Publications

ecent years have seen an explosion of the recruitment of Central American Temporary Foreign Workers (TFWs) by agricultural operations and other businesses in Québec small towns. The mobility of one group (the TFWs) underpins the ability of another group (Québec small-town residents) to avoid migration by contributing to the continued viability of economic activity in Québec small towns. In this article, we examine the “fragile entanglement of physical movement, representations, and practices” (Cresswell, 2010, p.18) as evidenced in Central American TFWs’ experiences interacting with local community members as well as the response of local businesses, local social and community services, and local churches to the presence of TFWs in their communities. Drawing on data from focus groups with TFWs (n=31) and interviews with employers (n=17), advocates (n=13) and government actors (n=10), we come to the conclusion that Québec small towns have been transformed by the cyclical mobility of TFWs but that the possibilities for diminishing the unequal power relationships and allowing for long-term integration and community development are limited so long as both the TFW Program continues to constrain the social, employment and geographic mobility of TFWs and Québec refuses to consider all occupational levels for permanent residency under the Québec Experience Program.

Beginning in 2015, Canada undertook an exceptional undertaking of sponsoring of more than 40,000 Syrian refugees to resettle in Canada. As the excitement of their initial arrivals dissipates, it is important to consider their longer-term settlement and integration in their new communities. This article offers a portrait and analysis of how Syrian refugees sponsored to Montreal are able to create social networks and access social support in order to build social capital for employment and housing purposes. Part of a larger, three-province, 4-year longitudinal study, here we report on the first wave of survey data collected from 626 Privately-Sponsored Refugees living in Quebec. We report on their family support and friendships, as well as the ways that these social connections helped them in terms of employment and housing. Differences in terms of age, gender and time in Canada are analyzed. We find strong evidence of bonding social capital among recently resettled Syrians in Montreal, and growing bridging capital.

Résumé:

Depuis 2015, le Canada est engagé dans un processus exceptionnel de parrainage de plus de 40,000 réfugiés syriens réinstallés au Canada. Alors que l’enthousiasme initial suscité par leur arrivée se dissipe, il est important d’examiner leur installation et leur intégration à long terme au sein de leurs nouvelles communautés. Cet article offre un portrait et une analyse de la manière dont les réfugiés syriens établis à Montréal réussissent à créer des réseaux sociaux et à accéder à l’appui social afin de pouvoir développer du capital social pour les fins de l’emploi et du logement. Faisant partie d’un projet longitudinal de 4 ans dans 3 provinces, ici nous partageons une partie des résultats de la première vague de données provenant de 626 réfugiés parrainés par la collectivité et vivant au Québec. Nous décrivons leur réseau de soutien familial et social et comment ces connections sociales les ont aidé à accéder à l’emploi et au logement. Les différences en termes d’âge, de genre et de résidences au Canada sont analysés. Nous observons une forte présence du capital social de liaison (bonding) parmi les réfugiés syriens installés dans la région de Montréal, et l’émergence du capital social de transition (bridging).

Drawing on eighty interviews with mixed couples in Quebec, this article discusses how parents in such unions negotiate strategies of cultural transmission and develop “identity projects” for their children, that is, blueprints for the children’s ethnic identities. Our data show that instead of one person having to take on the other’s culture, and the children adopting that culture, both partners usually embrace cultural differences as enriching for themselves, their children, and the society in which they live. It is not so much a question of transmitting a “heritage” but rather making available a set of virtual cultural resources to the child that he or she will activate (or not) later in life. We argue that through the choices they make, mixed couples contribute to shaping a society where plural identities are normalized. In so doing, they become important agents of social change and participate in the creation of an enduring diversity, a long-term transformation of Quebec society, and even contribute to the multiple meanings of “Quebecois.”

