Parenting adolescents from ethno-cultural backgrounds: A scan of community-based programs in Canada for the promotion of adolescent mental health
Ruiz-Casares, M.; Kolyn, L.; Sullivan, R.; Rousseau, C. (2015)
Objectives
To i) describe current community-based programs across Canada to support parents for the promotion of adolescent mental health, with special attention to ethno-cultural populations; and ii) identify needs, gaps, and opportunities for the development of a framework to support parents for the promotion of adolescent mental health.
Methods
We conducted an internet-based cross Canada scan of community-based parenting programs that promote adolescent mental health in ethno-culturally diverse populations, followed by structured phone interviews with program staff. Findings were categorized according to audience (ethnicity/culture and age group), geographical distribution and coverage, and program type. Barriers to access and outreach mentioned by interviewees were documented.
Results
We found a total of 47 programs that met our search criteria. The greatest numbers were found in the provinces of Ontario, British Columbia and Alberta, particularly in the Greater Toronto and Vancouver Areas. Most programs consisted of psycho-educational, information-based workshops, support groups, or used innovative approaches (e.g., arts, alternative medicine, mentorship, and skillsdevelopment courses). Five programs (11%) had parent and youth components. From the perspective of service providers, cultural distrust, stigma, financial constraints and language barriers pose challenges to outreach. Program evaluations are limited and often not publicly available.
Conclusion
There are gaps in geographic coverage and types of programs available to parents for the promotion of adolescent mental health in ethno-cultural communities. Inconsistent and insufficient funding [and other forms of institutional support] detract from the capacity of community-based organizations to adequately support families and conduct, publicize, and evaluate their programs.
DSM-5 Handbook on the Cultural Formulation Interview
Rousseau, C.; Guzder, J. (2015)
Interdisciplinary Case Discussions as a Training Modality to Teach Cultural Formualtion in Child Mental Health
Rousseau, C.; Johnson-Lafleur, J.; Papazian-Zohrabian, G. (2018)
The DSM-5 Cultural Formulation Interview (CFI) may become an important tool to help operationalize culture in the clinical realm. However, challenges exist in teaching its use to avoid the risk of stereotyping and oversimplification, which could result in misunderstanding and stigma. The aim of this article is to document whether the CFI can be taught using regular Interdisciplinary Case Discussion Seminars (ICDSs), proposed as continuing education in child mental health and as part of clinical rotations for new trainees. During a two-year evaluative research project, ICDSs were held monthly in three different primary care settings servicing recent immigrants in Montreal, Canada. ICDSs were recorded and analyzed to examine their effect on the cultural formulation process and focus groups were conducted to explore the subjective experience of the participant trainees and professionals. Results suggest that ICDSs are a helpful way to teach the use of the CFI. The group discussions helped participants to better capture the complexity of the cultural and social experience of the child and family by moving away from simple identity assignations, supporting an inquiry into structural dimensions, and considering stigma and inequality in their formulation. The multiple levels of diversity (individual, disciplinary, and interinstitutional) represented in the discussion groups helped clinicians to understand the cultural formulation as situated in a specific relational context and a particular moment and, in so doing, helped trainees to avoid cultural formulations that essentialize culture.
Le défi du vivre ensemble : Les déterminants individuels et sociaux du soutien à la radicalisation violente des collégiens et collégiennes au Québec
Rousseau, C Hassan, G Lecompte, V Oulhote Y El Hage H. Mekki-Berrada A Rousseau-Rizzi A (2016)
Uninsured immigrant and refugee children presenting to Canadian paediatric emergency departments: Disparities in help-seeking and service delivery
Rousseau, C.; Laurin-Lamothe, A.; Rummens, JA; Meloni, F.; Steinmetz, N.; Alvarez, F. (2013)
Access to health care for medically uninsured immigrant and refugee children is a public health concern due to the consequences of delayed or substandard care for child development and health. To explore possible differences in help-seeking and service delivery across migratory statuses, institutions and provinces. A review was undertaken of 2035 emergency files of immigrant, refugee and undocumented children without provincial health care coverage who sought care at three major paediatric hospitals in Montreal (Quebec) and Toronto (Ontario) during 2008 and 2009. Refugee claimant children with Interim Federal Health Program benefits consulted for less urgent problems than the overall hospital population, except in one hospital that had a multicultural paediatric ambulatory clinic. Undocumented children and new permanent resident immigrant children within the three-month waiting period for provincial health care coverage were over-represented in the very urgent triage category and presented more often for injuries, trauma and mental health problems than did refugee claimant children. Wide interhospital differences suggest that the predicament of limited access to health care of these groups of vulnerable medically uninsured children needs to be addressed through further research to inform policies and develop training.
