health
*'''Bridging program'''
+
* Mental health is more than the absence of illness
:May include assessment, training, work experience or mentoring for Internationally Trained Individuals (ITIs) who want to work in their field in Ontario (often for regulated occupations)
+
* Mental health is intimately connected with physical health and behaviour.
*'''Canadian experience'''
+
 
:A controversial term which generally refers to an immigrant's understanding of and experience in the Canadian labour market
+
==='''Skills'''===
*'''Credential assessment'''
+
====Cultural Competence====
:Process of evaluating education and job experience obtained in another country in relation to Canadian standards
+
Although there is no universally accepted definition of cultural competence, the common elements are the key principles of cultural competence, such as inclusiveness, holistic health, anti-oppression, and valuing diversity have been recommended for practice in settlement service delivery for immigrants and refugees. [http://www.ofcmhap.on.ca/sites/ofcmhap.on.ca/files/CulturalCompetwC%20(4).pdf  Ontario Federation of Community Mental Health and Addiction Programs, 2009]
*'''ePortfolios'''
+
<br>
: Also called Web CVs, [[EPortfolios for Employability and Professional Development|ePortfolios]] can be used for learning, information gathering and knowledge building; career development; qualifications recognition; job hunting; workplace performance management and talent management; ongoing professional development and learning
+
<br>
*'''Internationally Trained Individuals (ITIs)'''
+
Rationale for Cultural Competence in Service Delivery:
:Skilled immigrants whose education and experience were obtained outside Canada
+
* Ontario’s demographics have become vastly diverse. This diversity goes beyond language and culture.
*'''Professional Immigrants Networks (PINs)'''
+
* Service providers are finding it increasingly challenging to provide adequate mental health care to diverse populations.
:Networks for skilled immigrants run by and for Internationally Trained Individuals (ITIs)
+
* Evidence shows differential and inadequate levels of service for particular marginalized populations, resulting in negative health outcomes.[http://www.ofcmhap.on.ca/sites/ofcmhap.on.ca/files/CulturalCompetwC%20(4).pdf  Ontario Federation of Community Mental Health and Addiction Programs - 2009]<br>
*'''Regulated professions'''
+
<br>
:Fields for which a licence (issued by a provincial regulatory body) is needed to work
+
Benefits for Cultural Competence Approach in Service Delivery include improved access for underserved groups, improved service quality, greater satisfaction with services received, and reduced health disparities. In order to provide culturally safe services to respond to the diverse needs of Canadians immigrant and newcomer groups, service providers need to communicate and practice in a way that takes into account the social, political, linguistic and spiritual realities of individuals seeking our support while working in partnership with them. (Mental Health Commission of Canada - 2009).<br>
 +
 
 +
 
 +
====Some Guiding Principles for Dealing with Mental Health in Settlement Work====
 +
The [http://www.hongfook.ca/index.php?option=com_content&view=article&id=125 Hong Fook Reference Handbook 2012] includes the following themes, amongst others, in guiding settlement service to immigrants and refugees with mental health challenges:
 +
* Mental health can be conceptualized in terms of a continuum from wellness to illness instead of discrete states.
 +
* Empowerment and capacity building
 +
* Diversity and cultural competence
 +
* Wellness and recovery; and community participation.
 +
 
 +
 
 +
Common types of mental illnesses and their signs are described by the Centre for Addiction and Mental Health (CAMH) in the [http://www.camhx.ca/education/online_courses_webinars/mha101/                      Mental Health and Addiction 101 Series].<br>
  
  
==How to Learn More==
+
==How to Learn More==  
 
{| class="ambox ambox-move"
 
{| class="ambox ambox-move"
 
|-
 
|-
 
| class="mbox-image" | [[Image:40px-Crystal package settings.png|40px]]
 
| class="mbox-image" | [[Image:40px-Crystal package settings.png|40px]]
| class="mbox-text" | Featured Resource! [http://learnatwork.ca/course/view.php?id=24 Employment Services - A Training for Settlement Workers]
+
| class="mbox-text" | Featured Resource! [http://learnatwork.ca/   Journey to Promote Mental Health: A Training Series for Community Workers (Self-directed)] - Ontario Council of Agencies Serving Immigrants (OCASI) and Hong Fook Mental Health Association
 
|}
 
|}
 
 
<p>'''Further your knowledge with practical guides, best practices, projects and research.'''</p>
 
