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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
3.1.2

Gender-based violence

Women and girls face various challenges related to their position in society, their roles and their gender. In addition, gender-based violence caused by males is more likely to affect their health and well-being. Situations of conflict and displacement can change their role or position, worsen existing gender inequality and increase various forms of violence against women, often called gender-based violence.

Single women, single mothers and girls are particularly vulnerable to experiencing gender-based violence. Many women and girls face daily struggles to find resources to pay the rent, buy food and basic items, and access services. As a result, they may find themselves in precarious situations that put them at risk for violence and sexual assault. This may include living in relatively unsafe neighbourhoods pre-migration. For instance, some refugee women coming from camps sometimes have to travel long distances to fetch water or firewood (United States Agency for International Development [USAID], 2015).

Refugee women are more affected by gender-based violence than any other female population in the world (Vu et al , 2014). The gender-based violence that women and girls suffer takes various forms, including rape, sexual slavery, forced impregnation, trafficking and forced prostitution. Since World War II, the systemic rape of women and girls worldwide has been used as a deliberate weapon of war in ethnic cleansing (Majewski, 2020; Kivlahan & Ewigman, 2010).

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Impact of COVID-19

The global lockdowns as a result to the COVID-19 pandemic exposed and exacerbated gender-based violence for women and girls (UN Women , 2020).

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The UNHCR Guidelines on Gender-Related Persecution and Canada's Immigrant and Refugee Board (IRB) Chairperson's Guidelines acknowledge that persecution can be gendered. Women refugee claimants who demonstrate a well-founded fear of gender-related persecution can be granted refugee status in Canada.

click See the IRB Chairperson's Guidelines for more information.

Mental health problems and illnesses can also have a profound effect on the daily lives of individuals, often due to factors such as stigma, social isolation and discrimination.

We will discuss three types of gender-based violence in more detail:

Social support, gender and the post-migration experience

With Dr. Michaela Hynie (Social Psychologist, Centre for Refugee Studies, York University)

So we know that social support, post-migration, is a really important determinant of mental health and well-being. And this is true for refugees, but it's true for everybody. Social support is really critical to health and well-being. There are some interesting factors that emerge around social support and gender. And we know this from research that has been done not just with refugees, but with newcomers more broadly. We know that women are more likely to be socially isolated for reasons associated with lesser likelihood of being able to speak the language of the country they've migrated into. We also know that they may be more likely to be engaged in domestic work, taking care of children or taking care of other individuals who require care in the home, and therefore they may have fewer connections outside of the home. And so we see a greater level of social isolation among women than we do among men. Again this is in general, this is not for everybody. The other thing that we have found in some literature is that in terms of providing social support, some literature suggests that women provide more social support than men do and that there can be negative consequences as a result of providing more support than you have the capacity to provide. So for those individuals who are in extremely stressful circumstances, who have limited resources, some of these normally reciprocal social support relationships may actually turn out to be a greater burden for women who are providing more support than receiving support and may not necessarily have the resources that they need. So we need to think very carefully about supporting support givers and that this may be a gendered experience.