Emotional and Behavioral Difficulties and Academic Achievement in Immigrant Adolescents in Special Education
Rousseau, C.; Mustafa, S.; Beauregard, C. (2015)
The literature emphasizes that the school environment is a key factor for the mental health and academic achievementof immigrant and refugee children. However, few studies examined the role of school environment and peerrelationships for these youth attending a special education class. The aim of this paper is to study the associationbetween emotional difficulties and academic performance and their correlates in first and second generationimmigrants assigned to a special class in a multiethnic environment. The results emphasize the need to adopt aneco-systemic model to understand the complex and probably bidirectional relations between the mental healthsymptoms and academic performance in immigrant adolescents identified as having difficulties by the school system.The salience of peer relations and classroom environment suggests that schools need to promote positive school-basedrelationships to improve immigrant adolescent mental health.
Culture et migration
Rousseau, C.; Nadeau, L. (2016)
Perinatal health care for undocumented women in Montreal: when sub-standard care is almost the rule
Rousseau, C,; Ricard-Guay, A.; Laurin-Lamothe, A.; Gagnon, AJ.; Rousseau, H. (2014)
Objective: This mixed method study examines the perinatal health care for undocumented women in Montreal (Quebec) and documents their experiences of that care.
Method(s): Files of precarious status women were reviewed (n = 591) at a major hospital and two community health centres in Montreal to document maternity services received. Through in-depth semi-structured interviews, 18 undocu-
mented women described their experiences of help seeking during pregnancy.
Results: File review confirmed that being uninsured is associated with substandard prenatal care. The qualitative analysis highlighted the numerous difficulties and sometimes abusive situations that undocumented pregnant women encounter while trying to access perinatal care.
Conclusion: These results suggest that it is urgent to revise provincial health policies in order to facilitate the access of undocumented women to care during the perinatal period.
Psychological harm and the case for alternatives
Symbolic violence and disempowerment as factors in the adverse impact of immigration detention on adult asylum seekers’ mental health
Cleveland, J.; Kronick, R.; Gros, H.; & Rousseau, C. (2018)
OBJECTIVES:
The first objective of this qualitative component of a mixed-methods study is to provide a descriptive account of adult asylum seekers’ experience of detention in Canadian immigration detention centers. The second objective is to identify the main underlying factors accounting for their reported feelings of distress.
METHODS:
Researchers interviewed 81 adult asylum seekers held in two Canadian immigration detention centers concerning their experience of detention. Participants were drawn from a sample of 122 detained asylum seekers who had completed structured questionnaires about mental health and detention conditions.
RESULTS:
Asylum seekers expressed shock and humiliation at being “treated like criminals.” Detainees felt disempowered by the experience of waiting for an indeterminate period for the outcome of a discretionary decision over which they have little control, but which will determine their freedom and their future. For trauma survivors, detention sometimes triggered retraumatization.
CONCLUSIONS:
Detention, even for brief periods in relatively adequate conditions, was found to be detrimental to asylum seekers’ mental health. This adverse impact appears to be largely attributable to the combined effect of two factors: symbolic violence and disempowerment.
Mental health impact of detention and temporary status for refugee claimants under Bill C-31.
Cleveland, J.; Rousseau, C. (2012)
Psychiatric symptoms associated with brief detention of adult asylum seekers in Canada
Cleveland, J.; Rousseau, C. (2013)
Objectives:
To examine the association between brief detention and psychiatric symptom levels among adult asylum seekers.
Method:
The Harvard Trauma Questionnaire and the Hopkins Symptoms Checklist-25 were used to assess psychiatric symptoms and premigration trauma exposure in 122 detained and 66 nondetained adult asylum seekers in Montreal and Toronto.
Results:
After a mean detention of 31 days, the proportion of asylum seekers scoring above clinical cutpoints was significantly higher in the detained than the nondetained group for posttraumatic stress (X2 = 4.117, df = 1, P = 0.04), depression (X2 = 13.813, df = 1, P < 0.001), and anxiety (X2 = 4.567, df = 1, P = 0.03) symptoms. Hierarchical multiple regression models showed that posttraumatic stress, depression, and anxiety symptom levels were significantly higher among detained asylum seekers than among the nondetained comparison group, taking into account previous trauma and demographics. Incremental Fwas significant for the addition of detention status for all 3 models, indicating that detention contributed to increased symptom levels.
