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Course page How to navigate the course Course syllabus Glossary Course intro Details and logistics CoP SMEs Course agreements and conditions Acknowledgements

Module 1: Immigration and social determinants of health
1.1 — Understanding mental health in Canada
1.1.1. General prevalence and impact + 1.1.2 Legislation affecting the rights of clients
1.2 — Understanding immigration in Canada
1.2.1 A brief history + + 1.2.2 Temporary Residents 1.2.3 Permanent Residents + + 1.2.4 Immigration Trends + 1.2.5 Demographic trends + + + +
1.3 — Mental health of immigrants and refugees
1.3.1 Immigrant and Refugee Mental Health 1.3.2 The healthy immigrant effect 1.3.3 The determinants of mental health + 1.3.4 The migration journey 1.3.5 Social determinants in the post-migration context + + +
Case study: Ibraheem Summary

Module 2: Intro to Mental Health
2.1 Understanding mental illness
2.1.1 Understanding mental health and mental illness 2.1.2 The continuum of mental health and mental illness 2.1.3 Prevalence of mental health problems and illness among immigrants and refugees
2.2 Common mental disorders
2.2.1 Depressive disorders 2.2.2 Anxiety disorders 2.2.3 Posttraumatic stress disorder + 2.2.4 Psychosis 2.2.5 Substance abuse
Summary

Module 3: Key populations - women
3.1.1 Social risk factors affecting women 3.1.2 Gender-based violence + + 3.1.3 Pregnancy + 3.1.4 Barriers to seeking help 3.1.5 Clinical considerations 3.1.6 Providing mental health support + Summary

Module 4: Key populations - children
4.1.1 Immigrant and refugee children 4.1.2 Needs of adolescents and youth 4.1.3 Mental illness and mental health problems + + 4.1.4 Needs of adolescents and youth 4.1.5 Post-migration and social determinants of mental health 4.1.6 Risk and protective factors + + 4.1.7 Distress vs. mental disorder in refugee children + 4.1.8 Providing mental health support + + Summary

Module 5: Key populations...
5.1 Older adults
5.1.1 Older adults 5.1.2 Risk factors for mental health problems and illnesses 5.1.3 Clinical considerations 5.1.4 Promoting mental health
5.2 Survivors of torture
5.2.1 Survivors of torture 5.2.2 Effects of torture 5.2.3 Clinical considerations + + 5.2.4 Mental health interventions +
5.3 LGBTQ2+ immigrants and refugees
5.3.1 LGBTQ2+ immigrants and refugees 5.3.2 Risk factors for mental health 5.3.3 Clinical considerations 5.3.4 Mental health interventions
5.4 People living with disabilities
5.4.1 People living with disabilities 5.4.2 Risk factors 5.4.3 Clinical considerations 5.4.4 Providing mental health support
Summary

Module 6: Treatment and support
6.1 Treatment
6.1.1 Treatment 6.1.2 Providing newcomers with mental health services 6.1.3 Treatment models 6.1.4 Cultural competence in mental health care 6.1.5 Trauma-informed care 6.1.6 Resilience
6.2 Treatment interventions
6.2.1 Treatment interventions 6.2.2 Psychosocial interventions
6.3 Psychotherapy and counselling
6.3.1 Psychotherapy and counselling 6.3.2 Cultural factors 6.3.3 Psychotherapeutic interventions
6.4 Pharmacotherapy
6.4.1 Pharmacotherapy 6.4.2 Cultural factors 6.4.3 Practical issues
Summary

Module 7
7.1 Health equity
7.1.1 Health equity 7.1.2 Why health equity matters
7.2 Anti-Racism
7.2.1 Racism 7.2.2 Anti-Black racism 7.2.3 Racism and mental health + 7.2.4 Social inclusion and exclusion 7.2.5 Bias + + (SW) + (HP) + (SW) + (HP) Anti-oppression framework (SW) + (SW)
7.3 Intersectionality
7.3.1 Intersecting identities 7.3.2 Intersectionality and mental health (HP) 7.3.2 Intersectionality and mental health (SW)
7.4 Anti-oppression and allyship
7.4.1 Inclusive practice and how to work inclusively 7.4.2 Moving from cultural awareness to cultural humility + (HP) 7.4.2 The process of unlearning 7.4.4 Power and privilege +
Summary

Module 8: Service delivery + pathways to care
8.1 Pathways to Care
8.1.1 Navigating mental health services + 8.1.2 Factors that influence help-seeking + 8.1.3 Connecting with primary care
8.2 Facilitating effective service use
8.2.1 Facilitating effective service use 8.2.2 Make changes to programs, policies and institutions 8.2.3 Consider the impact of culture +
8.3 Working with interpreters
8.3.1 Language and its effects on access to care 8.3.2 Translation and interpreting + + + 8.3.3 Types of interpreters 8.3.4 Mental Health Interpretation +
Summary

Module 9: Partnerships + mental health promotion
9.1 Strategies for promoting mental health
Strategies for promoting mental health + +
9.2 Social Supports
9.2.1 Social Supports 9.2.2 Formal organizations 9.2.3 Informal social networks +
9.3 Community development and partnerships
9.3.1 Community development and partnerships 9.3.2 Asset-based community development + 9.3.3 Community partnerships + + +
Summary

Module 10: Self-care
10.1.1 Self-care 10.1.2 Compassion fatigue 10.1.3 Secondary trauma 10.1.4 Burnout and its effects + 10.1.5 Boundary issues + 10.1.6 Seeking help +
Summary Glossary
10.1.3

Secondary trauma

You can think of secondary trauma or vicarious trauma as the negative changes that happen to humanitarian workers over time as they witness other people's suffering and need (Pearlman & McKay, 2008). It refers to the range of negative effects associated with cumulative exposure to clients' experiences of trauma.

This type of trauma can affect a wide range of professionals. It is a process that unfolds over time and is the cumulative effect of contact with survivors of violence or disaster, or people who are struggling (Ibid.; Saakvitne & Pearlman, 1996). Secondary trauma can be an occupational hazard for providers who are repeatedly exposed to clients' experiences of trauma.

When providers experience secondary trauma, it can change their assumptions and beliefs about themselves and the world in a number of ways.
Frame of reference

Identifying too closely with clients' situations of helplessness, horror, sadness and cruelty disrupts providers' frame of reference, comfort zone and basic beliefs that people are good and the world is safe.

(Figley, 2002; Sprang et al. 2007)
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As seen earlier, the more aware providers are of the details of their clients' traumatic experiences, the greater their chances of developing secondary trauma.

Risk factors

Why do some people who work with trauma survivors experience secondary trauma, while others do not? The risk factors for experiencing this type of trauma can be grouped into three categories—personal, work-related and other psychosocial factors—as shown in the chart below.

(Hensel et al, 2015; McCann & Pearlman, 1990)

Signs and symptoms

How do providers know if they or someone they know are experiencing secondary trauma? The signs and symptoms derive from a number of different domains, some of which may overlap.

The most important ones include the following:
(Pross, 2006)