Droits humains

Abstract

This article introduces a thematic issue of Transcultural Psychiatry that presents recent work that deepens our understanding of the refugee experience—from the forces of displacement, through the trajectory of migration, to the challenges of resettlement. Mental health research on refugees and asylum seekers has burgeoned over the past two decades with epidemiological studies, accounts of the lived experience, new conceptual frameworks, and advances in understanding of effective treatment and intervention. However, there are substantial gaps in available research, and important ethical and methodological challenges. These include: the need to adopt decolonizing, participatory methods that amplify refugee voices; the further development of frameworks for studying the broad impacts of forced migration that go beyond posttraumatic stress disorder; and more translational research informed by longitudinal studies of the course of refugee adaptation. Keeping a human rights advocacy perspective front and center will allow researchers to work in collaborative ways with both refugee communities and receiving societies to develop innovative mental health policy and practice to meet the urgent need for a global response to the challenge of forced migration, which is likely to grow dramatically in the coming years as a result of the impacts of climate change.

Une déclaration de principe préparée par la section de psychiatrie transculturelle de l’Association des psychiatres du Canada (APC) et approuvée par le Conseil d’administration de l’APC le 9 juillet 2020

Canada has no legislation prohibiting forced labour, relying instead on human trafficking penal dispositions; the two are intimately related. However, there was only been one conviction for human trafficking for the purposes of forced labour. Here, we offer an analysis of jurisprudence according to a model of labour trafficking focusing on the intersection of labour exploitation and coercion, particularly among migrant workers. We argue that Canadian human trafficking law remains incomplete and fails to address situations of forced labour. There is a need to think creatively about recourses. Labour and human rights law recourses are more accessible to migrant workers than human trafficking law, given the lighter burden of proof and the unlikelihood that courts will recognize the systemic coercion to which migrant workers are subject. Workers and advocates are understandably drawn to these alternative recourses, yet consequences for employers profiting from forced labour are disappointingly minor.

Internationally, human trafficking is usually defined officially as involving a range of exploitative scenarios: forced labor, sexual exploitation, illegal adoption, and organ sales are all commonly included. Each of these phenomena, while having some commonalities, also has many different characteristics. When the state or civil society tries to respond to “human trafficking,” it can be difficult to find an approach that works for all these scenarios. This chapter will discuss the strengths and weaknesses and the advantages and disadvantages of endeavoring to serve the differing populations of people affected by sexual exploitation versus labor trafficking. To substantiate our analysis, we will highlight the experiences of frontline workers by drawing on the findings of 79 interviews conducted in Canada with stakeholders and practitioners in the field. In the context of increased efforts worldwide to counteract trafficking in all its forms, with a notable growing attention to forced labor, this chapter will examine the challenges that arise from tackling diverse forms of trafficking, looking specifically at forced labor and sexual exploitation.

While there is increasing attention to the perspectives of people caught up in human trafficking – attention that has helped illuminate the cloudy nature of consent and agency in situations of human trafficking – the perspectives of children are relatively absent from the debate. Western notions of childhood downplay children’s agency and decision-making. In this chapter, the results of a study that explored the perspectives of over 50 West African children “rescued” by Nigeria’s NAPTIP, a governmental agency mandated to fight human trafficking and protect its victims, are shared. One theme that emerged strongly from the children’s narratives was the centrality of their quest for education, training, and other life opportunities as a factor that led them into situations of human trafficking, a situation likely to exist in other contexts as well. The children’s desire for education was often part of what led them away from home, kept them in their situations of trafficking, and made many of them unwilling to return home after being “rescued” by NAPTIP. These findings suggest a critical need to provide for children’s educational needs if we hope to combat child trafficking, as well as the need to provide meaningful alternatives to children we purport to “rescue.”

