Module 5 described the challenges particular populations of immigrants and refugees face in their settlement or resettlement in Canada, and how these challenges can affect their mental health. This module further emphasized how various factors can affect the mental health of immigrant and refugee older adults, survivors of torture, 2SLGBTQ+ and persons living with disabilities, and explored clinicalservice considerations related to newcomers' needs, as well as potential interventions. Developing knowledge and awareness of these risk factors can promote understanding of the needs of newcomers and how to provide effective assessment and treatment practices related to counselling and case management.

You should now be able to:

• Describe the unique mental health vulnerabilities and needs of immigrant and refugee older adults, survivors of torture, 2SLGBTQ+ people and persons living with disabilities.
• Identify the risk and protective factors related to the unique mental health needs of specific immigrant and refugee populations.
• Explain clinical considerations and potential interventions related to the unique mental health needs of specific immigrant and refugee populations.
• Explain service considerations related to the unique mental health needs of specific immigrant and refugee populations.

Module 6 will focus on the treatment and support of immigrants and refugees with mental disorders.

Module 6 will focus on the counselling and case management of immigrants and refugees with mental disorders.

References

5.1 - Older adults

• Canadian Institute for Health Information. Canadian seniors and mental health (video). Accessed April 25, 2023.
• Chen, F., Lai, G. Y., & Yang, L. H. 2013. Mental illness disclosure in Chinese immigrant communities. Journal of Counseling Psychology, 603, 379–391. https://doi.org/10.1037/a0032620
• Fiske, A., Wetherell, J. L., & Gatz, M. 2009. Depression in Older Adults. Annual Review of Clinical Psychology, 51, 363–389. https://doi.org/10.1146/annurev.clinpsy.032408.153621
• Gee, E. M., Kobayashi, K. M., & Prus, S. G. 2004b. Examining the Healthy Immigrant Effect in Mid- To Later Life: Findings from the Canadian Community Health Survey. Canadian Journal on Aging =, 235, S55–S63. https://doi.org/10.1353/cja.2005.0032
• Government of Canada .2022. Social isolation of seniors: A Focus on New Immigrant and Refugee Seniors in Canada. Available: https://www.canada.ca/en/employment-social-development/corporate/seniors/forum/social-isolation-immigrant-refugee.html
• Government of Canada, Statistics Canada. 2018, December 5. Section 3: Police-reported family violence against seniors in Canada, 2018. https://www150.statcan.gc.ca/n1/pub/85-002-x/2021001/article/00001/04-eng.htm
• Handbook, U. E. 2020, May 18. Older persons. UNHCR. https://emergency.unhcr.org/protection/persons-risk/older-persons#:~:text=An%20older%20person%20is%20defined,or%20age%2Drelated%20health%20conditions.
• Johnson, S., Bacsu, J., McIntosh, T., Jeffery, B., & Novik, N. 2021. Competing challenges for immigrant seniors: Social isolation and the pandemic. Healthcare Management Forum, 345, 266–271. https://doi.org/10.1177/08404704211009233
• MacCourt P., Wilson K., & Tourigny-Rivard M-F. 2011. Guidelines for Comprehensive Mental Health Services for Older Adults in Canada. Calgary, AB: Mental Health Commission of Canada. Retrieved from: http://www.mentalhealthcommission.ca
• MacCourt P., Wilson K., & Tourigny-Rivard M-F. 2011. Guidelines for Comprehensive Mental Health Services for Older Adults in Canada. Calgary, AB: Mental Health Commission of Canada. Retrieved from: http://www.mentalhealthcommission.ca
• McCleary-Sills, J., A, K., Brakarsh, J., M, V., Dlamini, K., Namisango, E., R, N., Fritz, K., Wong, V. W., & Bowsky, S. J. 2013. Foundation for the Future: Meeting the Psychosocial Needs of Children Living With HIV in South Africa and Uganda. Journal of Hiv/Aids & Social Services, 121, 49–62. https://doi.org/10.1080/15381501.2012.749818
• Melanie, S. K., & Koehn, S. 2010, ICARE: Immigrant older women - care accessibility research empowerment. Visions: BC’s Mental Health and Substance use Journal, 6, 17. Retrieved from http://myaccess.library.utoronto.ca/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fmagazines%2Ficare-immigrant-older-women-care-accessibility%2Fdocview%2F2231806375%2Fse-2%3Faccountid%3D14771
• Mental Health Commission of Canada. 2021. Applying the Guidelines for Comprehensive Mental Health Services for Older Adults in Canada during COVID-19. Ottawa, ON.
• Ploeg, J., Lohfeld, L., & Walsh, C. A. 2013. What Is “Elder Abuse”? Voices From the Margin: The Views of Underrepresented Canadian Older Adults. Journal of Elder Abuse & Neglect. https://doi.org/10.1080/08946566.2013.780956
• Tam, S., & Neysmith, S. M. 2006. Disrespect and Isolation: Elder Abuse in Chinese Communities. Canadian Journal on Aging =, 252, 141–151. https://doi.org/10.1353/cja.2006.0043
• Tieu, Y., & Konnert, C. 2014. Mental health help-seeking attitudes, utilization, and intentions among older Chinese immigrants in Canada. Aging & Mental Health, 182, 140–147. https://doi.org/10.1080/13607863.2013.814104
• Tieu, Y., Konnert, C., & Wang, J. 2010. Depression literacy among older Chinese immigrants in Canada: a comparison with a population-based survey. International Psychogeriatrics, 228, 1318–1326. https://doi.org/10.1017/s1041610210001511
• Um, S., & Lightman, E. 2011. Long-term Care in South Korea—Migrant Care Workers and Transnational Social Welfare. Transnational Social Review, 11, 53–69. https://doi.org/10.1080/21931674.2011.10820695
• Walsh, C. A., Ploeg, J., Lohfeld, L., Horne, J., MacMillan, H. L., & Lai, D. W. L. 2007. Violence Across the Lifespan: Interconnections Among Forms of Abuse as Described by Marginalized Canadian Elders and their Care-givers. British Journal of Social Work, 373, 491–514. https://doi.org/10.1093/bjsw/bcm022
• Wu, Z., & Penning, M. J. 2015. Immigration and loneliness in later life. Ageing & Society, 351, 64–95. https://doi.org/10.1017/s0144686x13000470