<p>'''Further your knowledge with practical guides, best practices, projects and research.'''</p>
 
<p>'''Find out how to become qualified to work in the field through online or classroom-based training.'''</p>
 
<p>'''Find out how to become qualified to work in the field through online or classroom-based training.'''</p>
  
===Best Practices===
+
===Best Practices/Practical Guides===
*[[Training for Employment Support Services/Best Practices|Best Practices Wiki - Leave an Idea, Take an Idea]]
+
* [http://www.settlement.org/downloads/alone_in_canada.pdf  Alone in Canada: 21 Ways to Make It Better] - Centre for Addiction and Mental Health (CAMH) ''' - 2001'''
:A list of best practices for partnership building and information sharing
+
* [[Best Practices: Somali Family Mental Health Support Program]] - Midaynta Association of Somali Service Agencies, Family Outreach & Response Program and Somaliland Canadian Society of Metro Toronto - '''2005'''
 +
* [http://cbpp-pcpe.phac-aspc.gc.ca/public-health-topics/social-determinants-of-health/  Best Practices Portal] - Public Health Agency of Canada (PHAC)
 +
* [http://knowledgex.camh.net/policy_health/mhpromotion/culture_counts/Documents/Culture_Counts_2012.pdf  Culture Counts: A Guide to Best Practices for Developing Health Promotion Initiatives in Mental Health and Substance Use with Ethnocultural Communities] - Centre for Addiction and Mental Health (CAMH) ''' - 2012'''
 +
* [http://www.crvawc.ca/documents/guidebook%20on%20vicarious.pdf  Guidebook on Vicarious Trauma: Recommended Solutions for Anti-Violence Workers] - Health Canada - '''2001'''
 +
* [[Immigrant Settlement Counselling: A Training Guide/Module 7: Mental Health Issues]] - Ontario Council of Agencies Serving Immigrants (OCASI) ''' - 2000'''
 +
* [http://knowledgex.camh.net/amhspecialists/guidelines_materials/Documents/refugee_mental_health_prompractices.pdf  Refugee Mental Health:Promising Practices and Partnership Building Resources] - Centre for Addiction and Mental Health (CAMH) ''' - 2010'''
 +
* [http://www.who.int/mental_health/evidence/en/promoting_mhh.pdf  Report on the Promotion of Mental Health] - World Health Organization (WHO)''' - 2004'''
  
 
===Courses/Training===
 
===Courses/Training===
 
+
* [http://journeytopromotementalhealth.wordpress.com/ Journey to Promote Mental Health] Hong Fook Mental Health Association
* [http://www.informcanada.ca/certification/ InformCanada]
+
: An interactive 2-day training series for settlement service providers, offered across Ontario
: Administers the AIRS (Alliance of Information and Referral Systems) certification program
 
* [http://www.onestep.ca/index.php?option=com_content&view=article&id=23&Itemid=8 Ontario Network of Employment Skills Training Projects (ONESTEP)]
 
: Career and Information Specialist (CEIS) certificate training, Ethics training, Common Assessment Process (CAP) certification, and Personality Dimensions
 
 
* [http://www.ocasi.org/professional-education-and-training-pet Professional Education and Training (PET)]
 
* [http://www.ocasi.org/professional-education-and-training-pet Professional Education and Training (PET)]
 
: Individual and in-house group training for staff from immigrant service agencies whose positions are funded by [[Citizenship and Immigration Canada|Citizenship and Immigration Canada (CIC)]] and the Ontario [[Ministry of Citizenship and Immigration|Ministry of Citizenship and Immigration (MCI)]]
 
: Individual and in-house group training for staff from immigrant service agencies whose positions are funded by [[Citizenship and Immigration Canada|Citizenship and Immigration Canada (CIC)]] and the Ontario [[Ministry of Citizenship and Immigration|Ministry of Citizenship and Immigration (MCI)]]
  