The 14-year civil conflict in Liberia resulted in the separation of many children from their families. A population-based, multi-stage random cluster knowledge, attitudes, and practices (KAP) survey of 1157 child caregivers was conducted in 12 districts in Liberia. Knowledge of alternative care and adoption is low and varies significantly by residence. Common misunderstandings include thinking that biological parents may migrate in cases of inter-country adoption (42% of rural and Greater Monrovia (GM); p = 0.2138), and that there is a legal obligation to place children in institutions whenever they cannot be cared for by their parents (42% urban, 35% rural; p = 0.0009). Willingness is high to foster children across all settings; and to send children to live with relatives, non-relatives, or in orphanages, particularly in rural areas (p < 0.0001). Willingness to foster children with special needs is higher in GM (p < 0.0001). Access to schooling is the main reason children are separated from their parents. Relocating with spouse is common in GM (p = 0.0540) and to assist relatives or friends in rural and urban areas (p = 0.5047). Financial need drives child separation, mostly in GM (p = 0.0723). Regulatory measures and public education campaigns must be developed and evaluated overtime with due consideration of residence.

Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children’s rights are needed to promote equitable practices and advocacy against regulations limiting services.

Limited access to healthcare for vulnerable immigrant children in Europe and North America is increasingly worrisome as immigration policies harden. This paper analyzes the gap between States’ obligations under international human rights law and the disparate local implementations in diverse countries. Studies that are both multidisciplinary and incorporate micro and macro level indicators are needed to reveal discrepancies between entitlements and access. It is argued that the lack of available data on the magnitude of the problem and on its individual and public health consequences stems from the conflicting situation faced by health institutions required to simultaneously protect the best interest of each child and allocate limited resources. Collaboration in research is urgently needed to assist policy-makers and institutions make informed decisions.

Despite scarce empirical research in most countries, evidence has shown that young children are unsupervised or under the supervision of another young child while their adult caregivers attend work or engage in other activities outside the home. Lack of quality supervision has been linked to unintentional childhood injuries and other negative outcomes. Nationally representative, population-based data from rounds four and five of the Multiple Indicator Cluster Surveys (MICS) and four to eight of the Demographic and Health Surveys (DHS) from 61 low- and middle-income countries were used to estimate prevalence and socio-economic factors associated with leaving children under five years old home alone or under the care of another child younger than 10 years of age. Socio-economic factors included age and sex of the child, rurality, wealth, maternal education, and household composition. Large variations in the prevalence rates (0.1–35.3% for children home alone and 0.2–50.6% for children supervised by another child) and associated factors have been recorded within and across regions and countries. Understanding why and under what conditions children are home alone or under the supervision of another child is crucial to the development of suitable policies and interventions to protect young children, promote healthy growth, and support caregivers. View Full-Text

This introduction provides the rationale for the special issue of the International Journal of Human Rights on the topic of the children’s right to participation and protection in international development and humanitarian efforts. It summarises selected contributions relating to an international conference entitled ‘Facilitating Child Participation in International Child Protection’ that took place 5–6 October 2015 at Ryerson University in Toronto (Canada). The concepts of child participation and child protection are explored. Then, the challenges and opportunities are highlighted regarding the actual and potential participatory role of children and young people in effective child protection. Finally, an overview of the articles included in this collection is provided.

The main objective of this data article is to present the data set which depicts the impact of child restraint legislation in Chile and its regions. The population of the study consisted of all car crashes records provided by the national police from 2002 to 2014, which included children aged 0–3. Auto Regressive Integrated Moving Average ARIMA and Poisson model were used to present the association between the dependent and independent variables of interest. When the data are analyzed, it will help to determine the degree of relationship and the strength of significance between child restraint legislation policies enacted in 2005 and 2007, and child occupant fatalities and injuries. The data are related to “Impact of child restraint policies on child occupant fatalities and injuries in Chile and its regions: An interrupted time-series study” (Nazif-Munoz et al., 2018).

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.

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.

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.

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.

