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Kwegyir Tsiboe A, Raghuraman S, Marshall TC. Caught between two worlds: mental health literacy and stigma among bicultural youth. Int J Qual Stud Health Well-being 2024; 19:2321644. [PMID: 38431901 PMCID: PMC10911255 DOI: 10.1080/17482631.2024.2321644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE Bicultural youths are at higher risk of mental health problems and are less likely to utilize mental health services, yet our knowledge of their mental health literacy and help-seeking behaviours remains limited. METHODS To fill this gap, the current study explored bicultural youths' mental health literacy and stigma by conducting semi-structured interviews with 14 Canadian university students in 2021. RESULTS Our analysis revealed that bicultural youths may be torn between two worlds: intergenerational tensions between participants assimilated into individualistic Canadian culture and their more collectivist parents meant that they had different cultural perceptions of mental health literacy and stigma. While being caught between these two worlds may be detrimental for bicultural youth, our results also suggested that a trans-cultural factor-celebrities' mental health journeys-may promote help-seeking behaviour across participants. Furthermore, our study speaks to the ways that unprecedented events such as the COVID-19 pandemic impact mental health literacy among bicultural youth. Our findings might be used by university mental health services to encourage help-seeking among bicultural students. CONCLUSION The acculturation of mental health literacy, stigma, and associated intergenerational differences needs to be considered by university wellness services.
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Affiliation(s)
| | - Shruthi Raghuraman
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | - Tara C. Marshall
- Department of Health, Aging & Society, McMaster University, Hamilton, Canada
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Waterloo Better Beginnings as a Transformative Prevention Project: Impacts on Children, Parents, and the Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103442. [PMID: 32429058 PMCID: PMC7277741 DOI: 10.3390/ijerph17103442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
Better Beginnings Waterloo (BBW) is an ecological, community-driven, prevention program for children aged 4–8 and their families. BBW was implemented in two low-income communities with high percentages of visible minorities. Data on Grade 1–2 children and their parents (the baseline comparison group) were gathered through parent interviews (n = 34) and teacher reports (n = 68) in 2015, prior to BBW programs, and in the period 2018–2019, the same data were collected through parent interviews (n = 47) and teacher reports (n = 46) for children and parents participating in programs (the BBW group). As well, qualitative, open-ended individual interviews with parents (n = 47) and two focus groups were conducted in the period 2018–2019. Children in the BBW cohort were rated by their teachers as having a significantly lower level of emotional and behavioural problems than those in the baseline sample; parents in the BBW cohort had significantly higher levels of social support than parents in the baseline cohort; BBW parents rated their communities significantly more positively than parents at baseline. The qualitative data confirmed these findings. The quantitative and qualitative short-term findings from the BBW research showed similar positive impacts to previous research on program effectiveness, thus demonstrating that the Better Beginnings model can be successfully transferred to new communities.
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Hodes M, Vostanis P. Practitioner Review: Mental health problems of refugee children and adolescents and their management. J Child Psychol Psychiatry 2019; 60:716-731. [PMID: 30548855 DOI: 10.1111/jcpp.13002] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Since 2010, the numbers of refugees have increased and around half are under 18 years of age. It is known that experience of organised violence, displacement and resettlement increases the risk for psychiatric disorders and psychosocial impairment. This review integrates recent research into the risk and protective factors for psychopathology with service and treatment issues. METHODS We draw on and critically evaluate key systematic reviews in the selected areas, innovative robust studies and relevant government reports. RESULTS Many refugee children show resilience and function well, even in the face of substantial adversities. The most robust findings for psychopathology are that PTSD, and posttraumatic and depressive symptoms are found at higher prevalence in those who have been exposed to war experiences. Their severity may decrease over time with resettlement, but PTSD in the most exposed may show higher continuity. More severe psychiatric disorders including psychosis may also occur. Service delivery needs to take into account socioeconomic and cultural influences but, given the high level of unmet need even in high-income countries, stepped care delivery is required. The evaluation of psychological interventions, often delivered in group settings, suggests that they can be effective for many distressed children; however, for the more impaired, a greater range of disorder-specific therapies will be required. CONCLUSIONS Child and adolescent mental health clinicians and service providers need to be aware of the specific needs of this population and systems for service delivery. There are significant knowledge gaps in understanding risk and vulnerability, service delivery and treatment effectiveness.