 
====Online Learning====
 
====Online Learning====
* [http://learnatwork.ca/ Learn At Work]
+
* [http://www.sickkids.ca/culturalcompetence/elearning-modules/eLearning-modules.html  Cultural Competence E-Learning Modules Series] - The Hospital for Sick Children (Sick Kids)
: Free online courses to help settlement workers build their skills offered by [[Ontario Council of Agencies Serving Immigrants|OCASI - Ontario Council of Agencies Serving Immigrants]]
+
* [http://learnatwork.ca/   Journey to Promote Mental Health: A Training Series for Community Workers (Self-directed)] - Ontario Council of Agencies Serving Immigrants (OCASI) and Hong Fook Mental Health Association
* [http://www.jobsetc.gc.ca/eng/pieces.jsp?crumb=286&category_id=2140 Service Canada]
+
* [http://www.camhx.ca/education/online_courses_webinars/mha101/ Mental Health and Addiction 101 Series] - Centre for Addiction and Mental Health (CAMH)
: Free Career and Employment Information Specialists (CEIS) online course
+
* [http://www.camh.ca/en/hospital/health_information/the_forensic_mental_health_system_in_ontario/Pages/the_forensic_mental_health_system_in_ontario.aspx The Forensic Mental Health System in Ontario: An Information Guide] - Centre for Addiction and Mental Health (CAMH)
 
+
* [http://www.sickkids.ca/culturalcompetence/journey-to-cultural-competence-film/Journey-to-Cultural-Competence-Film.html The Journey to Cultural Competence Film] - The Hospital for Sick Children (Sick Kids)
===Internationally Trained Individuals (ITIs)===
 
*[http://www.settlement.org/alternativejobs/ Alternative jobs to regulated professions]
 
*[http://www.ontarioimmigration.ca/en/working/OI_BRIDGE.html Bridging programs]
 
*[http://www.ontarioimmigration.ca/en/working/OI_HOW_WORK_CAREER_MAPS.html Career maps for ITIs]
 
*[http://www.ontarioimmigration.ca/en/geo/index.htm Global Experience Ontario] - Resources for ITIs in all fields but health
 
*[http://www.healthforceontario.ca/Jobs/AccessCentre.aspx HealthForce Ontario (HFO)] - Resources for ITIs in the health field
 
*[http://www.fairnesscommissioner.ca/en/professions/index.php List of regulatory bodies]
 
*[http://www.tcu.gov.on.ca/eng/employmentontario/training/certification.html List of trades with mandatory certification]
 
*[http://www.settlement.org/sys/faqs_detail.asp?faq_id=4001352 Professional Immigrant Networks (PINs)] - A directory of networks by profession
 
  
===Labour Market Information===
+
===Related Projects/Initiatives===
*[http://www.tcu.gov.on.ca/eng/ojf/ Ontario Job Futures]
+
*[http://www.mcgill.ca/mmhrc/ Multicultural Mental Health Resource Centre (MHCC)]
*[http://www.workforceplanningontario.ca/english Training boards] - Labour force information for your community
+
*[[RISE (Recovery during Immigration and Settlement)|Recovery during Immigration and Settlement (RISE)]]
*[http://www.workingincanada.gc.ca/welcome.do?lang=en Working in Canada Tool]
+
*[http://www.uhn.ca/clinics_&_Services/clinics/community_mental_health.aspUniversity Health Network (UHN) Clinics & Centres – Community Mental Health program]
  
 
===Further Reading===
 
===Further Reading===
*[http://www.settlement.org/topic_articles.asp?section=EM&t=Employment Employment articles] - Settlement.Org
+
* [[ARQ2: Asking the right questions 2 - Talking With Clients about Sexual Orientation And Gender Identity in Mental Health, Counselling and Addiction Settings]] - Centre for Addiction and Mental Health (CAMH)''' - 2007'''
*[[Language_Training#HLLT_.28Higher-level_Language_Training.29|Employment-related language training]]
+
* [http://www.evasinitiatives.com/2012/05/07/backgrounder-on-homeless-youth-and-mental-health/ Backgrounder on Homeless Youth and Mental Health] - Eva's Initiatives''' - 2012'''
*[http://www.tcu.gov.on.ca/eng/document/brochure/ProgrameGuide2010.pdf Program Guide] - Employment Ontario (EO)
+
* [http://strategy.mentalhealthcommission.ca/strategy/ Canada's National Mental Health Strategy] - Mental Health Commission of Canada - 2012
*[http://www.yorku.ca/tiedi/index.html Toronto Immigrant Employment Data Initiative (TIEDI)]
+
* [[Central American Immigrant Men and Mental Health: Problems with your Nerves? What can you do?]] - York Community Services Legal Health and Social Services''' - 2000'''
 +
* [[CMAS Support Documents|CMAS (Childminding Advisory and Support)]] This includes, amongst others, tip sheets, "Care for Newcomer Children Requirements" and "Stress and Mental Health in the Newcomer Child"
 +
* [[Improving Health Outcomes for Government Assisted Refugees – Final Report]] - PSTG Consulting for Citizenship and Immigration Canada''' - 2012'''
 +
* [[Mental Health for Immigrants - Video of an ESL Class Workshop]] Canadian Mental Health Association (CMHA) Toronto
 +
: CMHA runs the Working Together: Across Cultures Project. In partnership with community, settlement, and employment organizations CMHA Toronto provides mental health capacity and cultural competency workshops to increase the quality of life of newcomers who are experiencing resettlement stress and mental health issues.
 +
* [[Racialised Groups and Health Status: A Literature Review Exploring Poverty, Housing, Race-Based Discrimination and Access to Health Care as Determinants of Health for Racialised Groups|Racialised Groups and Health Status]] - Access Alliance Multicultural Health and Community Services''' - 2005'''
 +
* [[State of Refugees: An Introduction to Refugee and Immigration Issues in Canada]] - Canadian Council for Refugees (CCR)''' - 2008'''
  