On les appelle mineurs non accompagnés, mineurs isolés ou encore enfants séparés. Ces dénominations différentes traduisent la difficulté à saisir la complexité et la diversité des situations qu’ils vivent, même s’ils ont en commun le fait d’être âgés de moins de 18 ans et d’avoir migré vers d’autres Etats sans un adulte qui soit responsable d’eux. Cet ouvrage interdisciplinaire réunit et synthétise onze contributions provenant de la sociologie, du droit, de l’anthropologie, de la communication, des sciences de l’éducation, de la psychologie sociale et du travail social.

While access to healthcare for permanent residents in Canada is well known, this is not the case for migrants without healthcare coverage. This is the first large-scale study that examines the unmet healthcare needs of migrants without healthcare coverage in Montreal. 806 participants were recruited: 436 in the community and 370 at the NGO clinic. Proportions of individuals reporting unmet healthcare needs were similar (68.4% vs. 69.8%). The main reason invoked for these unmet needs was lacking money (80.6%). Situations of not working or studying, not having had enough food in the past 12 months, not having a medical prescription to get medication and having had a workplace injury were all significantly associated with higher odds of having unmet healthcare needs. Unmet healthcare needs were more frequent among migrants without healthcare coverage than among recent immigrants or the citizens with health healthcare coverage (69%, 26%, 16%). Canada must take measures to enable these individuals to have access to healthcare according to their needs in order to reduce the risk of worsening their health status, something that may have an impact on the healthcare system and population health. The Government of Quebec announced that all individuals without any healthcare coverage will have access to COVID-19 related health care. We hope that this right, the application of which is not yet obvious, can continue after the pandemic for all health care.

In our study, almost half of immigrants without health insurance perceived  their health as negative, much higher than reports of negative self-perceived health in previous Canadian studies (8.5% among recent immigrants, 19.8% among long-term immigrants, and 10.6% among Canadian-born). Our study also suggests a high rate of unmet health care needs among migrants with precarious status, a situation that is correlated with poor self-perceived health. There is a need to put social policies in place to secure access

This article examines how the Canadian immigration regime socially organizes the everyday lives of queer and trans migrants with precarious status. Drawing from key findings from an institutional ethnographic study, this article maps out the disjuncture between the actual experiences of queer and trans migrants with precarious status and the ideological and textual production of precarious status by the Canadian state. Making explicit this disjuncture reveals how the Canadian immigration regime enacts structural violence upon queer and trans migrants. This article also engages with the response-based approach to violence in order to understand how queer and trans migrants actively respond to this violence. In doing so, this article highlights the ways in which queer and trans migrants respond and resist the structural violence integral to the Canadian state’s production of precarious status.

This article examines how the Canadian immigration regime socially organizes the everyday lives of queer and trans migrants with precarious status. Drawing from key findings from an institutional ethnographic study, this article maps out the disjuncture between the actual experiences of queer and trans migrants with precarious status and the ideological and textual production of precarious status by the Canadian state. Making explicit this disjuncture reveals how the Canadian immigration regime enacts structural violence upon queer and trans migrants. This article also engages with the response-based approach to violence in order to understand how queer and trans migrants actively respond to this violence. In doing so, this article highlights the ways in which queer and trans migrants respond and resist the structural violence integral to the Canadian state’s production of precarious status.

This Working Paper examines the concept of the vulnerability of migrants which has become a key term in the UN’s negotiations for a Global Compact on Safe, Orderly and Regular Migration. The authors argue that the concept must be interpreted inclusively and related to the human rights obligations of states through the UN conventions. All too often migrants are vulnerable because of state action. States must ensure that they deliver on their human rights obligations in ways which reduce the vulnerability of migrants.

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.