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Affiliation(s)
- Matthew Hodes
- Centre for Psychiatry, Imperial College London, London, UK
| | - Panos Vostanis
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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Kushnirovich N. Labor Market Integration of Skilled Immigrants. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2019. [DOI: 10.1007/s12134-018-00648-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Graefe DR, De Jong GF, Howe Hasanali S, Galvan C. Immigrants, Place, and Health: Destination Area Health Contexts and Routine Physician and Dental Care for Children of Mexican Immigrants. INTERNATIONAL MIGRATION REVIEW 2018. [DOI: 10.1177/0197918318789128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Notable healthcare disparities are shown among the children of Mexican immigrants across different Hispanic immigrant destinations. A hostile local immigrant-receptivity climate and alternative institutional community context indicators are integrated with individual-level data on physician and dental care from the 1996 and 2001 Survey of Income and Program Participation to explain this variation. Mexican immigrants’ children in new Hispanic immigrant destinations are 20 percent less likely to see a doctor, and a negative receptivity climate explains about half of this effect. Community health clinic availability and greater state leniency toward immigrant child public health insurance eligibility facilitate healthcare access.
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Saunders NR, Lebenbaum M, Lu H, Stukel TA, Urquia ML, Guttmann A. Trends in mental health service utilisation in immigrant youth in Ontario, Canada, 1996-2012: a population-based longitudinal cohort study. BMJ Open 2018; 8:e022647. [PMID: 30224392 PMCID: PMC6144399 DOI: 10.1136/bmjopen-2018-022647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe trends in mental health service use of youth by immigration status and characteristics. DESIGN Population-based longitudinal cohort study from 1996 to 2012 using linked health and administrative datasets. SETTING Ontario, Canada. PARTICIPANTS Youth 10-24 years, living in Ontario, Canada. EXPOSURE The main exposure was immigration status (recent immigrants vs long-term residents). Secondary exposures were region of origin and refugee status. MAIN OUTCOME MEASURE Mental health hospitalisations, emergency department (ED) visits and outpatient visits within consecutive 3-year time periods. Poisson regression models estimated rate ratios (RR). RESULTS Over 2.5 million person years per period were included. Rates of recent immigrant mental health service utilisation were at least 40% lower than long-term residents (p<0.0001).Mental health hospitalisation and ED visit rates increased in long-term residents (hospitalisations, RR 1.09 (95% CI 1.08 to 1.09); ED visits, RR 1.15 (1.14 to 1.15)) and recent immigrants (hospitalisations RR 1.05 (1.03 to 1.07); ED visits, RR 1.08 (1.05 to 1.11)). Mental health outpatient visit rates increased in long-term residents (RR 1.03 (1.03 to 1.03)) but declined in recent immigrant (RR 0.94 (0.93 to 0.95)). Comparable divergent trends in acute care and outpatient service use were observed among refugees and across most regions of origin. Recent immigrant acute care use was driven by longer-term refugees (hospitalisations RR 1.12 (1.03 to 1.21); ED visits RR 1.11 (1.02 to 1.20)). CONCLUSIONS Mental health service utilisation was lower among recent immigrants than long-term residents. While acute care use is increasing at a faster rate among long-term residents than recent immigrants, the decrease in outpatient mental health visits in immigrants highlights a potential emerging disparity in access to preventative care.