Conclusions:
For asylum seekers, even brief detention is associated with increased psychiatric symptoms. Governments should consider the many viable alternatives to incarceration of asylum seekers, such as temporary placement in a supervised residential facility, to minimize the risks of psychological harm to this vulnerable population.
Mouvement des frontières identitaires dans les dessins d’élèves immigrants
Beauregard, C.; Papazian-Zohrabian, G.; Rousseau, C. (2018)
Pour l’élève immigrant, le contact interculturel occasionné par l’immigration génère une prise de conscience des différences et des ressemblances entre lui et les autres, ce qui influence son sentiment d’ipséité et sa perception de l’altérité. C’est notamment en jouant et en déplaçant les limites de son identité que l’enfant (re)définit qui il est. Cependant, cette mobilité des frontières identitaires peut ne pas être facilement perceptible. Une manière de rendre ce mouvement plus concret est d’avoir recours au dessin. Par le dessin, l’élève peut dévoiler d’importantes informations sur lui-même dont il n’est pas nécessairement conscient. Le dessin peut également lui permettre d’utiliser des symboles qui facilitent l’expression d’expériences qui n’ont pas été extériorisées et de les partager avec autrui. Enfin, le dessin peut ouvrir l’accès aux identifications vécues par l’enfant en donnant une forme symbolique ou figurative aux personnes auxquelles il s’identifie ou non.
L’objectif de cet article est d’examiner les dessins créés par deux jeunes immigrants sous l’angle du mouvement des frontières définissant l’identité et l’altérité. L’étude s’appuie sur des données obtenues dans le cadre d’une recherche-intervention de 14 semaines dans des classes d’accueil pour enfants immigrants d’une école primaire multiethnique de Montréal (Canada). À partir d’entrevues semi-dirigées auprès d’élèves immigrants, de leurs parents et de leurs enseignants, ainsi qu’à partir d’autoportraits thématiques et de dessins libres commentés qu’ils ont réalisés lors de l’intervention, les auteures décrivent comment deux jeunes élèves nouvellement arrivés au Québec (re)définissent leur identité en jouant dans leurs dessins avec les limites identitaires. Les résultats suggèrent que les élèves immigrants ont recours à des stratégies d’assimilation et de différenciation qui sont illustrées dans les dessins qu’ils réalisent, de façon séparée ou simultanée. Le dessin semble soutenir la (re)définition de l’identité de ces enfants.
The Use of Video in Knowledge Transfer of Teacher-Led Psychosocial Interventions: Feeling Competent to Adopt a Different Role in the Classroom/L’utilisation de la vidéo dans le transfert de connaissances dans les interventions psychosociales
Beauregard, C.; Rousseau, C.; Mustafa, S. (2015)
Because they propose a form of modeling, videos have been recognised to be useful to transfer knowledge about practices requiring teachers to adopt a different role. This paper describes the results of a satisfaction survey with 98 teachers, school administrators and professionals regarding their appreciation of training videos showing teacher-led psychosocial interventions. The association between teachers’ appreciation of the video and their desire to implement the intervention are explored in terms of authenticity, vicarious learning and self-efficacy, in an attempt to further comprehend how the use of video supports different aspects of modeling (skills – know-how, attitudes – know-how to be). The authors suggest that training videos featuring teachers leading psychosocial interventions support knowledge transfer because learners can relate to successful peers and can think of themselves as competent to replicate the intervention and comfortable to adopt a different role in the classroom. Parce qu’elles proposent une forme de modelage, les vidéos ont été reconnues comme utiles pour le transfert de connaissances au sujet des pratiques exigeant que les enseignants jouent un rôle différent. Cet article décrit les résultats d’une enquête sur la satisfaction réalisée auprès de 98 enseignants, administrateurs et professionnels scolaires quant à leur appréciation des vidéos de formation montrant des interventions psychosociales menées par des enseignants. Le lien entre l’appréciation de la vidéo par les enseignants et leur désir de mettre en pratique l’intervention est exploré en matière d’authenticité, d’apprentissage par procuration et d’auto-efficacité, pour tenter de mieux comprendre comment l’usage de la vidéo appuie différents aspects du modelage (aptitudes, savoir-faire, attitudes, savoir-être). Les auteurs suggèrent que les vidéos de formation montrant des enseignants menant des interventions psychosociales appuient le transfert de connaissances, car les apprenants peuvent s’identifier à des pairs qui réussissent et peuvent s’imaginer comme ayant la compétence pour reproduire l’intervention et être à l’aise d’adopter un rôle différent dans la salle de classe.