Au Canada, les demandeurs d’asile détenus en vertu des lois sur l’immigration sont enfermés dans des établissements de type carcéral, même si moins de 6 % d’entre eux sont soupçonnés de criminalité ou de dangerosité. Nous présentons un survol de la situation canadienne, incluant des données tirées de notre récente étude sur l’impact de la détention sur la santé mentale des demandeurs d’asile. Cette étude fut menée auprès de 122 demandeurs d’asile adultes détenus dans des centres de surveillance de l’immigration, à Montréal et à Toronto, et d’un groupe témoin de 66 demandeurs d’asile non détenus. Les demandeurs d’asile détenus vivent un sentiment de disempowerment et de perte d’agentivité en raison du régime de surveillance et de règles strictes dans lequel ils sont placés et de la durée indéterminée de leur détention. Après une incarcération moyenne de 31 jours, le niveau de symptômes psychiatriques était nettement plus élevé chez les demandeurs d’asile détenus que chez les non-détenus ayant eu une exposition traumatique prémigratoire équivalente. La Loi visant à protéger le système d’immigration du Canada (projet de loi C-31) prévoit que des demandeurs d’asile désignés par le ministre, incluant des jeunes de 16 ans et plus, seront automatiquement détenus avec une possibilité très limitée de demander la libération. Il faudrait, au contraire, envisager des solutions de rechange moins contraignantes.

This paper discusses results from a pilot study conducted in the spring of 2014 among young adults living in Montreal. The main objective of this study was to assess the relation between perception of the Charter of Quebec Values,¹ self-identification, perception of intercommunity relations, perceived discrimination, and psychological well-being in young students enrolled in undergraduate or graduate programs of a francophone university in Montreal. A total of 441 students (30.5% male, 69.5% female) took part in a web survey designed by the research team. The data analyses and results suggest that the debate around the Charter of Quebec values was associated with a shift from a predominantly positive perception of intercommunity relations to a predominantly negative one, particularly among women, immigrants, and those who self-identified as cultural or religious minorities. In addition, more than 30% of participants reported having experienced some form of ethnic or religious discrimination since the Charter was released (personally or as a witness). This was particularly the case among immigrants, as well as those who self-identified as bicultural or from cultural or religious minority groups. This study’s results thus highlight the exacerbation of intercommunity tensions linked to the public debate around identity and intercommunity relations in Quebec.

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.

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.

Immigration is extremely stressful and has an impact on children’s identity construction. When immigrating, children must make sense of the changes they experience in order to develop a flexible and plural identity. Schools can foster this meaning-making process by promoting the creation of bridges between home and school social markers. These bridges allow movement between different aspects of students’ identity and account for multiple identity configurations. One way to promote connections between identities is to offer creative expression activities within classrooms. When drawing, children project their inner feelings onto images through symbols and identify to elements of their drawings, which contribute to their identity construction. In this paper, the authors rely on data obtained from immigrant children’s drawings and interviews to present three identity expression strategies put in place in their drawings: protective withdrawal on the identity of origin to allow movement between identities, mastery of globalized youth cultural identity and neutralization of identities. These strategies reveal the relationship between identities, particularly between the cultural identity of origin and that of the host culture. One strategy, the protective withdrawal on the identity of origin to allow movement between identities will be illustrated by the case of a young Chinese boy.

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.

Depuis quelque temps, on observe une prise de conscience publique concernant les enjeux que vivent les personnes trans migrantes et les jeunes trans, surtout au Québec. Néanmoins, il existe très peu de littérature sur le vécu des jeunes trans migrants et racisés.

Notre article vise à pallier cette lacune apparente dans les recherches francophones sur les personnes trans migrantes, en particulier chez les jeunes, en présentant les résultats préliminaires d’un projet de recherche-action participative communautaire visant à mieux comprendre les expériences des jeunes trans âgés de 15 à 25 ans vivant au Québec.