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Affiliation(s)
- Natasha Ruth Saunders
- Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Sickkids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Michael Lebenbaum
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Hong Lu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Therese A Stukel
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Marcelo Luis Urquia
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
- Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Sickkids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
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George MA, Bassani C. Influence of Perceived Racial Discrimination on the Health of Immigrant Children in Canada. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2018; 19:527-540. [PMID: 30996694 PMCID: PMC6434967 DOI: 10.1007/s12134-018-0539-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Racial discrimination and racism are recognized as determinants of health for adults. Less is understood regarding the influence of discrimination targeted towards parents, the family, or the cultural and children's health. Data from the New Canadian Children and Youth Study (NCCYS) are used in this paper. The NCCYS is a national, longitudinal study of children whose families settled in urban centers of Canada. We analyzed data from individuals who settled in the metropolitan Vancouver area from six ethnic communities: Mainland China, Hong Kong, the Philippines, Iran, Afghanistan, and the Punjab who were interviewed at two times, approximately 2 years apart. Data were collected on perceived parental, family, and cultural discrimination. Our dependent variable was parent-reported child health status. Over time, perceived parental discrimination and perceived family discrimination decreased; and both forms of discrimination had a positive effect on child health. In contrast, perceived cultural discrimination increased over time and had a negative effect on child health at both times. Different forms of discrimination have different effects on child health. Racial discrimination is complex. Its influence on either increasing family cohesion, and thereby leading to improved health, or increasing stress, thereby leading to poorer health needs to be explored further.
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Affiliation(s)
- M. Anne George
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia Canada
- BC Children’s Hospital Research Institute, Vancouver, British Columbia Canada
- School of Population & Public Health, University of British Columbia, Vancouver, British Columbia Canada
| | - Cherylynn Bassani
- Sociology, Kwantlen Polytechnic University, Surrey, British Columbia Canada
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Ginn CS, Mughal MK, Syed H, Storteboom AR, Benzies KM. Sustaining Engagement in Longitudinal Research With Vulnerable Families: A Mixed-Methods Study of Attrition. JOURNAL OF FAMILY NURSING 2017; 23:488-515. [PMID: 29117759 DOI: 10.1177/1074840717738224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this mixed-methods study was to investigate attrition at the age 10-year follow-up in a study of vulnerable children and their families living with low income following a two-generation preschool program in Calgary, Alberta, Canada. Quantitative factors associated with attrition included: (a) food bank use; (b) unstable housing; (c) child welfare involvement; (d) unpartnered status; and (e) caregiver noncompletion of high school. Qualitative themes related to attrition included: (a) income and employment; (b) health; (c) unstable housing; (d) change of guardianship; (e) domestic violence; (f) work and time management challenges; and (g) negative caregiver-child relationships. Triangulation of quantitative and qualitative results occurred using Maslow's Hierarchy of Needs; families with unmet physiological, safety, belongingness and love needs, and esteem needs were more likely to attrite. Attrition in longitudinal studies with vulnerable families is complex, affected by frequently changing life circumstances, and struggles to access necessities of life. Strategies for retaining vulnerable families in longitudinal research are offered.
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Affiliation(s)
| | | | - Hafsa Syed
- 2 Calgary Urban Project Society (CUPS) Health Education Housing, Alberta, Canada
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Li C, Jiang S, Fang X. Effects of multi-dimensional social capital on mental health of children in poverty: An empirical study in Mainland China. J Health Psychol 2017; 25:853-867. [PMID: 29069940 DOI: 10.1177/1359105317737608] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Using the data of 1314 underprivileged children in Xiushui, China, this study adopted an ecological framework to explore how social capital embedded in family, peer, school, and community interplay and affect the mental health of poor children. Structural equation modeling was employed to verify the hypothesized model. The results demonstrated that higher levels of family, peer, and school social capital were all associated with better mental health outcomes of children in poverty. Moreover, family, peer, and school social capital fully mediated the effect of community social capital on children's mental health. Theoretical and practical implications were discussed.