Making sense of collective identity and trauma through drawing: The case study of a Palestinian refugee student
Beauregard, C.;Papazian-Zohrabian, G.; Rousseau, C. (2017)
Identity construction can be very complex for refugee children, especially for Palestinian refugee children. For refugee children, organised violence and immigration are important parts of their life experience that can lead to trauma, which in turn influences how they construct their collective identity. Schools have to consider this specific experience as the development of a meaningful identity is an important factor in refugee students’ well-being and school adjustment. School-based activities centred on creative expression can help refugee students in expressing trauma and in making sense of their identity and migration experience. This paper presents the case study of a 9-year-old Palestinian refugee boy in Canada and explores how he expressed and made sense of his multiple identities in his drawings. Many features of the boy’s drawings evoked a wounded identity, especially spatial disorganisation and enmeshment. Data analysis revealed that the boy might have been experiencing collective identity trauma and that he used drawing and a peer as props to heal his wounded identity. Both drawing and the space offered by his teacher to safely explore and experiment with different identities contributed to the integration of his multiple identities into a meaningful whole, which contributed to his school adjustment.
L’impact pédagogique de la visite du Musée commémoratif de l’Holocauste chez des élèves québécois.
Audet, G.; Coté, B.; Potvin, M.; Mc Andrew, M. (2016)
Partnership between schools and immigrant families and communities
Audet, G.; Mc Andrew, M.; Vatz-Laaroussi, M. (2016)
Regards croisés sur la fin de vie et le mourir dans un Montréal pluriel
Colloque Dans le cadre de cette rencontre, nous souhaitons ouvrir un dialogue à plusieurs voix sur la fin de vie et la « bonne mort » du jeune au grand âge. Celles et ceux qui interviennent auprès de personnes en fin de vie tout comme celles et ceux qui visent à en documenter les possibles […]
SHERPA Publications
Programmes d’expression créatrice
Accueil
Accueil [URIS id=2046]
Travailler en soutien à domicile dans un contexte pluriethnique. Quand faire, c’est être
Laquerre, ME (2015)
Quelles sont les particularités de l’intervention en soutien à domicile auprès des personnes âgées immigrantes ? L’auteure propose de les décrire et de les comprendre en s’intéressant précisément aux dimensions relationnelles et communicationnelles, qui se révèlent fondamentales à l’échec ou à la réussite des interventions.
Mettant au premier plan les hommes et les femmes qui œuvrent dans ce secteur d’activité, l’approche ethnographique adoptée permet de saisir l’interaction dans ses multiples facettes : interactionnelles, subjectives, intersubjectives, organisationnelles et sociales. Des cas concrets, tirés d’observations d’interventions, et des extraits d’entretiens démontrent que la culture, en lien avec l’ethnicité, n’est qu’un des éléments qui caractérisent l’intervention et qu’il importe de prendre en considération l’influence d’autres espaces identitaires et culturels (cultures institutionnelles et organisationnelles, culture du service, culture professionnelle, culture du domicile).
La démarche proposée déborde des cadres théoriques actuels et intègre de multiples perspectives : communicationnelles, sociales, cliniques, critiques et éthiques. Les résultats interrogent notamment le rapport à l’altérité et dénotent l’importance de considérer la diversité chez l’ensemble de la clientèle, que celle-ci ait un vécu migratoire ou non. Ils remettent aussi en question le fonctionnement actuel de l’organisation des soins et des services à domicile en dénonçant les effets de l’implantation de l’idéologie gestionnaire dans ce contexte particulier d’intervention.
L’ouvrage intéressera avant tout les intervenants et les gestionnaires du réseau de la santé et des services sociaux qui souhaitent connaître, de l’intérieur, le travail réel et le travail vécu des intervenants en soutien à domicile dans un contexte pluriethnique.
