OCASI Conference 2009

Supporting Newcomer Immigrants and Refugees from Racialized Communities with

Mental Health IssuesNovember 5, 2009

8:15-11:15 AM

Agenda8:15 Introduction

About Across BoundariesExpectations; Goals and Objectives

8:45 What is Mental Health?What is the understanding of different cultures about mental health?

9:15 Mental health issues experienced by newcomer immigrants and refugees from Racialized communities

9:45 Break

10:00 Early Warning Signs of Mental Health Problems

10:20 Common Mental Disorders

10:30 Case Study: Providing support to people experiencing mental health problems

11:00 Resources in the local communities/ Forging partnerships

11:15 The End

Goals and Objectives

• Define mental health

• Discuss barriers experienced by refugees and newcomers

• Learn early warning signs of mental health problems

• Learn new knowledge of common mental disorders

• Learn resources in local communities

Introductions

• Why are you interested in this workshop?

• What are the mental health needs of newcomer immigrants and refugees that you are faced with in your agency?

• What have you done to meet these needs?

What Is Mental Health?

Mental Health – is a state of well-being in which the individual realizes his/her own abilities, can cope with the normal stresses in life, can work productively and fruitfully and is able to make a contribution to his/her community.

(World Health Organization)

Problems experienced by refugees which impact their

mental health:• Experience social exclusion, social

inequality and discrimination. • Discrimination interacts with other social

determinants and is experienced as trauma • Major Issues

– a) lack of support systems; – b) misplaced family members due to war; – c) family conflict and breakdown; – d) peer pressure from other disenfranchised

youth; and – e) systemic and structural discrimination.– f) problems with immigration status

Mental Health Issues Faced by Newcomer Immigrants and Non-

Recent Immigrants• Trauma caused by systemic discrimination –racism,

sexism, homophobia, xenophobia, etc.• Homelessness (One third of Toronto’s homeless are

immigrant)• Underhoused, overcrowding• High rate of mental health problems and alcohol and

substance use of homeless non-recent immigrants• In Toronto, 60% of poor families are from Racialized

communities• Mood and anxiety disorder, diabetes, heart condition

caused by poverty

Immigrants, Non-recent Immigrants

• Migrants from Racialized communities earn 40% less than their white counterparts

• Suicide attempts are 10 times higher than for citizens not living with poverty

• Low self-esteem caused by unemployment or underemployment

• Many newcomers live in poverty because they fail to have their credentials recognized and are underemployed

Continuation..

• Domestic violence

• Youth violence

• Social isolation –increased level of sadness and loneliness

• Family breakdown

• Exposure to toxic and other environmental hazards

Problems experienced by immigrants and refugees in

accessing MH services:

• 3-month wait period for new immigrants to be provided OHIP coverage

• Temporary foreign migrant workers have no health benefits even if they are paying taxes

• Racialized health disparities caused by social and health policies, conditions and practices

Access…

• Lack of culturally competent with anti-oppression skills of service providers and decision makers in the health system

• Poor access to affordable housing• Lack of access to information (language

barrier)• Inappropriate mental health services and

programs• Lack of access to skills training

Access..

• Dominance of Eurocentric approach to care

• Lack of community engagement in the mental health system

• Inappropriate outreach services and programs

• Inappropriate health promotion and mental illness prevention programs

• Lack of social supports

Early Warning Signs of Mental Health Problems

• Anxiety, nervousness• forgetfulness• Inability to experience pleasure• lack of motivation• Feeling slowed down or speeded up• Avoiding others or isolating• Being obsessed with minor issues• Beginning irrational thought pattern• Feeling unconnected to your body• Increased irritability• Increased negativity• Increase in smoking• Increase in gambling

Warning signs…

• Aches and pains• Dizziness• Muscle cramping• Excessive sweating• Poor motor coordination with no physical reason• Feeling of discouragement and hopelessness• Substance abuse• Not answering the phone Turning off the phone

machine• Overeating/Undereating• Weepiness• Compulsive behaviours

Warning signs

• Controlling/manipulative behaviours• Being too quiet• Easily frustrated• Feelings of abandonment and rejection• Taking too much pain medication • Not keeping appointments• Spending money on unneeded items• Impulsivity• Feeling worthless and inadequate• Secretiveness

Common Mental Disorders and Symptoms

• Schizophrenia- a failure of the brain’s chemical to function properly

• Leads to disjointed ideas, confuse or disconnected thoughts or sounds

• Or sensations experienced as real when they only exist in the person’s mind

• A combination of some of the following symptoms that exist more than six months: delusions, hallucinations, disrupted thoughts and behaviours, grossly disorganized behaviours

• Flattened or blunted affect• No energy

Common Mental Disorders• Bi-Polar Disorder –a medical condition as a result of genetic

predisposition in which people have extreme mood swings. The symptoms could be signs of depression or mania.

• inflated self importance, delusions or hallucinations• feeling all powerful and destined for greatness• feeling high, excessively optimistic• irritable, aggressive, provocative, intrusive behaviour• Extremely talkative and sociable• Flight of ideas• Inability to concentrate• Pressure of speech, racing• Excessive involvement in pleasurable or high risk activities such as

sex• Lacks insight

Common Mental Disorders• Depression – a medical disorder that affects one’s thoughts,

feelings, physical health and behaviour.• A depressive episode must have a certain level of severity and a

minimum duration of two weeks• - feeling hopeless, sad, discouraged or empty• - Inability to experience pleasure• - Significant weight loss or weight gain• - Insomnia or oversleeping• - anxiety, restlessness, slow speech• - Fatigue• - Strong feelings of worthlessness or guilt• - perceived faults and mistakes• - Memory problem• - suicidal thoughts• - somatic symptoms

Other Mental Disorders

• Personality Disorder• Anxiety• Post-Partum Depression• Psychosis• Concurrent Disorder• Addiction• Anorexia• Dual Diagnosis

UNDERSTADING RACISM IN THE MENTAL HEALTH SYSTEM

ORGANIZATION

IDEAS OF SUPERIORITY

SOCIAL NORMS

STRUCTURES/SYSTEMS INDIVIDUAL BEHAVIOUR

• MENTAL HEALTH SYSTEM

• MEDIA

• EDUCATION

• WORKPLACE POLICES AND PROCEDURES

• ATTITUDES

• FEELINGS

• BELIEFS

WHAT IS AN ANTI-RACISM FRAMEWORK?

ANTI-RACISM

TRAINING/EDUCATION

ANTI-RACISM

ORGANIZATIONAL CHANGE

ANTI-RACISM

SERVICE DELIVERY