Q & A with Dr. Ghayda Hassan and Vince Pietropaolo

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

“Hello, I am a social worker in the hospital (acute care). Usually, I have seen many refugees admitted to the hospital for what seems like "physical illnesses" (pseudo-seizures, gastro issues and so on). Due to the nature of acute care, there is no time to really go in depth into counselling or offering mental health support. What would be the best way to support someone coming for such a short period of time? what should I be mindful of?”

Response

Response by Dr. Ghayda Hassan, Psychologist, Université du Québec à Montréal (UQAM)

It is indeed difficult to provide more in-depth psychosocial support in acute and short term care settings. But some things can be done to comfort that are very supportive and soothing for the client and may leave positive impact on the experience of care as well as more generally.

• Firstly, and because many refugees have suffered from lack of care and deprivation of basic needs, it is important that you make sure the client is feeling comfortable and safe about the care you are providing. Be caring about the comfort of your client, e.g. do they need a glass of water, are they feeling safe and fine with the examinations you are doing, explain what you will be doing and if they will feel pain or not etc.. ask them if they have questions and if they have concerns, ask them if the services are provided in ways that respect their values etc.
• To make clients feel at ease and safe you can create a setting where diversity is represented through pictures on the wall for example, handouts of self-care in different languages etc.
• Make your client feel they are part of the care, ask them what they think could be good solutions and what they need and how you can help while also explaining what you suggest in terms of treatment.
• Provide Trauma informed care, this is very important in settings where physical examinations or symptoms may be connected or reactivate trauma, there are many training programs offered about trauma informed care
• You can have handouts in your office in different languages about self-care and mental health, you do not need to offer one directly to your client- or you can depends really on the situation - but at least your client sees this and may be a first step.

Question

“ As an ESL Instructor I get to see my predominately refugee, newcomer clients more frequently than their settlement workers. This in turn leads to strong relationships being formed. The vast majority of my students have shared their experiences and concerns with me. It feels like I am ignoring the elephant in the room by not addressing mental health in the classroom. Am I over stepping my boundaries as an instructor? And if not, what routine activities can I use to promote a sense of well-being?"

Response

Response by  Vince Pietropaolo, General Manager, Mental Health Services Program, COSTI

It’s wonderful to hear how connected you are with your students….

It appears that the students you’re teaching are very trusting of you and want to relate and tell their stories.  Like many refuges their stories may be filled with trauma and devastating experiences of both survival and suffering.

I’m glad to hear that you have recognized indicators of mental health and that students may benefit from some mental health education.

I would recommend having a quest speaker with expertise in mental health come and address the class. You could provide mental health resources for your students and having meditation sessions is always helpful.

Hope this helps.