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Stewart M, Makwarimba E, Letourneau NL, Kushner KE, Spitzer DL, Dennis CL, Shizha E. Impacts of a Support Intervention for Zimbabwean and Sudanese Refugee Parents: “I Am Not Alone”. Can J Nurs Res 2017. [DOI: 10.1177/084456211504700409] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
This study examines challenges faced by refugee new parents from Africa in Canada. Refugee new parents from Zimbabwe (n = 36) and Sudan (n = 36) were interviewed individually about challenges of coping concurrently with migration and new parenthood and completed loneliness and trauma/stress measures. Four group interviews with refugee new parents (n = 30) were subsequently conducted. Participants reported isolation, loneliness, and stress linked to migration and new parenthood. New gender roles evoked marital discord. Barriers to health-related services included language. Compounding challenges included discrimination, time restrictions for financial support, prolonged immigration and family reunification processes, uncoordinated government services, and culturally insensitive policies. The results reinforce the need for research on influences of refugees' stressful experiences on parenting and potential role of social support in mitigating effects of stress among refugee new parents. Language services should be integrated within health systems to facilitate provision of information, affirmation, and emotional support to refugee new parents. Our study reinforces the need for culturally appropriate services that mobilize and sustain support in health and health related (e.g., education, employment, immigration) policies.
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George MA, Bassani C. The health of immigrant children who live in areas with high immigrant concentration. ETHNICITY & HEALTH 2016; 21:426-438. [PMID: 26242800 DOI: 10.1080/13557858.2015.1066762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Our objective is to contribute to the literature regarding the association between immigrant children's health, their ethnicity and their living in neighbourhoods with a high ethnic concentration of one's own ethnicity. Using data from families from five ethnic groups who all immigrated to Vancouver metropolitan region in Canada, our research question asks: How ethnicity, ethnic concentration and living in a neighbourhood with others of the same ethnic background contribute to the health of immigrant children? DESIGN Two data sets are integrated in our study. The first is the New Canadian Children and Youth Study, which collected original data from five ethnic groups who immigrated to metropolitan Vancouver. The second data set, from which we derived neighbourhood data, is the Canadian census. The dependent variable is health status as reported by the parent. Independent variables are at both the individual and neighbourhood levels, including ethnicity, sex and the percentage of people living in the neighbourhood of the same ethnic background. Analysis was completed using hierarchical linear modelling. RESULTS Children (n = 759) from 24 neighbourhoods were included in the analyses. Health status varied by ethnicity and ethnic concentration, indicating the heterogeneity of immigrant populations. CONCLUSION With the lack of research on the health of immigrant children and youth living in ethnic concentrations, our findings make an important contribution to understanding the influences on the well-being of immigrant populations.
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Affiliation(s)
- M A George
- a Department of Pediatrics , University of British Columbia , Vancouver , British Columbia , Canada
- b Child & Family Research Institute , Vancouver , British Columbia , Canada
- c School of Population & Public Health , University of British Columbia , Vancouver , British Columbia , Canada
| | - C Bassani
- d Sociology , Kwantlen Polytechnic University , Surrey , British Columbia , Canada
- e Faculty of Health Sciences , Simon Fraser University , Burnaby , British Columbia , Canada
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Mughal MK, Ginn CS, Perry RL, Benzies KM. Longitudinal effects of a two-generation preschool programme on receptive language skill in low-income Canadian children to age 10 years. EARLY CHILD DEVELOPMENT AND CARE 2016; 186:1316-1326. [PMID: 27453625 PMCID: PMC4940896 DOI: 10.1080/03004430.2015.1092141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/06/2015] [Indexed: 05/26/2023]
Abstract
We explored longitudinal effects of a two-generation preschool programme on receptive language scores in children (n = 78) at age 10 years, living with low income. Scores at four time-points, programme intake, exit, age 7, and age 10 years were measured using the Peabody picture vocabulary test (3rd ed.). Effects of culture (Aboriginal, other Canadian-born, and recent immigrant), and gender of the children were explored. Between programme intake and age 10, scores improved significantly, F(3, 75) = 21.11, p < .0005. There were significant differences among cultural groups at all time-points except age 10. Scores differed significantly for girls, but not boys, at age 10, F = 5.11, p = .01. Recent immigrant boys reached the Canadian average, while girls were two-thirds of the standard deviation below average. Early intervention programmes must include a focus on the unique circumstances of recent immigrant girls; supportive transition workers in schools are one recommendation.
