This module provided a brief introduction to the six most common mental disorders experienced by immigrants and refugees, including the symptoms and prevalence rates among the general and newcomer populations. The module also explored best practices and tools for assessing the disorders.

Immigrants and refugees have higher incidence rates than the general population for some mental disorders, while for other disorders there is no significant difference in rates between newcomers and the general population. Deeper analysis shows that specific immigrant subgroups have higher incidence rates of certain disorders (e.g., schizophrenia) than both fellow migrants from other regions and the general population. Such variability demonstrates the need to consider the differences within the immigrant and refugee population and their experiences of mental health problems and illness. This further emphasizes how a one-size-fits-all approach to mental health care and support cannot work.

You should now be able to:

• Describe the continuum of mental health and mental illness.
• Describe the prevalence of mental health problems and illness among immigrant and refugee populations.
• Recognize the effects of mental health problems and illness and common misconceptions about them.
• Identify the symptoms and effects of six common mental disorders experienced by immigrants and refugees in Canada.
• Describe the main similarities and differences in prevalence for each of the six common mental health disorders.
• Describe common assessment practices and tools related to each of the disorders.

The next three modules will examine the mental health needs of specific population immigrant and refugee groups.

References

2.1 — Understanding mental health and mental illness

• American Psychiatric Association (APA). (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed.,DSM-IV-TR. Washington, DC: American Psychiatric Association.
• American Psychiatric Association APA. 2013a. Diagnostic and statistical manual of mental disorders 5th ed. DSM-5. Washington, DC: Author.
• Anderson, K. K., Cheng, J., Susser, E., McKenzie, K. J., & Kurdyak, P. 2015. Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario. Canadian Medical Association Journal CMAJ, 1879, E279–E286. https://doi.org/10.1503/cmaj.141420
• Blackmore, R., Boyle, J. A., Fazel, M., Ranasinha, S., Gray, K. M., Fitzgerald, G., Misso, M., & Gibson-Helm, M. 2020. The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis. PLoS Medicine, 179, e1003337–e1003337. https://doi.org/10.1371/journal.pmed.1003337
• Brandt, L., Henssler, J., Müller, M., Wall, S., Gabel, D., & Heinz, A. 2019. Risk of Psychosis Among Refugees: A Systematic Review and Meta-analysis. JAMA Psychiatry, 7611, 1133 - 1140.
• Ciaramella, M., Monacelli, N., & Cocimano, L. C. E. 2022. Promotion of Resilience in Migrants: A Systematic Review of Study and Psychosocial Intervention. Journal of Immigrant and Minority Health, 245, 1328–1344. https://doi.org/10.1007/s10903-021-01247-y
• CMHA. 2020, January 13. Mental health: What is it, really? Retrieved from Canadian Mental Health Association, National: https://cmha.ca/mental-health-what-is-it-really/
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• Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J., Hassan, G., Rousseau, C., & Pottie, K. 2011. Common mental health problems in immigrants and refugees: general approach in primary care. Canadian Medical Association Journal, 18312, E959–E967. https://doi.org/10.1503/cmaj.090294
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• WHO. 2018, March 30. Mental health: strengthening our response. Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-respons

2.2 — Common mental disorders

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• American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, V.A: American Psychiatric Association.
• American Psychiatric Association (APA). (2017a). What are anxiety disorders? Available: www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders.
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• Anjara, S. G., Bonetto, C., Van Bortel, T., & Brayne, C. 2020. Using the GHQ-12 to screen for mental health problems among primary care patients: Psychometrics and practical considerations. International Journal of Mental Health Systems, 141, 62–62. https://doi.org/10.1186/s13033-020-00397-0
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• Cécile Rousseau, Kevin Pottie, Brett D. Thombs, Marie Munoz, Tomas Jurcik.(2011).Post traumatic stress disorder: evidence review for newly arriving immigrants and refugees . Available: https://www.cmaj.ca/content/suppl/2010/06/07/cmaj.090313.DC1/imm-ptsd-11-at.pdf
• Close, C., Kouvonen, A., Bosqui, T., Patel, K., O’Reilly, D., & Donnelly, M. 2016. The mental health and wellbeing of first generation migrants: A systematic-narrative review of reviews. Globalization and Health, 121, 47–47. https://doi.org/10.1186/s12992-016-0187-2
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