In a time of mass displacement, countries across the globe are seeking to protect borders through coercive methods of deterrence such as immigration detention. In Canada, migrants—including children—may be detained in penal facilities having neither been charged nor convicted of crimes. In this paper we examine how we dealt with the series of ethical dilemmas that emerged while doing research in immigration detention centres in Canada. Using a critical ethnographic approach, we examine the process of our research in the field, seeking to understand what our emotional responses and those of the staff could tell us about detention itself, but also about what is at stake when researchers are faced with the suffering of participants in these spaces of confinement. The findings suggest that field work in immigration detention centres is an emotionally demanding process and that there were several pivotal moments in which our sense of moral and clinical obligations toward distressed detainees, especially children, were in conflict with our role as researchers. We also grapple with how the disciplinary gaze of the detention centre affects researchers entering the space. Given these tensions, we argue, spaces of critical reflection that can consider and contain the strongly evoked emotions are crucial, both for researchers, and perhaps more challengingly, for detention centre employees and gatekeepers as well.

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.

This article maps the global governance processes on migration and assesses whether the human rights of migrants are effectively included and mainstreamed therein. It is argued that the lack of a comprehensive framework for migration governance and the insufficient focus on the human rights dimension in migration management have led to serious human rights violations in the treatment of migrants and asylum seekers, and to a lack of oversight and accountability when these violations occur. The article commences with an examination of the legal and normative framework related to the three areas that have been the main objects of global migration governance: the refugee regime, international labour standards and transnational criminal law regarding human trafficking. It goes on to explore the complex institutional framework of global migration governance and how it has been mostly informal, ad hoc, non-binding and State-led. The article concludes with a discussion on the future perspectives for a human rights-centred approach in global migration governance. It is contended that there is a need to bring the migration dialogue inside the United Nations, as it already plays a key role in international cooperation, with human rights as one of its pillars.

Migration towards Europe has surged over the past few years, overwhelming government authorities at the national and EU levels, and fuelling a xenophobic, nationalist, populist discourse linking migrants to security threats. Despite positive advances in the courts and worthy national initiatives (such as Italy’s Operation Mare Nostrum), the EU’s governance of migration and borders has had disastrous effects on the human rights of migrants. These effects stem from the criminalisation of migrants, which pushes them towards more precarious migration routes, the widespread use of administrative detention and the processing of asylum claims under the Dublin system, and now the EU–Turkey agreement. Yet, this paper finds that with the right political leadership, the EU could adopt different policies in order to develop and implement a human rights-based approach to migration that would seek to reconcile security concerns with the human rights of migrants. Such an approach would enable member states to fully reap the rewards of a stable, cohesive, long-term migration plan that facilitates and governs mobility rather than restricts it at immense cost to the EU, the member states and individual migrants.

Children and parents seeking asylum are regularly detained in Canada, however little is known about the experiences of detained families. International literature suggests that the detention of children is associated with significant morbidity. Our study aims to understand the experiences of detained children and families who have sought asylum in Canada by using a qualitative methodology that includes semistructured interviews and ethnographic participant observation. Detention appears to be a frightening experience of deprivation that leaves children feeling criminalized and helpless. Family separation further shatters children’s sense of well-being. Children’s emotional and behavioral responses to separation and to detention suggest that the experience is acutely stressful and, in some cases, traumatic–even when detention is brief. Distress and impairment may persist months after release. Given the burden of psychological suffering and the harmful consequences of separating families, children should not be detained for immigration reasons and parents should not be detained without children.

From 2011 until 2012, members of the Canadian parliament debated three iterations of legislation relating to the detention of asylum seekers. The final bill, unlike its predecessors, exempted children under the age of 16 from mandatory year-long detention, opening the door to children’s prolonged separation from parents or invisible detention as guests alongside mandatorily detained parents. Using a critical discourse analysis approach, we examine parliamentary debates and seek to determine how speech acts within the Canadian parliament construct a (detained) migrant child. Our results suggest that parliamentarians invoke logics of human rights and humanitarianism and that a reconfiguration of these paradigms places the state rather than the refugee in need of protection, thus introducing a hierarchy of compassion. Within this discourse, children are rendered so vulnerable as to be voiceless, enforcing the corollary image of the threatening adult refugee, which ultimately allows detention of children to be framed as a protective measure. We hypothesize mechanisms that make such constructions possible and discuss the implications for advocacy efforts.