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Affiliation(s)
| | - Carla S. Ginn
- Faculty of Nursing, University of Calgary, Calgary, Canada
| | - Robert L. Perry
- Strategic Initiatives, Calgary Urban Project Society, Calgary, Canada
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Mental Health Effects of Premigration Trauma and Postmigration Discrimination on Refugee Youth in Canada. J Nerv Ment Dis 2016; 204:464-70. [PMID: 27101023 DOI: 10.1097/nmd.0000000000000516] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This report examines the role of pre- and post-migration trauma in explaining differences in refugee and immigrant mental health. Data were derived from mother-youth refugee and immigrant dyads from six countries of origin who were living in Canada at the time of the study. Youth reports of emotional problems (EP) and aggressive behavior (AB) were the mental health outcomes. EP and AB were regressed on predictor blocks: a) status (refugee versus immigrant), visible minority, and gender; b) premigration trauma and postmigration discrimination; c) parent and youth human and social capital; d) poverty, neighborhood, and schools. Refugees suffered higher levels of EP and AB, premigration traumas, and discrimination. Postmigration perception of discrimination predicted both EP and AB and explained immigrant versus refugee differences in EP. Antirefugee discrimination net of discrimination based on immigrant or visible minority status has deleterious mental health consequences.
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Hilario CT, Oliffe JL, Wong JPH, Browne AJ, Johnson JL. Migration and young people’s mental health in Canada: A scoping review. J Ment Health 2015; 24:414-22. [DOI: 10.3109/09638237.2015.1078881] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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George U, Thomson MS, Chaze F, Guruge S. Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13624-48. [PMID: 26516884 PMCID: PMC4627052 DOI: 10.3390/ijerph121013624] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/24/2015] [Accepted: 10/20/2015] [Indexed: 11/16/2022]
Abstract
The Mental Health Commission of Canada's (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). Over two decades of relevant literature on immigrants' health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed.
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Affiliation(s)
- Usha George
- Faculty of Community Services, Ryerson University, 99 Gerrard Street East, SHE-690; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Mary S Thomson
- Faculty of Community Services, Ryerson University, 99 Gerrard Street East, SHE-690; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Ferzana Chaze
- Community Studies, Sheridan College, 7899 McLaughlin Road, Brampton, ON L6Y 5H9, Canada.
| | - Sepali Guruge
- School of Nursing; Ryerson University, Faculty of Community Services; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
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Two sides of the same coin: Factors that support and challenge the wellbeing of refugees resettled in a small urban center. Health Place 2015. [DOI: 10.1016/j.healthplace.2015.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Improving Immigrant Populations’ Access to Mental Health Services in Canada: A Review of Barriers and Recommendations. J Immigr Minor Health 2015; 17:1895-905. [DOI: 10.1007/s10903-015-0175-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Predictors of immigrant children's mental health in Canada: selection, settlement contingencies, culture, or all of the above? Soc Psychiatry Psychiatr Epidemiol 2014; 49:743-56. [PMID: 24318040 DOI: 10.1007/s00127-013-0794-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 10/28/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND STUDY AIMS A previous publication from the New Canadian Children and Youth Study, a national study of immigrant children and youth in Canada, showed a gradient of levels of emotional distress with children from Hong Kong (HK) at the most severe end, Filipino children at the least severe, and children from the People's Republic of China (PRC) in between. Based on the premise that country of origin can be regarded as an index for differing immigration trajectories, the current study examines the extent to which arrival characteristics, resettlement contingencies and cultural factors account for country of origin variations in immigrant children's mental health. Arrival characteristics included child's age at arrival, parental education, parental fluency in English or French, and assistance from family at arrival. Resettlement contingencies included parental mental health, intra-familial conflict, settlement