Newcomer Youth Mental Health -a discussion on needs, barriers and promising practices

Sheeba Narikuzhy, M.A (Psychology)

Oleg Valin, OCT

Why focus on newcomer youth mental health?

Strengthen & expand our existing models of care

Early Intervention & Treatment

Economic cost of mental illness in Canada- $7.3 billions

in 1993 & $57 billion in 2010 (CAMH study 2010)

Growing newcomer population in Canada

1996 - Immigrants represent 17% of total population in

Canada (Stats Canada)

1996 - 42% of all Toronto residents were immigrants

Mental Health Problems in Newcomer Youth

Increased somatoform disorders in Asian

children ( Jawed et.al, BJP 1991) possibly due to

parental readiness to detect & acknowledge

physical problems

Increase in depression, self harm/suicide

rates

Bullying/ Cyber bullying

Major Themes identified from working with Newcomer Families

Undiagnosed/unidentified mental health

problems

Stigma

Lack of knowledge about mental health

problems & available services

Post traumatic symptoms related to

violence/war & trauma

Determinants of mental health for newcomer youth

Social, cultural and economic status

Parental psycho pathology

Family discord

Ineffective parenting/harsh disciplines

Children prematurely assuming adult roles

Adjusting to Canadian education system

Stigma related to ESL classes

Shakya et.al., Canada Metropolis.net 2008

Determinants of mental health for newcomer youth, continued….

Traumatic experiences in their native country

Experiences during their journey to the new

country

Settlement related difficulties in the new

country

Increased psychological stress for immigrant youth

Rapid physical development and deep

emotional changes during adolescence

Increased vulnerability to stress

Accentuated stress for immigrant youth

Role of Family in Adolescent Mental Health

Supportive Family Networks buffer against

effects of stress ( Maynard. J et. al, 2010)

Social Support, Peer & Community relations

Quality of Family Interactions

Socio economic status

Family structure/traditions/values

Role Modeling

Protective Factors for Newcomer Youth Mental Health

Supportive Family Networks buffer against

effects of stress ( Maynard. J et. al, 2010)

Ethnic Density- People reside in

neighbourhoods of higher own group density

experiences buffering effects from social risk

factors of psychosis (Munshi J. et. Al, BJP 2012 )

Protective Factors- contd…

Social Support, Peer & Community relations

Quality of Family Interactions & Frequency of

Family Activities

Socio economic status

Family structure/traditions/values- extended

family support

Stats

Mental health problems account for half of all

disability among young people between the

age of 10-24

45% of youth disability is related to

depression, bipolar disorder, schizophrenia

and substance abuse

Study by WHO - Health.com June 6, 2011

Stats continued…

10-20% of Canadian youth are affected by mental illness

In Canada 1 in 5 kids have mental health problems and only 1 out of 5 children who need mental health services receives them

Approximately 4,000 youth die prematurely each year by suicide

Stats Canada

Stats contd…

Low income rate for newcomer youth is 3 times higher than for Canadian born youth.

Unemployment rate for newcomers is 15.4% compared to 12.5% for Canadian born youth.

Census Canada (2009)

Immigrant kids who arrive late more likely to drop out of high school

15% boys & 11% girls who come to Canada

after the age of 9 ultimately dropped out of

high school compared to Canadian average

10.3 & 6.6 % respectively

21.6% (more than 1 in 5) kids who come to

Canada at age 15 dropped out of school - Corak’s study (2011) , based on Census Canada 2006

High risk for emotional problems for Immigrant children in Toronto

Immigrant children (from Hong Kong, China &

Philippines) living in Toronto are at high risk for

emotional problems

Possible reasons include: Poor home –school

relationships and marginalization

Dr. Beiser et.al, 2010 ( New Canadian Children

and Youth Study)

Challenges in Engaging Parents of Newcomer Youth for Mental Health Services

Family’s belief system/previous experience

may impede their youth’s treatment and

recovery

Stigma and lack of awareness/knowledge on

mental health issues/services

Language barrier & cultural shock

Challenges in ethnic identity formation

Case Example Client Y, a 15 yr old female

Family came to Toronto as refugees

Language barrier & financial problems

Referral to EMYS from hospital for individual

& family work, had multiple admissions for

psychotic episodes; symptoms stabilized with

medication

Parents deeply concerned & reaching out for

support

Case Example Challenges

Parents believed someone “casted eye” on Y

Family took Y to faith healer who suggested a sugar

free diet and special prayers & to stop taking

medication

Y stopped taking medication & had a relapse

Treatment outcomes: Y was placed at residential program

Parents agreed with treatment plan after many

sessions of intensive family therapy/ psycho

education sessions

Y was transitioned to adult mental health system

Challenges continued…

Parents’ mental health issues

Emotional and social unavailability of parents

Unidentified mental health issues

Long waitlist for services

Limited linguistically appropriate services

Lack of understanding about, and trust for

available resources

Newcomer Youth Program- EMYS

Acculturation and Mental Health

“Out of the Box Approach”

Statistics on our program

External partnerships

Concerns and challenges

Promising Practices for Newcomer Family Engagement

Psycho education

Cultural competent services

Provision of linguistically appropriate

services

Mental Health Awareness through various

media e.g. ethnic newspapers/ radio

stations, Facebook etc.

Education of Family Physicians

Promising Practices – contd…

Facilitating Leadership involving family &

community members from minority groups

Collaboration between agencies for cultural

consultation & interpretation

School based screening/ skills training for

identified youth

Building social/peer support system for youth

Promising Practices- contd….

Creative/ ‘out of the box’ approach to

engaging women e.g. Women’s sewing or

cooking groups, girls soccer team etc.

Connecting Families with ethno specific

social/recreational groups

Involving Family in therapeutic process as

much as possible

Promising Practices- contd….

Information sessions on appropriate

parenting practices at settlement

agencies/other agencies serving newcomers

Information on available resources e.g. kids

helpline, mobile crisis unit

Collaboration with religious

leaders/institutions to support and enhance

youth/family engagement

Questions or Comments?

Sheeba Narikuzhy Clinical Supervisor

East Metro Youth Services

E-mail: snarikuzhy@emys.on.ca