 
==Find Services==
 
==Find Services==
 
+
* [http://www.camh.ca/en/hospital/visiting_camh/rights_and_policies/Pages/Challenges_and_Choices.aspx  Challenges & Choices: Finding Mental Health Services in Ontario] Centre for Addiction and Mental Health (CAMH) '''$'''
* [http://www.211ontario.ca/ 211 Ontario]
+
* [http://www.kidsmentalhealth.ca/professionals/service_seeking.php  Children's Mental Health Ontario Website] - Children's Mental Health Ontario (CMHO)
* [http://www.tcu.gov.on.ca/eng/search.asp Employment Ontario (EO)]
+
* [http://www.connexontario.ca/ ConnexOntario Health Service Information] - ConnexOntario
 +
* [http://www.ontario.cmha.ca/about_mental_health.asp?cID=23055  Immigrants and Refugees: Related Resources] - Canadian Mental Health Association (CMHA)
 +
* [http://www.crct.org/choices/MakingChoicesGuide-v4-web.pdf Making Choices - Guide to  Adult Mental Health Services and Supports in Toronto] - Community Resource Connections of Toronto (CRCT)''' - 2011'''
 +
* [http://www.cmha.ca/mental-health/ Mental Health: Your Mental Health, Understanding Mental Illness and Finding Help] - Canadian Mental Health Association (CMHA)
 +
* [http://www.crct.org/lanresources/PDFs/CRCT-NMHS-English.pdf  Navigating Mental Health Services in Toronto. A Guide for Newcomer Communities] - Community Resource Connections of Toronto (CRCT)
 +
* [http://www.ontario.cmha.ca/admin_ver2/maps/network_23-3_winter_2008.pdf Navigating the System] - Canadian Mental Health Association (CMHA) of Ontario ''' - 2008'''
 +
* [http://www.mentalhealthhelpline.ca/Search/ServiceTypes Types of Mental Health Services in Ontario] - Ontario Mental Health Helpline
 
* [http://www.settlement.org/findhelp/ Services Near Me] - Settlement.Org
 
* [http://www.settlement.org/findhelp/ Services Near Me] - Settlement.Org
 
+
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Revision as of 19:29, 22 February 2013

Settlement and Mental Health

Quick Facts Concepts, Skills and Terminology How to Learn More Find Services
Head.jpgSettlement workers need to have knowledge of mental health, enhanced capacity to detect early signs of mental health issues in immigrants and refugees who face migration stressors and risks of developing mental illness, and strengthened ability to connect those at risk to the appropriate services.

Quick Facts

Mental Health in Canada

1. Most newcomers arrive in better health, including mental health, than Canadian-born residents.
2. Overall, newcomers lose their health advantage and their health declines over time.
3. Newcomers have diverse health needs. Certain newcomer sub-populations are at higher risk for specific mental health issues, including women, low income newcomers, some racialized newcomers and refugees.
4. Settlement is a health issue.
5. Newcomers experience multiple barriers to accessing necessary services. This includes access for mental healthcare and services for newcomers to specialists, counselling and therapy, and education and prevention programs.
6. Newcomers' health knowledge and positive behaviours should be acknowledged and promoted.