The issue of irregular migration is experiencing heightened attention in political, social and legal arenas. While deterrence and crime-control discourse and practices dominate current approaches to irregular migration, this article seeks to focus on the problematic neglect of the treatment of irregular migrants in destination countries, in relation to their ability to access fundamental rights and basic public services. This article will put forth an argument for the establishment of firewalls – a separation between immigration enforcement activities and public service provision. This article will canvass existing trends and practices that have both contributed to the erosion of firewall protections, and have built and maintained meaningful firewalls between immigration and public service provision.

The Canadian government’s recent cuts to healthcare coverage for refugee claimants has rekindled the debate in Canada about what medical services should be provided to individuals with precarious immigration status, and who should pay for these services. This article further explores this debate, focussing on the perceptions of healthcare workers in Montreal, a large multiethnic Canadian city. In April–June 2010, an online survey was conducted to assess how clinicians, administrators, and support staff in Montreal contend with the ethical and professional dilemmas raised by the issue of access to healthcare services for pregnant women and children who are partially or completely uninsured. Drawing on qualitative analysis of answers (n = 237) to three open-ended survey questions, we identify the discursive frameworks that our respondents mobilized when arguing for, or against, universal access to healthcare for uninsured patients. In doing so, we highlight how their positions relate to their self-evaluations of Canada’s socioeconomic situation, as well as their ideological representations of, and sense of social connection to, precarious status immigrants. Interestingly, while abstract values lead some healthcare workers to perceive uninsured immigrants as “deserving” of universal access to healthcare, negative perceptions of these migrants, coupled with pragmatic considerations, pushed most workers to view the uninsured as “underserving” of free care. For a majority of our respondents, the right to healthcare of precarious status immigrants has become a “privilege”, that as taxpayers, they are increasingly less willing to contribute to. We conclude by arguing for a reconsideration of access to healthcare as a right, and offer recommendations to move in this direction.

On connait peu de choses sur la vie des immigrants sans papiers au Canada, et encore moins lorsqu’ il s’agit des jeunes. À partir d’ un terrain ethnographique, cette thèse examine les interactions complexes entre les politiques d’ immigration et les vies de jeunes migrants (14-20 ans) sans papiers, issus de pays latino-américains ou caribéens et vivant à Montréal. Cette thèse a deux objectifs principaux. Premièrement, à partir de l’étude des lois et décisions juridiques de la dernière décennie au Canada, cette thèse vise à explorer comment les politiques d’immigration construisent des jeunes migrants simultanément comme des Autres menaçants et comme des êtres vulnérables, leur enlevant ainsi leur voix. Ces politiques d’ exclusions sociales transforment dramatiquement la vie de ces jeunes en limitant les possibilités de leurs interactions quotidiennes et en restreignant leur accès à des services sociaux. Deuxièmement, à partir d’un terrain ethnographique réalisé auprès de jeunes migrants sans papiers, cette thèse a comme objectif de comprendre comment ces sujets réinterprètent activement leur position sociale subordonnée et affirment leur pouvoir d’agir. La thèse postule que la multiplicité des stratégies développées par les jeunes migrants pour faire face aux incertitudes et à la liminalité découlant de leur statut migratoire est ancré dans de complexes relations d’interdépendance et dans des sentiments ambivalents d’appartenance. Comme cette étude le montre, la vie de ces jeunes et les façons dont ils conçoivent leur existence ne devraient pas être interprétées comme des récits de victimisation ou de résistance. Les jeunes ont plutôt des façons multiples, complexes et parfois paradoxales de (re)prendre parole, en se situant de façon ambivalente et ambigüe comme étant “présents”. Ce n’est qu’à travers l’examen du pouvoir d’ agir et des appartenances ambivalentes des jeunes ainsi qu’à travers des recherches empiriques que nous pourrons améliorer notre capacité à répondre aux besoins des jeunes migrants sans papiers et comprendre l’impact des politiques migratoires sur leurs vies.