Working with interpreters
Leanza, Y.; Miklavcic, A.; Boivin, I. et E. Rosenberg (2013)
Interpreting in medical and especially in psychiatric and psychotherapy settings is an ethical imperative. In mental health, clinical assessment and intervention require that the interpreter have specific skills and sensitivity to work with a patient-centered approach. This chapter provides an orientation to working with mental health interpreters, with a review of relevant research literature and theoretical models followed by guidelines and practical recommendations relevant to cultural consultation. Key principles are presented on how to work with interpreters in various contexts (e.g. CBT, psychodynamic, family therapy). Case vignettes from the CCS are provided throughout the text to illustrate the main points. In cultural consultation, issues of roles, neutrality and the interpreter’s identity (age, gender, ethnicity, religion, political orientation) should be carefully considered. In addition to the individual characteristics of interpreters, it is essential that organizational efforts are made to adapt institutional policies to patients’ linguistic and cultural diversity. Institutional change depends on recognizing interpreters’ skills and contributions to clinical work and encouraging practitioners to work with trained interpreters rather than untrained or ad hoc interpreters, especially family members. Quality assurance standards must formally require the routine use of interpreters in mental health and there must be mechanisms in place to monitor and enforce these standards.
Providing Health Care in the Context of Language Barriers: International Perspectives (In E. Jacobs & L. Diamond (Ed.))
Leanza, Y., Brisset, C., Rocque, R., &Boilard, A. (2017)
L’interprétariat en santé mentale à Montréal
Brisset, C.; Leanza, Y. (2015)
L’importance de l’interprétariat dans le domaine de la santé mentale en situation de barrières linguistique et culturelle n’est plus à démontrer. Le dialogue est la base à partir de laquelle l’évaluation et le traitement sont élaborés, et la langue est le principal moyen par lequel les usagers transmettent leurs souffrances et par lequel les intervenants partagent leur compréhension de la situation de ces derniers. La présence d’un interprète est dès lors cruciale en contexte plurilingue. Toutefois, travailler avec un interprète ne s’improvise pas et nécessite de savoir à qui on a à faire et ce que l’on en attend, mais implique également des enjeux relationnels que cette tierce personne peut susciter. Les conséquences éthiques sont grandes et les dilemmes qui peuvent en résulter soulignent une nécessité d’encadrement
La recherche clinique en sciences sociales
Hamisultane, S. (2013)
L’implication se pose, et s’insinue de manière complexe, dans nos réflexions et nos choix, en tant que chercheur. Elle nous apparaît dans sa complexité comme le contenant d’un ensemble de liens que nous avons avec l’objet de recherche, sa « naissance », sa construction, son cheminement, son devenir, en nous et hors de nous. L’implication est ce terme général qui « permet d’inclure toutes les relations…
L’institution éventrée
Hamisultane, s. (2017)
Parcours de résilience: accompagner les réfugiés suite aux traumas
Colloque L’augmentation récente de personnes réfugiées au Québec a entraîné un besoin croissant de soins de santé adaptés à la culture et au contexte spécifique de la migration forcée. Les personnes réfugiées ont souvent vécu de nombreux traumas et pertes lors de leur parcours de migration, aux conséquences multiples sur leur santé physique et mentale. […]
Une bibliothèque vivante avec de jeunes syriens à l’école
Clinique en sciences sociales Sens et pratiques alternatives
Fortier, I.; Hamisultane, S.; , Ruelland, I.; Rhéaume, J et S. Beghdadi (2018)
Les pratiques de recherche et d’intervention dans le champ des sciences sociales sont assujetties à des changements structuraux et sociohistoriques majeurs dans nos sociétés. Des développements théoriques et méthodologiques issus, entre autres, de la psychologie sociale, de la sociologie et de l’anthropologie ont défini une approche clinique du social. Les pratiques qui en découlent peuvent être associées à des formes de résistance, voire à des réponses aux orientations et aux institutions sociales dominantes. Ce qui caractérise cette nouvelle approche est le travail de proximité avec les personnes et les groupes, la réponse à leur demande sociale et l’implication des intervenants.
Le présent ouvrage, qui présente les contributions de nombreux collaborateurs du Québec et d’ailleurs, témoigne de la vivacité et de la nécessité de la clinique en sciences sociales. Sont ainsi explorés les fondements théoriques et méthodologiques de la posture clinique, les pratiques d’intervention sociales éclairées – en particulier par des contributions brésiliennes – et les pratiques innovantes d’une recherche clinique du travail et des organisations.