5.2 — Survivors of torture

• de C Williams, A. C., & van der Merwe, J. (2013). The psychological impact of torture. British journal of pain, 7(2), 101-106.

• International Rehabilitation Council for Torture Victims. (2009). Psychological Evaluation of Torture Allegations: A practical guide to the Istanbul Protocol - for psychologists. Copenhagen: International Rehabilitation Council for Torture Victims (IRCT). Retrieved from https://irct.org/assets/uploads/pdf_20161120165022.pdf

• Kienzler, H., & Sapkota, R. P. (2019). The Long-Term Mental Health Consequences of Torture, Loss, and Insecurity: A Qualitative Study Among Survivors of Armed Conflict in the Dang District of Nepal. Frontiers in psychiatry, 10, 941-941.

• Madrid, P. A. (2021, March 15). Torture Survivors: A Mental Health Provider's Guide to Conducting Evaluations. Retrieved from Psycom Pro: https://pro.psycom.net/special_reports/trauma-survivors-ptsd-treatment-approaches/evaluating-victims-of-torture

• Pérez-Sales. (2020). Impact of the COVID-19 pandemic on work with torture survivors: Clinical and community perspectives. Journal on Rehabilitation of Torture Victims and Prevention of Torture.

• The Center for Victims of Torture. (2015, April). Effects of Torture. Retrieved from CVT: https://www.cvt.org/sites/default/files/downloads/CVT Effects Torture April 2015.pdf

• UNHCR. (n.d.). Refugee resettlement to Canada. Retrieved from UNHCR Canada: https://www.unhcr.ca/in-canada/unhcr-role-resettlement/refugee-resettlement-canada/

• United Nations. (2017). Torture victims in the context of migration: identification, redress and rehabilittation. Geneva: United Nations.

• United Nations. (2020). COVID-19 exacerbates the risk of ill-treatment and torture worldwide - UN experts. Retrieved from https://www.ohchr.org/en/stories/2020/06/covid-19-exacerbates-risk-ill-treatment-and-torture-worldwide-un-expert

5.3 — 2SLGBTQ+ people

• Fernando, R. &. (2019). Queer credibility in the homonation-state: interrogating the affective impacts of credibility assessments on racialized sexual minority refugee claimants. Refuge: Canada's Journal on Refugees.

• Government of Canada. (2020, July 07). The human rights of lesbian, gay, bisexual, transgender, queer, 2-spirit and intersex persons. Retrieved from Government of Canada: https://www.international.gc.ca/world-monde/issues_development-enjeux_developpement/human_rights-droits_homme/rights_lgbti-droits_lgbti.aspx?lang=eng

• Heartland Alliance for Human Needs & Human Rights. (2012). Rainbow Response: A Practical Guide to Resettling LGBT Refugees and Asylees. Chicago: Heartland Alliance.

• Heartland Alliance for Human Needs & Human Rights. (2013). A Rainbow Retrospective: Reflection on Best Practices and Successes From the Field. Chicago: Heartland Alliance.