Le présent article discute des facteurs d’oppression ainsi que de certains privilèges, de même que de l’influence qu’ils ont sur l’expérience des jeunes trans migrants et racisés lorsqu’ils naviguent les normes de genre préétablies. L’article traite des manières dont des facteurs tels que l’identité de genre, la citoyenneté, la race et l’âge s’entrecroisent et interagissent, et ultimement influencent les transitions médicales, sociales et légales de ces jeunes. De plus, nous discutons des axes de différenciation sociale, ainsi que la manière dont ils façonnent les difficultés qui marquent le parcours de ces jeunes et qui empêchent parfois l’affirmation de leurs multiples identités. Nous reconnaissons également la force et la résilience chez les jeunes trans migrants et racisés ainsi que la manière dont ces jeunes réagissent aux oppressions multiples.

La plupart des travaux de recherche sur les migrants queer et trans ciblent leurs expériences postmigratoires. Cet article fait en revanche suite à une étude doctorale qui comprend des entretiens avec les participants et une analyse de textes au contenu politique ou médiatique pour rendre les dimensions historiques, géopolitiques, sociales et économiques qui façonnent dans le monde non seulement la violence homophobe et transphobe, mais aussi les migrations de personnes queers et trans des pays du Sud vers le Canada. Ces réalités sont analysées sous le prisme de la colonialité et à l’échelle de l’empire, afin d’historiciser la manière dont les vies des migrants queer et trans sont façonnées par des histoires oubliées de violence coloniale. Cette étude laisse penser que l’hypervisibilité du traitement « généreux » du Canada vis-à-vis des réfugiés queer et trans occulte la manière dont le régime frontalier empêche les personnes provenant des pays du Sud d’entrer dans ce pays.

Background: The literature on trans youth has been dominated by etiological studies interested in trans experience as a medical phenomenon. An emerging body of literature has begun to document that trans youth are a diverse, vulnerable, yet resilient population, and to investigate the role of various sites of support such as the family, peer groups, institutions, and community spaces in contributing to or impeding trans youth’s well-being.

Method: This article presents the results of Stage One of interviews (n = 24) conducted for a Community-Based Participatory Action Research (CBPAR) qualitative research project based in Quebec. It studies the factors that enhance trans youth’s well-being as well as the factors of oppression that negatively affect it. This paper offers a brief overview of the anti-oppressive methodology used for this project, emphasizing how CBPAR was combined with Grounded Theory (GT) methods to encourage the direct involvement of communities and the translation of knowledge into action.

Results: We present preliminary categories emerging through the ongoing axial coding process. These categories address trans youth’s experiences in and perceptions of various “sites”: 1) healthcare services both for gender-related and general care, 2) other institutional spaces, 3) the family and other social circles, and 4) community spaces.

Conclusion: While much of this study’s results support existing evidence on trans youth’s experiences, they also provide a more nuanced portrayal of the complex ways in which recognition, as well as non-, mis-, or mal-recognition, influence trans youth’s well-being at different sites. We also argue that recognition itself must be considered through the lens of intersectionality.

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.

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

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.

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…

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.

Cet article porte sur le sujet de la mort et du deuil en contexte migratoire. Il  repose sur deux recherches qualitatives menées sur le territoire du Québec au Canada. La première a permis de rencontrer des femmes et hommes endeuillés, des informateurs clés de religions chrétienne, musulmane et hindoue. La deuxième porte sur les transmissions intergénérationnelles de trios générationnels de femmes réfugiées. Les principaux résultats présentés mettent en avant l’importance des pratiques rituelles funéraires lorsque la perte d’un être cher se produit dans la société d’accueil. Cependant, le respect et l’application de ces pratiques dépendent du cadre juridique de la société d’accueil. Les personnes endeuillées s’adaptent alors et développent des stratégies pour maintenir les pratiques les plus significatives. Enfin, le discours des femmes réfugiées nous amène à porter un autre regard sur l’investissement des réseaux transnationaux et la migration lors de l’événement de la mort et du deuil.

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.

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.

