sheeba narikuzhy - newcomer youth mental health needs, barriers & best practices
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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
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