SHERPA Lunch Webinars
Youth and violent extremism on social media. Mapping the research
Alava, S.; Frau-Meigs, D.; Hassan, G. (2017)
Does social media lead vulnerable individuals to resort to violence? Many
people believe it does. And they respond with online censorship, surveillance
and counter-speech. But what do we really know about the Internet as a
cause, and what do we know about the impact of these reactions?
All over the world, governments and Internet companies are making decisions on the basis of assumptions about the causes and remedies to violent attacks. The challenge is for analysis and responses to be firmly grounded. The need is for policy constructed on the basis of facts and evidence, and not founded on hunches or driven by panic and fearmongering.
It is in this context that UNESCO has commissioned the study titled Youth and Violent Extremism on Social Media. This work provides a global mapping of research (mainly during 2012-2016) into the assumed roles played by social media in violent radicalization processes, especially as they affect youth and women.
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La ritualisation dans la trajectoire du mourir : l’action rituelle funéraire. Thèse de doctorat
Labescat, Gil (2016)
Cette thèse de doctorat propose de comprendre la spécificité rituelle des pratiques funéraires au début du XXIe siècle. Les analyses rituelles classiques (interactionnistes et structuro-fonctionnalistes) nous ont conduit à nous intéresser au processus rituel plutôt qu’au rituel lui-même et à cheminer par l’entremise d’une approche de l’action rituelle, plutôt que par celle des fonctions ou des symboles. Pour restreindre la part de réalité sociale étudiée, nous avons considéré que, parmi les différentes transformations funéraires, le phénomène de la crémation était une porte d’entrée pour comprendre cette spécificité. Cette thèse poursuit un double objectif : 1) Le premier objectif est descriptif. Dans la trajectoire du mourir, à partir d’une perspective relationnelle, nous avons exploré le processus funéraire, notamment celui ayant pour perspective la crémation comme mode de transformation du corps, en le décomposant comme une chaîne opératoire du mourir. Nos données sont recueillies par la méthode de la participation observante de pratiques au sein du milieu funéraire. L’exemplarité du phénomène crématiste, en tant que pratique réunissant les attributs de l’évolution récente funéraire à partir des années 1980, a dirigé notre sélection vers un échantillon diversifié dans deux contextes socioculturels (France et Québec) et deux agglomérations (Strasbourg et Montréal) où le taux de crémation est historiquement élevé. 2) Le second objectif consiste à comprendre la spécificité de la ritualisation funéraire à partir de ces données, en s’intéressant à l’action rituelle en train de se faire dans le processus funéraire, c’est-à-dire expliquer la mise en forme et en acte de relations sociales. Par-delà une lecture socioanthropologique de l’organisation des relations contextuelles de ritualisation, une lecture psychosociologique des actions rituelles complète l’interprétation. Notre compréhension de la spécificité du processus rituel funéraire fait apparaître la complexité relationnelle de cette pratique sociale : d’une part, en tant qu’actions interagies par et dans des relations interindividuelles, faisant appel à des ressources réflexives (habilitantes) et permettant la réduction de l’état de dissonance provoqué par la mort; d’autre part, en tant qu’actions enserrées par et dans les règles des systèmes sociaux. La mise à jour de la prépondérance de ces caractéristiques relationnelles dans la ritualisation funéraire actuelle a pour vocation de comprendre à la fois la diversification des pratiques funéraires et leur normalisation.
Mental Health of Refugees and Asylum Seekers: Assessment and Intervention
Kronick, R. (2017)
With unprecedented numbers of displaced persons worldwide, mental health clinicians in high-income countries will increasingly encounter refugee and asylum-seeking patients, many of whom have experienced significant adversity before and after their migration. This paper presents a summary of the recent evidence on the assessment and treatment of refugees across the lifespan to inform clinicians’ approaches to care of refugee patients in mental health care settings. Assessment and interventions for refugees are grounded in an ecosystemic approach which considers not only pre-migratory trauma, but social, familial, and cultural determinants of mental health in the host country. Evidence for psychotherapy and pharmacological treatments are reviewed, highlighting promising interventions while acknowledging that further research is needed. Ultimately, serving refugees necessitates a biopsychosocial approach that engages clinicians as medical experts, therapists, and advocates
Social Psychiatry and Psychiatric Epidemiology
Frounfelker, R. ; Gilman, S.E.; Betancourt, T.; Aguilar-Gaxiola, S. ; Alonso, J.; Bromet, E.J.; Bruffaerts, R.; de Girolamo, G.; Gluzman, S.; Gureje, O.; Karam, E.G.; Lee, S.; Lépine, J.P.; Ono, Y.; Pennell, B.E.; Popovici, D.G.; Ten Have, M.; Kessler, R.C.; WHO Survey Collaborators (2017)
Establishing Common Linguistic Space in Nursing Clinical Care Practice: Whom to call? Who calls? What is called for? Who will be called upon?