Our goal was to examine maternal mental health and associated stresses in a sample of high-risk immigrant mothers, and its association with child insecure attachment in the years following childbirth. Mothers and their child (Mage = 37 months) were recruited through a Health and Social Service organization in the Parc-Extension neighborhood in Montreal, Quebec. Mothers completed the Hopkins Symptoms Checklist (HSCL-25), the Multidimensional Scale of Perceived Social Support (MPSS) and a sociodemographic questionnaire that included questions on premature delivery and birth weight. Attachment behaviors were coded out of a videotaped free play sequence using the Preschool and Early School-Age Attachment Rating Scales (PARS). Analysis revealed high levels of clinical anxiety and depression, low social support and low attachment security. Significant mean differences and associations were found between anxiety, depression, social support, preterm delivery and child attachment. These results underscore the importance of screening for anxiety and depression early in the postnatal years, in order to prevent associated consequences such as child insecure attachment. Results also highlight the importance of building positive social networks, especially with immigrant populations.

La recherche qualitative auprès de populations vulnérables en institutions de soins soulève de nombreux enjeux éthiques. Cet article se veut un exercice réflexif sur la particularité et la complexité des enjeux soulevés par ce type de recherche.

Pour ce faire, nous revisiterons notre expérience récente d’une recherche en santé mentale jeunesse auprès de réfugiés. Partant de
considérations méso-éthiques pour en arriver à des considérations micro-éthiques, nous aborderons la question de l’éthique de la recherche avec les réfugiés, les complexités éthiques d’ordre procédural rencontrées dans le processus d’approbation institutionnelle du projet (enjeux de protection) ainsi que les enjeux éthiques fondamentaux qui ont été soulevés lors du recrutement des participants et de la cueillette des données par entretien (responsabilité et sollicitude). Notre expérience nous permet de conclure à la complémentarité des différents niveaux éthiques (procédural/pratique) en recherche qualitative et à la nécessité de la réflexivité du chercheur pour permettre le développement de pratiques éthiques, particulièrement dans des contextes de vulnérabilité.

Cet article documente les perspectives d’intervenants de la santé et des services sociaux desservant des communautés pluriethniques de Montréal au sujet de l’impact du débat public sur le projet de Charte des valeurs proposé par le gouvernement du Québec à l’automne 2013. Les résultats suggèrent que ce débat public a eu des répercussions sur les intervenants et sur le bien-être des communautés, surtout minoritaires, mais également de la majorité. Ces résultats soulignent également que des débats sociaux suscitant la division peuvent influencer le vivre-ensemble et le rapport à l’Autre dans les services de santé et de services sociaux.

Youth mental health (YMH) services are greatly underutilized, particularly for migrant youth. Collaborative models of care offer promising avenues, but research on these treatment modalities is still scarce, particularly for migrants. The goal of this exploratory study is to better understand quality of care including factors improving access to care and collaborative YMH services use, efficacy and satisfaction, for this vulnerable population. This qualitative study relies on a multi-informants (youth, parents, clinicians) and multiple case study design to explore YMH collaborative services for migrant youth living in an urban setting (Montreal, Canada). Participants are five young patients (12–15 years old), one of their parents and their primary care therapist (N = 15). They come from migrant families, have a psychiatric diagnosis and have been receiving mental health services in a collaborative care setting for at least 6 months. Transcripts of semi-structured interviews for the five triads were thematically analyzed to draw similarities and contrasts between actors, across and within case-studies. Based on these findings, four themes emerged concerning the optimal care setting for collaborative YMH services for migrant families: (1) providing an equilibrium between communication, collaboration and privacy/confidentiality, (2) special attention to ensuring the continuity of care and the creation of a welcoming environment where trusting relationships can develop, (3) the inclusion of family intervention, and (4) the provision of collaborative decision-making pathways to care, addressing interprofessional and interinstitutional collaboration as well as cultural differences in explanatory models and values.