Social Determinants of Health

  • Social factors may have an influence over a life course to increase or decrease someone‟s risk of developing a mental health problem or illness. Some increase vulnerability while others act as factors that precipitate illness. Some prolong illness and still others prevent illness and restore health.
  • Vulnerability at specific transitions in life, such as during migration, are due to a significant increase in life stresses at a time when the social safety-net may not be as strong.
  • The Public Health Agency of Canada (PHAC) lists 12 determinants of health. With the exception of the biology and genetic endowment determinant, the rest of the 11 of these determinants could be considered social determinants of health and may be particularly pertinent to immigrant and refugee groups. In addition, an important determinant of health that is relevant to immigrants and refugees is their migration experience and immigration category. The Global City: Newcomer Health in 2011

Mental Health and Culture

  • Although mental illnesses have similar symptoms across cultures, their manifestations and how people describe and interpret symptoms vary with ethnicity and culture.
  • For instance, some ethno-cultural groups are more likely to present emotional problems as physical problems.
  • Similarly, stigma within a culture varies according to the cultural and sociological backgrounds of the community.
  • There is evidence that ethnic minorities experience mental illness stigma more harshly than majority groups. Due to family-shared shame, and different cultural perceptions of mental illness and its causes, many members of minority groups delay treatment. Canadian Mental Health Association (CMHA) Ontario.

Concepts, Skills & Terminology

Discover important concepts, definitions and terms relating to mental health in the settlement sector.

Terminology

  • The WHO (World Health Organization) describes mental health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. It is the foundation for well-being of individuals, families and communities.
  • The WHO defines mental health as “... a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

Resources

Concepts

Three ideas central to the improvement of health follow from the definition above:

  • Mental health is an integral part of health
  • Mental health is more than the absence of illness
  • Mental health is intimately connected with physical health and behaviour.

Skills

Cultural Competence

Although there is no universally accepted definition of cultural competence, the common elements are the key principles of cultural competence, such as inclusiveness, holistic health, anti-oppression, and valuing diversity have been recommended for practice in settlement service delivery for immigrants and refugees. Ontario Federation of Community Mental Health and Addiction Programs, 2009

Rationale for Cultural Competence in Service Delivery:

  • Ontario’s demographics have become vastly diverse. This diversity goes beyond language and culture.
  • Service providers are finding it increasingly challenging to provide adequate mental health care to diverse populations.
  • Evidence shows differential and inadequate levels of service for particular marginalized populations, resulting in negative health outcomes.Ontario Federation of Community Mental Health and Addiction Programs - 2009


Benefits for Cultural Competence Approach in Service Delivery include improved access for underserved groups, improved service quality, greater satisfaction with services received, and reduced health disparities. In order to provide culturally safe services to respond to the diverse needs of Canadians immigrant and newcomer groups, service providers need to communicate and practice in a way that takes into account the social, political, linguistic and spiritual realities of individuals seeking our support while working in partnership with them. (Mental Health Commission of Canada - 2009).


Some Guiding Principles for Dealing with Mental Health in Settlement Work

The Hong Fook Reference Handbook 2012 includes the following themes, amongst others, in guiding settlement service to immigrants and refugees with mental health challenges:

  • Mental health can be conceptualized in terms of a continuum from wellness to illness instead of discrete states.
  • Empowerment and capacity building
  • Diversity and cultural competence
  • Wellness and recovery; and community participation.


Common types of mental illnesses and their signs are described by the Centre for Addiction and Mental Health (CAMH) in the Mental Health and Addiction 101 Series.


How to Learn More

40px-Crystal package settings.png Featured Resource! Journey to Promote Mental Health: A Training Series for Community Workers (Self-directed) - Ontario Council of Agencies Serving Immigrants (OCASI) and Hong Fook Mental Health Association

Further your knowledge with practical guides, best practices, projects and research.

Find out how to become qualified to work in the field through online or classroom-based training.

Best Practices/Practical Guides

Courses/Training

An interactive 2-day training series for settlement service providers, offered across Ontario
Individual and in-house group training for staff from immigrant service agencies whose positions are funded by Citizenship and Immigration Canada (CIC) and the Ontario Ministry of Citizenship and Immigration (MCI)

Online Learning

Related Projects/Initiatives

Further Reading

CMHA runs the Working Together: Across Cultures Project. In partnership with community, settlement, and employment organizations CMHA Toronto provides mental health capacity and cultural competency workshops to increase the quality of life of newcomers who are experiencing resettlement stress and mental health issues.

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