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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
2.2.5

Substance abuse

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Substance use disorder is described as a “problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress” (APA, 2013).

Rates: Similarities and differences

Overall, newcomers are less likely to use substances (43%) compared to the Canadian-born population (64.3%) (Ru & Li, 2021). Furthermore, refugees are less likely to have substance use disorder compared to non-refugee immigrants (Salas-Wright & Vaughn, 2014). However, both refugees and non-refugee newcomers experience limited access to services, including prevention and treatment programs, which may in turn worsen outcomes (Edward & Haozhen, 2020; Agic et al., 2016).

Several studies have indicated ethnocultural differences in substance use, particularly among youth (Ellickson et al., 2004; Nishimura et al., 2005; Broman et al., 2006; Duff et al, 2011; Lui & Zamboanga, 2019). White youth report higher levels of substance use compared to other ethnocultural groups, with Chinese-born youth exhibiting the lowest level of consumption (Duff et al., 2011).

In general, Canadian-born youth report higher substance use than foreign-born youth (Ibid.), however the risk of developing substance use disorders increases with time spent in Canada and level of acculturation. The risk for substance use is lower for first-generation immigrant youth compared to second-and third-generation immigrant youth (Korczak, 2015).

Assessment

The following barriers may be involved when screening for substance use among immigrant and refugee populations:
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    A family's resistance to admitting that a substance use disorder is present due to cultural stigmatization.

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    A generational gap between the traditional values of the parents and the speed of acculturation for youth and adolescents.

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    The differential meanings of substances and beliefs about appropriate use across cultures.

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    Approaches to substance use disorders in the country of origin, such as long-term institutionalization, may also be a cause of fear.

(Korczak, 2015)

Review question

Match the example to the concept

Description

A depression that may start during pregnancy or at any time up to a year after the birth of a child.

A complex mental illness that affects how a person thinks, feels, behaves and relates to others. A person may experiences hallucinations and delusions.

Several disorders that share features of excessive fear and anxiety.

Trauma-and-stressor-related disorder that occurs after a person has been exposed to actual or threatened death, serious injury or sexual violence.

Mental disorder

  • Post-partum depression
  • PTSD
  • Schizophrenia
  • Anxiety disorder