Asylum seeking children arriving in Canada regularly face incarceration in medium-security-style immigration detention centres. Research demonstrates the human cost of detaining migrant children and families and the psychiatric burden linked with such imprisonment. This study aims to understand the lived experiences of children aged 3–13 held in detention. Informed by a qualitative methodology of narrative inquiry, child participants created worldsin the sand and generated stories to express their subjective experience. Results suggest that children’s sandplay confirms the traumatic nature of immigration detention while also revealing children’s sometimes conflicting understanding of the meaning of detention and their own migration. The results are contextualized by a description of detention conditions and the psychiatric symptoms associated with immigration incarceration. The study highlights the need for more research examining the impact of immigration detention on children’s mental health, while also underlining how refugee children’s voices provide important direction for policy change.

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.

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

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.

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.

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.

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.

Cette étude de cas multiples poursuit l’objectif de mieux comprendre les soins de santé mentale offerts aux familles réfugiées. Des données qualitatives ont été recueillies auprès de 8 familles et de leurs intervenants. Notre analyse révèle deux dynamiques dans l’expérience de soins. D’une part, des soins adaptés et coordonnés pourraient contribuer à la reconstruction du filet social autour de la famille et de l’enfant, auparavant détruit par la violence collective. Cependant, une certaine violence institutionnelle pourrait répéter les ruptures traumatiques chez l’enfant réfugié. Les résultats sont interprétés à partir des cadres complémentaires de l’ethnopsychiatrie et de la souffrance sociale.

L’objectif de cet article utilisant une lunette qualitative à partir de mesures quantitatives est de dresser le portrait de quatre mères Indiennes réfugiées vivant un stress migratoire élevé et de présenter les conséquences liées à l’attachement de l’enfant. Les résultats indiquent des niveaux cliniques d’anxiété et de dépression ainsi qu’un soutien social variable selon la source de soutien. Chez l’enfant, la sécurité d’attachement est faible, il y a absence de comportements évitants et la prévalence de comportements ambivalents et désorganisés est élevée. Les résultats suggèrent que des approches qui misent sur un soutien de la dyade mère-enfant pourraient être appropriées pour ces femmes.

Les exemples liés à l’utilisation de l’art comme moyen d’expression et de transformation foisonnent chez les autochtones. Toutefois, nous en connaissons peu sur ce qui se produit en termes de transformations via l’art et la créativité du point de vue de l’expérience des jeunes eux-mêmes. Cette étude, s’insérant dans un devis ethnographique, porte un regard phénoménologique sur un collectif de cirque (Artcirq) dans une communauté inuit et vise à mieux comprendre le vécu des jeunes qui y participent. Nos données de recherche incluent à la fois des entrevues avec les jeunes inuit impliqués dans Artcirq, des notes et observations de terrain et des entretiens complémentaires avec divers acteurs de la communauté. Nos analyses nous amènent à décrire trois dimensions centrales à l’expérience des jeunes, relativement à Artcirq comme espace : 1) où reconnaître et développer ses forces ; 2) où se lier et appartenir et 3) où vivre sa culture inuit et la transmettre. Les implications potentiellement thérapeutiques de tels espaces communautaires au service du mieux-être des jeunes inuit sont évoquées en 

Clinical guidelines in refugee mental health increasingly advocate phased approaches to intervention that foreground the provision of pragmatic and social support in contexts of ongoing instability. However, the impact of such interventions has rarely been explored from the perspective of refugees themselves. We conducted ethnographic research on the experiences and perceptions of users of an intervention embodying this approach: a community Day Center for asylum seekers in Montreal. Data comprising 15 interviews and field notes from 50 participant observation visits were analyzed using an established theoretical framework to identify mechanisms supporting self-perceived wellbeing among users in the domains of safety, social networks, justice, identity/roles, and existential meaning. Results shed light on how this nonspecific buffering intervention responds to the threats and pressures asylum seekers themselves identify as most salient in the immediate postflight context. These findings are discussed in relation to emerging theoretical frameworks in refugee mental health that emphasize agency, justice, and the role of local ecologies. We conclude that the Day Center shows significant promise as an innovative early stage mental health intervention for precarious status migrants and merits further research and evaluation. (PsycINFO Database Record (c) 2018 APA, all rights reserved)