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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
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Imagine this scenario

Anti-Asian racism and discrimination were amplified during the COVID-19 pandemic due to Asians being blamed for COVID-19. Hate and racism were even extended to Asian youth 18 years and under. Reports of discrimination by children and adolescents increased by 286% in 2021 compared to 2020, making up 29% of reports (CCNCTC &Project 1907, 2022).

These two, short, real-life scenarios highlight the experiences of some young people.

To support young people, researchers from the Factor-Inwentash Faculty of Social Work, University of Toronto, the Asian Canadian Living Archive and Hong Fook Mental Health Association initiated a project entitled My Script, My Voice.

The project, which included focus group discussions and photo story (photography and visual arts), was designed to better understand the following:

click Learn more about the project

“Racism and discrimination constitute pervasive stressors in the daily lives of many racial and ethnic minority individuals and our Asian youth is not immune. Racial discrimination has become a contributory factor in the occurrence of physical and mental health conditions. At Hong Fook, we hear from Asian youth that they feel ashamed of their social identities, i.e., being Asian. They find it difficult to share these experiences with their parents. This can cause more feelings of isolation, anxiety and depression and prevent them from social participation in the Canadian society.”

Bonnie Wong, Executive Director of Hong Fook Mental Health Association (published by Chinese Canadian National Council Toronto Chapter in the “Another Year: Anti-Asian Racism across Canada, Two Years into the COVID-19 Pandemic document.”

Activity: Racism and mental health

Describe at least three factors related to racism that contribute to mental health problems for immigrants and refugees.

Perceived racism is a risk factor for mental health problems. Canadian research has shown that perceived discrimination is connected with declining self-reported mental health for immigrants, post-migration. When newcomers and racialized groups experience, perceive or expect that they will be discriminated against, it influences their interest in accessing programs and services. Instead, they may resort to other non-medical interventions to address their mental health problems or illnesses (Mental Health Commission of Canada,[MHCC] 2019).

Studies have shown that higher rates of depression and anxiety are likely when there is misalignment between education and occupational level. For instance, immigrants generally have higher levels of education than persons born in Canada, but they earn less than the Canadian-born population. In 2015, immigrants working full time earned less than non-immigrant Canadians with the same degree (MHCC, 2019).

Although Canada prides itself on multiculturalism and is considered a cultural mosaic, racial hierarchy exists. As with all societies, classism also exists. New immigrants often experience a change in social status, moving from a higher status in their home country to a lower status in their host country. This can have a negative effect on mental health (MHCC & CAMH, 2009).