stress, separations from parents and child's age when mother started working outside the home. Cultural factors included one-child family composition and parenting styles. METHODS A national survey of 2,031 families with at least one child between the ages of 4 and 6 or 11 and 13 from HK, the PRC and the Philippines was conducted with the Person Most Knowledgeable (PMK) in snowball-generated samples in 6 different cities across Canada. Predictors of the dependent variable, emotional problems (EP), were examined in a hierarchical block regression analysis. EP was regressed on ethnic and country of origin group in model 1; arrival characteristics were added in model 2; resettlement contingencies in model 3 and cultural factors in model 4. RESULTS The final set of predictor variables accounted for 19.3 % of the variance in EP scores among the younger cohort and 23.2 % in the older. Parental human and social capital variables accounted for only a small amount of the overall variance in EP, but there were statistically significant inverse relationships between EP and PMK fluency in English or French. Settlement contingencies accounted for a significant increase in the explanatory power of the regression equation, net of the effects of country of origin and selection characteristics. This block of variables also accounted for the Filipino mental health advantage. Levels of parent's depression and somatization, harsh parenting, intrafamilial conflict, and resettlement stress each varied directly with levels of children's EP. Cultural variables made a significant contribution to explaining the variance in EP scores. Harsh parenting was significantly associated with increased levels of EP in both age groups, and supportive parenting was a mental health protective factor for younger children. CONCLUSIONS Immigrant family human and social capital, according to which immigrants are selected for admission to Canada, play a relatively small role in determining children's mental health. These effects are overshadowed by resettlement contingencies and cultural influences. Concentrating on trying to find a formula to select the "right" immigrants while neglecting settlement and culture is likely to pay limited dividends for ensuring the mental health of children.
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McPherson KE, Kerr S, McGee E, Morgan A, Cheater FM, McLean J, Egan J. The association between social capital and mental health and behavioural problems in children and adolescents: an integrative systematic review. BMC Psychol 2014; 2:7. [PMID: 25566380 PMCID: PMC4270040 DOI: 10.1186/2050-7283-2-7] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 03/14/2014] [Indexed: 11/24/2022] Open
Abstract
Background Mental health is an important component of overall health and wellbeing and crucial for a happy and meaningful life. The prevalence of mental health problems amongst children and adolescent is high; with estimates suggesting 10-20% suffer from mental health problems at any given time. These mental health problems include internalising (e.g. depression and social anxiety) and externalising behavioural problems (e.g. aggression and anti-social behaviour). Although social capital has been shown to be associated with mental health/behavioural problems in young people, attempts to consolidate the evidence in the form of a review have been limited. This integrative systematic review identified and synthesised international research findings on the role and impact of family and community social capital on mental health/behavioural problems in children and adolescents to provide a consolidated evidence base to inform future research and policy development. Methods Nine electronic databases were searched for relevant studies and this was followed by hand searching. Identified literature was screened using review-specific inclusion/exclusion criteria, the data were extracted from the included studies and study quality was assessed. Heterogeneity in study design and outcomes precluded meta-analysis/meta-synthesis, the results are therefore presented in narrative form. Results After screening, 55 studies were retained. The majority were cross-sectional surveys and were conducted in North America (n = 33); seven were conducted in the UK. Samples ranged in size from 29 to 98,340. The synthesised results demonstrate that family and community social capital are associated with mental health/behavioural problems in children and adolescents. Positive parent–child relations, extended family support, social support networks, religiosity, neighbourhood and school quality appear to be particularly important. Conclusions To date, this is the most comprehensive review of the evidence on the relationships that exist between social capital and mental health/behavioural problems in children and adolescents. It suggests that social capital generated and mobilised at the family and community level can influence mental health/problem behaviour outcomes in young people. In addition, it highlights key gaps in knowledge where future research could further illuminate the mechanisms through which social capital works to influence health and wellbeing and thus inform policy development. Electronic supplementary material The online version of this article (doi:10.1186/2050-7283-2-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kerri E McPherson