• Immigration and Refugee Board of Canada. (2020, December 30). Interpretation of Convention Refugee and Person in Need of Protection in the Case Law: Chapter 5 - Well-founded fear. Retrieved from Immigration and Refugee Board of Canada: https://irb.gc.ca/en/legal-policy/legal-concepts/Pages/RefDef05.aspx

• Immigration and Refugee Board of Canada. (2021, December 17). Guideline 9: Proceedings Before the IRB Involving Sexual Orientation, Gender Identity and Expression, and Sex Characteristics. Retrieved from Immigration and Refugee Board of Canada: https://irb-cisr.gc.ca/en/legal-policy/policies/Pages/GuideDir09.aspx

• Immigration, Refugees and Citizenship Canada. (2019, June 01). Canada announces new initiative to support LGBTQ2 refugees. Retrieved from Government of Canada: https://www.canada.ca/en/immigration-refugees-citizenship/news/2019/06/canada-announces-new-initiative-to-support-lgbtq2-refugees.html

• International Lesbian, Gay, Bisexual, Trans and Intersex Association. (2019). State-Sponsored Homophobia. Geneva: ILGA.

• Logie et al. (2016). “It's for us - newcomers, LGBTQ persons, and HIV-positive persons. You feel free to be”: a qualitative study exploring social support group participation among African and Caribbean lesbian, gay, bisexual and transgender newcomers and refugees in Toronto, . BMC Int Health Hum Rights.

• Messih, M. (2017). Mental Health in LGBT Refugee Populations. The American Journal of Psychiatry Residents' Journal, 11(7), 5-7.

• Molnar. (2018). LGBTQ2+ refugees in Canada. The Canadian Encyclopedia.

5.4 — People living with disabilities

• Hameed, S., Sadiq, A., & Din, A. U. (2018). The Increased Vulnerability of Refugee Populations to Mental Health Disorders. Kansas journal of medicine, 11(1), 20.

• Reid, B. E. (2020). Internet architecture and disability. Indiana Law Journal, 95, 591.

• Tam, D. M., Smith-Carrier, T., Kwok, S. M., Kerr, D., & Wang, J. (2021). Challenges Encountered by Newcomers with Disabilities in Canada: An Illustration of the Ontario Disability Support Program. Canadian journal of disability studies, 10(3), 119-146.

• Government of Canada. (2018). Temporary Public Policy Excessive Demand on Health and Social Services. Ottawa, June 1, 2018. Retrieved from: https://www.canada.ca/en/immigration-refugees-citizenship/corporate/mandate/policies-operational-instructions-agreements/excessive-demand-june-2018.html

• Government of Canada. (2022). Regulations Amending the Immigration and Refugee Protection Regulations (Excessive Demand): SOR/2022-39. Canadian Gazette, Part II, 156(6). Retrieved from: https://www.gazette.gc.ca/rp-pr/p2/2022/2022-03-16/html/sor-dors39-eng.html

• Hansen, S., Wilton, R.D., & Newbold, K.B. (2017). 'There is always this feeling of otherness': exploring the lived experiences of visually impaired immigrant women in Canada. Disability & Society, 32 (8): 1121-1141.

• Khanlou, N., Mustafa, N., Vazquez, L.M., Haque, N., & Yoshida, K. (2015). Stressors and barriers to services for immigrant fathers raising children with developmental disabilities. International Journal of Mental Health and Addiction, 13: 659-674.

• Khanlou, N., Haque, N., Mustafa, N., Vazquez, L.M., Mantini, A., & Weiss, J. (2017). Access barriers to services by immigrant mothers of children with autism in Canada. International Journal of Mental Health and Addiction, 15 (2): 239-259.

• Lindsay, S., King, G., Klassen, A.F., Esses, V., & Stachel, M. (2012). Working with immigrant families raising a child with a disability: challenges and recommendations for healthcare and community service providers. Disability & Rehabilitation, 34 (23): 2007-2017.

• Luce, A. (2018). Asylum seekers and refugees with intellectual disabilities in Europe: The need for increased awareness and inclusion of migrants with intellectual disabilities during the recent migrant crisis. Samuel Centre for Social Connectedness, Oakville: Canada. Retrieved from: https://www.socialconnectedness.org/wp-content/uploads/2019/10/Asylum-Seekers-and-Refugees-with-Intellectual-Disabilities-in-Europe-1-1.pdf

• Mirza, M. & Heinemann, A.W. (2012). Service needs and service gaps among refugees with disabilities resettled in the United States. Disability and Rehabilitation, 34 (7): 542-552. DOI: 10.3109/09638288.2011.611211

• Statistics Canada. (2018). Table 13-10-0381-01 Immigrant status and period of immigration for persons with and without disabilities aged 15 years and over, by sex, Canada. Retrieved from: https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310038101

• United Nations General Assembly (UNGA). (2006). Convention on the Rights of Persons with Disabilities (A/RES/61/106). Retrieved from: https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html

• United Nations High Commissioner for Refugees (UNHCR). (2019). Working with Persons with disabilities in forced displacement. Retrieved from: https://www.refworld.org/docid/5ce271164.html

• Women's Commission for Refugee Women and Children. (2008). Disabilities among refugees and conflict-affected populations. Retrieved from: http://reliefweb.int/node/280071