Vissandjee, B. ; Carnevale, F.; Battaglini, A.; Rosenberg, E.; (2017)
Dans le Black Box d’Igloolik : le cirque comme espace thérapeutique pour de jeunes Inuit ?
Lemaire, A.; Sokoloff, M. ; Fraser, S.; Vachon, M. (2016)
Les taux élevés de suicide chez les jeunes Inuit sont souvent considérés comme symptomatiques des changements culturels survenus en quelques générations seulement. Aujourd’hui, les jeunes Inuit ont à transiger entre des cultures qui peuvent être vécues comme deux mondes opposés, avec des valeurs, des attentes et des contraintes parfois inconciliables. La littérature en santé mentale soulève le problème de l’accès aux soins, mais aussi le manque d’adéquation des services avec les besoins spécifiques des Inuit et de leur culture. Plusieurs auteurs suggèrent des modèles de guérison alternatifs prometteurs qui se distinguent des modèles conventionnels de soins « occidentaux ». On dit souvent « penser à l’extérieur de la boîte ». Mais qu’en est-il de penser autrement, « dans la boîte », en s’intéressant aux ressources déjà présentes ? Le Black Box, local d’Artcirq à Igloolik où s’entraînent des Inuit à l’art du cirque, nous amène à réfléchir sur l’intervention en santé mentale en contexte inuit. Cet article vise à élaborer une réflexion sur l’espace de « l’entre deux » où se trouvent les jeunes Inuit d’aujourd’hui, dans une culture en transformation. Cette situation pourrait nécessiter un ajustement créatif pour répondre à la fois aux contraintes d’une société contemporaine et à celles liées à un ancrage dans une identité inuit. Pour ce faire, nous explorerons le concept de la tradition ainsi que l’apport de l’art pour la négociation des identités culturelles à l’aide de l’exemple d’Artcirq. Le potentiel thérapeutique de cet espace artistique au niveau communautaire sera discuté à partir de nos observations d’un terrain ethnographique.
Collaborating to improved child mental health in Nunavik
Fraser, S.; Rouillard, R. ; Nadeau, L.; D'Ostine-Racine, L.; Mickpegak, R. (2016)
Addressing culture and context in humanitarian response: preparing desk reviews to inform mental health and psychosocial support
Greene, C.; Jordans, M.; Kohrt, B.; Ventevogel, P.; Kirmayer, L.J.; Hassan, G.; Chiumento, A.; Van Ommeren, M. ; Tol, W. (2017)
Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners with crucial background information to improve their capacity to work efficiently and with maximum benefit. In this paper, we draw on experience implementing desk review guidance from the World Health Organization (WHO) and UNHCR, the United Nations Refugee Agency (2012) in four diverse humanitarian crises (earthquakes in Haiti and Nepal; forced displacement among Syrians and Congolese). We discuss critical parameters for the design and implementation of desk reviews, and discuss current challenges and future directions to improve mental health care and psychosocial support in humanitarian emergencies.
What stories to tell: A trilogy of methods used for knowledge exchangein a community-based participatory research project
Fraser, S. (2017)
Researchers in the field of Aboriginal health generally have a keen interest in ‘participating in change’ to address the ongoing injustices experienced by Aboriginal peoples. Perhaps the most promoted methods for this purpose are those described as Indigenous methods and action research. Criteria of authenticity are generally used to assess the quality of research. In this essay, we reflect on how certain basic principles of action research, more notably ontological authenticity and educative authenticity can penetrate the process of knowledge exchange, creating spaces of ontological contamination and transformation. We reflect on the context of sharing ‘difficult knowledge’, knowledge that is encountered and shared in a post-colonial context of unequal power dynamics. We describe a trilogy of methods used for such knowledge exchange activities with three distinct audiences, and distinct goals. A commonality amongst the three described methods is the ‘unfinished’ and unorganised nature of what is transmitted, requiring the receptor to actively participate in the differentiation and reorganisation of information in a way that makes sense to him/her.