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Susan Kerr
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Elizabeth McGee
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Antony Morgan
- GCU London, 40 Fashion Street, Spitalfields, London, E1 6PX UK
| | - Francine M Cheater
- School of Nursing Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Jennifer McLean
- Glasgow Centre for Population Health, 1st Floor, House 6, 94 Elmbank Street, Glasgow, G2 4DL UK
| | - James Egan
- Glasgow Centre for Population Health, 1st Floor, House 6, 94 Elmbank Street, Glasgow, G2 4DL UK
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Beiser M, Hou F. Chronic health conditions, labour market participation and resource consumption among immigrant and native-born residents of Canada. Int J Public Health 2014; 59:541-7. [PMID: 24504154 DOI: 10.1007/s00038-014-0544-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 01/15/2014] [Accepted: 01/22/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To compare chronic illnesses, economic dependence and health-care use by immigrants and native-born Canadians. METHODS A secondary analysis of the Canada Community Health Survey national data (2009-2010) was conducted. RESULTS Recent and established immigrants were healthier than native-born Canadians. Healthy, established immigrants were more likely than native-born Canadians to be working, and no more likely to use transfer payments. Health-challenged recent immigrants had high employment rates, but low rates of health care. Health-challenged established immigrants and native born were equally likely to be working, depending on transfer payments and using health care. Regardless of nativity or health, education, male gender and linguistic fluency increased the probability of employment. Female gender and advancing age increased the likelihood of dependency. Residents of Canada's most prosperous regions were the most likely to be employed and the least likely to receive transfer payments. CONCLUSIONS Immigrants with chronic illnesses do not inevitably dilute the economic benefits of immigration or create excessive burden. Timely programs to promote integration can help ensure a favourable balance between economic contribution and social cost. Neglecting the health of new immigrants may eventuate in long-term disability.
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George MA, Bassani C. Does living in a neighbourhood with others of the same ethnic background contribute to health of Canada's immigrant children? Canadian Journal of Public Health 2013; 104:e482-6. [PMID: 24495825 DOI: 10.17269/cjph.104.4101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 11/25/2013] [Accepted: 11/07/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To understand how neighbourhood characteristics affect the health of immigrant children in Canadian cities. We question whether the health of children is influenced by immigrants living in enclaves of people with similar ethnic and socio-economic backgrounds. METHODS Two datasets were used: the New Canadian Children and Youth Study (NCCYS) and Statistics Canada census data. The NCCYS comprises children from Hong Kong, the Philippines and Mainland China living in Canada's largest cities. Logistic regression was used to examine the influence of neighbourhood ethnic concentrations and mean income on health. RESULTS Girls were more likely to be reported to have excellent health compared to boys, as were children living in neighbourhoods with lower mean parental education. Children from Hong Kong were less likely to have excellent health compared to the reference group. For the Mainland Chinese group only, there was an inverse relationship between reported health status and the concentration of people from the same ethnic background in the neighbourhood. CONCLUSION The health of children from different ethnic backgrounds is influenced by different social and economic factors. In practice and in research, "immigrants" and even broadly defined cultural groupings, such as "Asian immigrants", should be considered as heterogeneous.
