Question and Answer with Dr Clare Pain, Bonnie Wong and Vanessa Wright

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:

I notice there is good support mechanisms for counselling women and support groups.  Unfortunately immigrant men from broken families, going through lot of stress and difficulties don't have much resources to avail.  Please share free in person and online help for battered men. Thank you.

Response:

Vanessa Wright, nurse practitioner, Crossroads Refugee Health Clinic

I completely hear you, thank you for your question and concern you raise. I have also found this, throughout my work in the health care sector, particularly for young men who arrive on their own. I think your recognition of this is excellent. Although there are not many identified service organizations for men fleeing situations of domestic violence (in Canada), there are several mental health organizations that might offer group counselling or individual support to newcomer men in such situations. The same principles apply across all genders in terms of domestic violence counselling and mental health support. In addition to the websites below, I find many specific cultural organizations have wonderful leaders of all genders who engage in this sort of work. 

Regarding newcomer men: I'm not too sure if you're speaking to family separation or those who have experienced domestic violence? or maybe both? Here are a few resources that might be helpful in terms of reading more about the impact of domestic violence on men and supports available in Canada:

• Help for Men Who Are Being Abused - HelpGuide.org
• Find Help Across Canada - Ending Violence Association of Canada
• Canadian Mental Health Association (Canada wide - mental health support search)
• Newcomer men: Unique challenges and considerations

Question:

So far on reading on immigration and refugee mental health, I have noticed there are the different phases in the migration journey of an immigrant/refugee. How do you properly reflect these different phases when working with immigrants/refugees, in terms of documentation, gathering information etc.

Response

by Bonnie Wong, Executive Director, Hong Fook Mental Health Association; and Dr. Clare Pain, director, Psychological Trauma Program, Mount Sinai Hospital; Associate Professor of Psychiatry, University of Toronto

Bonnie Wong says:

Pre and post migration factors impact case management; considerations include:

• It is always helpful to prepare a checklist of physical and mental health conditions for which the client should be screened.
•  Ask the client to complete a questionnaire about social stressors that impact his or her health.
• It doesn’t matter whether the stressors have been generated from pre or post migration, it is important to find out what helps them to find comfort and healing, even in prevention of psychiatric disorders.
• Often, we are aware that any negative life event is a risk factor for depression.
• Client’s own religion, moral, family, cultural, and ethical values and perspectives may be contrary to western society’s values and the provider’s clinical values and perspective; to facilitate effective case management intervention, providers should be educated about the necessary requirement for a workable helping relationship.

Dr. Clare Pain also writes:

Of the 3 stages (pre migration, migration, and post migration) it is the third stage that is the most stressful and difficult for most refugees. You’d think that the pre migration trauma and displacement would be the worst stage, and the journey to come to Canada which can be horrendous would be worse than settling here.  However, we tend to assume the pre migration issues are the determinants of current stress and symptoms which is not necessarily or even frequently true – missing family back home or being worried about their wellbeing certainly preoccupy the newcomer but being open to what the determinants are is helpful.

Have a good or promising practice you’d like to share with other providers on how you are supporting the mental health or influencing the social determinants of mental health for immigrants and refugees? Then contact us at irmhproject@camh.ca