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November 27, 2011

Mental Health Policy for Newcomers

Reuel S. Amdur

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According to Farah Mawani, international studies have shown that immigrants and refugees have higher rates of mental health problems, and the problems may increase over time. She is a Ph.D. student at the Dalla Lana School of Public Health at the University of Toronto and was speaking at St. Paul University in Ottawa at the "Cultural Diversity & Mental Illness" conference of Healthcare Canada on November 18. She recently completed a contract with the Mental Health Commission of Canada.

One important factor with an impact on mental health is age at time of immigration.  While tendencies may differ from one country of origin to another, as a general rule in case of mental ill health, men tend to turn to addictions while women are more apt to become depressed. 

In looking at the mental health of newcomers, it is necessary to consider not only the situation after settlement but also what the person was like in the home country.  Research is needed, she urged, as to pre-immigration factors implicated in positive and negative mental health in the receiving country.

Economics, political, social, and physical environmental factors all play a role.  Especially salient are expectations.  We have all heard stories about physicians driving taxi.  There is the joke about the person having a heart attack: for immediate care, call a taxi.  In Ontario, she reported that Peel Region has undertaken a program of providing clear information to people back in the home country about what they can reasonably expect when they come.

Events in the home country can also have an important impact on mental health.  Thus, worries related to the tsunami in Sri Lanka affected Tamils in Canada whose families back home were suffering.  Social inclusion and available support in Canada are also affected by experiences in the sending country.  Experiences back home can also affect the next generation born in Canada.  The chemical warfare waged by Saddam Hussein on the Kurds has resulted in Kurdish children who are born in Canada with defects.

Mawani urged that workplaces be supportive of immigrant employees with mental health problems, for example, the stress occurring when coping with what is happening to family back home.  However, more broadly, Canadian society needs to address at multiple levels the issue of determinants of mental health. She noted that Australia first adopted a national strategy in 1981 and has since revised it.  Canada is expected to have one next year. 

She argued for a policy of mental health equity.  It was pointed out that current government policy on increasing incarceration runs counter to that concept.  On the one hand, it means that more Indians, Métis, and Inuit, already heavily over-represented in jails and prisons, will end up there in even greater numbers.  On the other hand, while there they will not receive needed mental health treatment.

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