Advocacy as Key to Structural Competency in Psychiatry
Kirmayer, L.; Kronick, R.; Rousseau, C. (2018)
Structural competency is an approach to clinical training and practice that aims to improve health care by directing attention to the social inequities that are among the root causes of health disparities.1 Recognizing these forms of social adversity may allow clinicians to better understand patients’ predicaments. However, to move beyond mere recognition, psychiatrists must find ways to address social structural issues and work toward systemic change. Without specific actions, structural competency risks being an academic exercise. Advocacy is one crucial way to translate insights into the social determinants of health into structurally competent practice. In this Viewpoint, we argue that advocacy can be a key aspect of structural competency.
Community being well for family wellbeing : exploring the socioecological determinants of wellbeing in an Inuit community of Northern Quebec
Fraser, S.; Parent, V.; Dupery, V. (2018)
Impuissance et contre-transfert culturel : le rôle des discussions de cas interinstitutionnelles pour dénouer les impasses thérapeutiques
Johnson-Lafleur, J.; Daxhelet, M.L.; Papazian-zohrabian, G. ; Rousseau, C. (2018)
Perception of interprofessional collaboration and co-location of specialists and primary care teams in youth mental health
Rousseau, C. ; Pontbriand, A. ; Nadeau, L.; Johnson-Lafleur, J. (2017)
Objectives
Interprofessional collaboration is a cornerstone of youth mental health collaborative care models. This article presents quantitative results from a mixed-methods study. It analyses the organizational predictors of the perception of interprofessional collaboration of professionals comparing two models of services within recently constituted youth mental health collaborative care teams.
Methods
Professionals (n=104) belonging to six health and social services institutions completed an online survey measuring their perceptions of interprofessional collaboration through a validated questionnaire, the PINCOM-Q.
Results
Results suggest that the integrated model of collaborative care in which specialized resources are co-located with the primary care teams is the main significant predictor of positive perception of interprofessional collaborations in the youth mental health team.
Conclusion
More research on the relation between service delivery models and interprofessional relations could help support the successful implementation of collaborative care in youth mental health.
A Systematic Review of Refugee Women’s Reproductive Health
Gagnon, A.; Merry, L. ; Robinson, C. (2002)
Intercultural Cities : Policy and Practice for a New Era
Côté, D.; White, B.W. (2017)
MedActuel
Vandesrasiers, A.; Lussier, M.; Thoer, C. (2017)
The Intersection of Exploitation and Coercion in Cases of Canadian Labour Trafficking
Beatson, J.; Hanley, J.; Ricard-Guay, A. (2017)
The gap between entitlement and access to healthcare: An analysis of”candidacy”in the help-seeking trajectories of asylum seekers in Montreal
Chase, L.; Cleveland, J.; Beatson, J. ; Rousseau, C. (2017)
In 2012 the Canadian government made significant cuts to its historically strong federal refugee health coverage plan. While this policy had negligible effects on the level of coverage provided to asylum seekers in Quebec, there is evidence that this group nonetheless experienced reduced healthcare access during the period of polarized national debate that ensued. This study engaged the “candidacy” model of healthcare access to illuminate factors contributing to the observed gap between entitlement and access. Twenty-five semi-structured interviews were conducted with asylum seekers in Montreal to elicit narrative accounts of difficulties encountered in the pursuit of healthcare. Thematic content analysis in conjunction with a holistic examination of help-seeking trajectories revealed several important barriers to obtaining care, including widespread confusion and misinformation about refugee health coverage, cumbersome administrative procedures specific to asylum seekers, and long wait times. Feelings of marginalization and insecurity associated with precarious migratory status appeared to amplify the effects of these barriers to care such that even a minor access difficulty could have dramatic effects on future help-seeking and access outcomes. Demonstrating awareness of public discourses interrogating their deservingness of health coverage, participants often interpreted access difficulties as evidence of health professionals’ unwillingness to serve them. Such interpretations conspired with fears associated with the asylum claim process to suppress self-advocacy, further help-seeking, and at times even information-seeking. This finding is particularly significant in that it suggests a mechanism through which hostile public representations of forced migrants–increasingly prevalent in Western host countries–can themselves endanger the physical, psychological, and social health of highly disadvantaged populations, even in the presence of strong entitlement policies. We close with reflections on how theoretical models of healthcare access might be adjusted to better accommodate the unique experiences of precarious status migrants.