The Immigrant and Refugee Mental Health Project facilitates a virtual Community of Practice (CoP) comprised of health, settlement and social services providers across Canada who support the mental health of immigrants and refugees. The CoP online discussion board allows providers to pose questions to the Project’s panel of subject matter experts (SMEs). We will be bringing you some of the questions posed by providers and answers provided by the SMEs.
Question
How do you support an individual that you know is experiencing mental health challenges, such as a constant feelings of being sad and expressing anxiety but is refusing to access help due to stigma and the fear of being re-traumatized?
Dr. Debra Stein, staff psychiatrist (child and adolescents), SickKids Centre for Community Mental Health, writes:
I think it really begins with the trusting, safe relationship we are building with the individual we would like to see accessing mental health supports. As care providers, we need to be seen as a person who really understands their situation and has their best interests in mind, all the while demonstrating respect for their boundaries. In my experience, it is easier for clients to make the leap to seeing a mental health clinician once they feel safe in that first caring relationship.
It is even easier if that first care provider knows the clinician they are referring to personally, and can vouch for their work. At (name of organization), it was very helpful that we psychiatrists worked alongside the settlement staff and had our offices right there. Not only could the staff mention my name and describe me as a trusted clinician, but we could also do a soft "meet-and greet" where the client could simply come by and meet me in person after their meeting with their settlement worker (truly a 3-5 minute warm introduction, with a smile and hello, not much more). I found this really helped ease anxiety about the referral.
Another would be to explore the client's fears and try to address their specific concerns. It is sometimes surprising what comes up when clients are asked directly what worries them about seeing a mental health clinician. Some psychoeducation about how mental health supports are very broadly accessed by many people in Canada (and not just people with serious persisting mental disorders like schizophrenia) can also go a long way in easing fears.
Finally, unless there are acute safety concerns, it is important to go slowly. This is usually a process that takes time and patience.