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Beiser M, Taa B, Fenta-Wube H, Baheretibeb Y, Pain C, Araya M. A comparison of levels and predictors of emotional problems among preadolescent Ethiopians in Addis Ababa, Ethiopia, and Toronto, Canada. Transcult Psychiatry 2012; 49:651-77. [PMID: 23015641 DOI: 10.1177/1363461512457155] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
According to a literature of theory and advocacy, immigration and resettlement jeopardize the mental health of children and youth, largely because of factors such as intergenerational tensions arising from conflicts about the retention of traditional values, and experiences of prejudice and discrimination. The current study examines the specificity of these putative mental health risks to the immigration experience. The level and predictors of emotional problems among preadolescent Ethiopians living in immigrant families in Toronto, Canada, were compared with a matched sample of Ethiopian youngsters in Addis Ababa, Ethiopia. Data came from structured interviews with the person most knowledgeable about the family (usually a parent), as well as from the children themselves. Youth reported higher levels of emotional problems (EP) than their parents. Predictors differed for parent and child ratings. In both the Toronto and Addis Ababa samples, parental mental health predicted parent-rated, but not self-rated EP. Contrary to immigration stress theory, parental perceptions of prejudice predicted EP in Addis Ababa, but not Toronto, and parent-child discordance regarding ethnic adherence were predictors of self-rated emotional problems in Ethiopia, but not in Canada. Perceived discrimination was a significant predictor of self-rated emotional problems in both settings. Implications for theory and further research are discussed.
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Affiliation(s)
- Morton Beiser
- Department of Psychology, Ryerson University, 350 Victoria St., JOR-1016, Toronto, Ontario, M5B 2K3 Canada.
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Oxman-Martinez J, Rummens AJ, Moreau J, Choi YR, Beiser M, Ogilvie L, Armstrong R. Perceived ethnic discrimination and social exclusion: newcomer immigrant children in Canada. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2012; 82:376-388. [PMID: 22880976 DOI: 10.1111/j.1939-0025.2012.01161.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This article examines relationships between perceived ethnic discrimination, social exclusion, psychosocial functioning, and academic performance among newcomer immigrant children from the People's Republic of China, Hong Kong, and the Philippines using a subsample from the New Canadian Children and Youth Study of children aged 11-13 years (1,053) living in Montreal, Toronto, Vancouver, and the Prairies. Bivariate analysis showed that 25% of children reported being treated unfairly by peers and 14% by teachers because of who they are. Regression analyses revealed that perceived ethnic discrimination by peers and teachers was negatively related to children's sense of social competence in peer relationships. Children's self-esteem and sense of academic competence were negatively related to perceived discrimination by teachers. One in 5 children reported feeling like an outsider, with boys revealing higher levels of psychological isolation than girls. More than 1 in 10 were socially isolated and reported never participating in organized activities. This may reflect economic exclusion, as over one third of respondents belonged to families living below the Canadian Income Adequacy Measure. Psychological isolation, social isolation, and economic exclusion were significant predictors of children's sense of academic competence and actual academic grades. Variations exist across age, sex, ethnicity, family structure, parental education, region of settlement, and length of time since arrival in Canada.
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Affiliation(s)
- Jacqueline Oxman-Martinez
- University of Montreal The Hospital for Sick Children University of Montreal McGill University Ryerson University University of Alberta University of British Columbia.
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Influence of Perceived Racial Discrimination on Health and Behaviour of Immigrant Children in British Columbia. ACTA ACUST UNITED AC 2012. [DOI: 10.1155/2012/274963] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examines the influence of perceived discrimination on the health and behaviour of ethnic minority immigrant children in British Columbia, Canada. Using data from the New Canadian Children and Youth Study, we examine perceived discrimination experienced by the parent, family, and cultural group in Canada to test the influence of micro-, meso-, and macrolevels of discrimination on children. Families from 6 ethnic backgrounds participated in the study. Parents’ perceptions of the child’s health and six behavioral scales (hyperactivity, prosocial behaviour, emotional problems, aggression, indirect aggression, and a general combined behaviour scale) were examined as outcome variables. After controlling for ethnicity and background variables, our findings suggest that perceived micro- and macrodiscrimination has the greatest influence on the health and behaviour of our immigrant child sample. Variation among ethnic groups provided the largest explanation of health and behavioural discrepancies in our study.
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Stewart M, Simich L, Beiser M, Makumbe K, Makwarimba E, Shizha E. Impacts of a social support intervention for Somali and Sudanese refugees in Canada. ACTA ACUST UNITED AC 2011. [DOI: 10.1108/17570981111250840] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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