D7 Journey To Promote Mental Health: A workshop for Immigrant & Refugee Service Workers_Raymond...
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Transcript of D7 Journey To Promote Mental Health: A workshop for Immigrant & Refugee Service Workers_Raymond...
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Journey to Promote Mental Health: A Workshop for Community Workers
Serving Ethno-racial Communities
Hong Fook Mental Health Association
Raymond Chung, Linda Yoo & Maria LoApril 23, 2009
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Goals
To heighten Participants’ awareness of the interconnectedness between Mental Health and Settlement Services
To enhance Participants’ knowledge base on Wellness, Mental Health and Mental Illness
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OutlineOutline• Welcome & Introduction
• Holistic Health & Migration
• Cultural Competence
• Stigma & Mental Health
Break Time
• Introduction on Mental Health & Mental illness
• Introduction of Mental Health System
• Introduction to Community Resources
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What makes someone healthy?
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Most people think that our health is dependent on…
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Some even think of “lifestyle”…
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SocialInclusion
Income Education
Employment
Healthy Child Development
HousingFood
Health/Social Services
Safe PhysicalEnvironmentTransportation
.
Social Determinants of Health
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Factors Affecting our Mental Health and that are
Particularly Important to Immigrants
Income and social status Social support networks Education and literacy, i.e. health literacy Employment / Working conditions Social environments Physical environmentsHealthy child development
Source: The Public Health Agency of Canada
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Spirit
Mind Body
Capacity
Resources
Support
Roles &
ResponsibilitiesRelatio
nship
CommunicationAccess
Equity
Social JusticeResources
Supp
ort
UNDERSTANDINGMUTUAL
UNDERSTANDING
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What needs to be addressed in promoting mental health beyond the
individual factors?
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Biological/Genetic
Lifestyles Health Disparities
Individual
SocietalInequity In our social and health care system
e.g. public policies that lead to inequitable distribution of resources & power; systemic oppressions & barriers.
Health Disparities Result From…
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Identifying the Stressors Associated With the Migration Process
Case Example:
Can you name stressors immigrants and refugees
may face?
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Case Example- Ling is a 20 yrs old new immigrant who came from China
2 years ago with her mother- Ling is unemployed and attending ESL class - she appears to be passive, submissive, withdrawn and
seems to lack self confidence- Her mother was diagnosed with Depression in China
some time ago but has not reconnected with any mental health services in Toronto
- Ling is not sleeping well, waking up early, and talking about the lack of meaning in life after coming to Toronto
- Her father has been here for 15 years and works long hours as a chef to support the family
- The family shares a house with 2 other families with young children
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Question:
If you are the settlement worker serving Ling, what are the stressors in her circumstances that you would attend to in supporting her?
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Identifying the Stressors Associated With the Migration Process
Chronic Stress has been linked to the 6 leading causes of death:
Heart diseases CancerLung ailments
75-90% of all visits to healthcare professionals are for stress-related disorders
(Source: The Stress Solution by Lyle H. Miller, Ph.D., and Alma Dell Smith, PhD)
Cirrhosis of the liver
AccidentsSuicide
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Moving Beyond Information Services
What could we do?as a frontline settlement worker……..
as an organization for your communities…….
to make system changes………
to reduce health and social inequities?
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Mental Health & Mental Illnesses: A Cultural Competence Framework
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Cultural Competence
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Diversity
Gen
der
Age
Sexuality
CitizenshipStatusSocioeconom
ic
StatusC
lass
EthnicityMental/Physical
Abilities
Faith/Religion
Language
Other, etc.
Racial
Identity
The Diversity Flower has been adopted from the Power Flower (Source: Arnold, R., Burke, B., James, C. & Martin, D. (1991) Educating for a Change, Toronto, ON: Between The Lines)
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SexismRacism
Ableism
Classism
Heterosexism/Homophobia
Other Oppressions
Ageism Inequities
.
While we may acknowledge diversity, we must also acknowledge that inequities and oppressions exist…
Overlapping oppressions impact negatively on the well-being of the individual, group or community
Each individual, group or community usually belongs to a set of overlapping dimensions
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Definition of Cultural Competence
“ A set of congruent behaviours, attitudes and policies that come together in a system, agency or among professionals and enables that system, agency, or those professionals to work effectively in cross-cultural situations “
(Cross et al, 1989).
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Am I culturally competent if I …
tell my Chinese client that I am Chinese too and an immigrant also, so I know what she is going through & needs to do. refer my client who is Vietnamese by ethnic origin to a Vietnamese-speaking counselor with the belief that this arrangement is culturally appropriate for her.share my client’s situation with his mother who did not tell her son that she was calling me with the assumption that family plays an important part in an individual’s life in Asian culture so parents should know what’s happening to their children.
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Key Points
Holistic Health
Social Justice
Equity
Diversity
Stereotyping & labeling as
“Absolute No”
Interpretation of culture by the
individual
Critical Self Awareness &
Reflective Practice
Culture beyond language
compatibility
Cultural Competence at Service Level
Cultural Competence at Organizational Level
Cultural Competence at System Level
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Warm up activities!!!!
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How do we see mental health & mental illness?Statement #1: People with mental illness are violent and dangerous
Statement #2: People with mental illness are poor and/or less intelligent
Statement #3: Mental Illness is caused by personal weakness
Statement #4:If I do not have mental illness, it means I am having good
mental health
TRUE or FALSE
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Stigma & Mental Illness
Stigma relates to:Misconception of mental illnessLack of knowledgeDiscomfort with differencesFear
Stigma & discrimination impacts on help seeking behavior & delay in treatment
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15 minutes Break
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What is Mental Health?
Mental health is about striking a balance in the physical, mental, spiritual, social and economic aspects of our lives.
Reaching a balance is a unique experience for each individual.
Mental Health as a Continuum
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Mental Health as a Continuum
Wellness Illness
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The 4 Ps of Mental Health
• Precipitating factors: triggered by stressful events.
• Predisposing factors: things that make a person more vulnerable to being distressed.
• Perpetuating factors: things that prolong the problem. The person’s road to recovery may be affected
• Protective factors: things that help recovery.
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Some Early signs and symptoms of mental health issues (not a check list or an exhaustive list)
• Physical fatigue and low energy• Restlessness• Insomnia• Panic attacks• Loss of appetite• Weight gain or loss• Physical symptoms, such as headaches and
stomach aches
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Other Common Symptoms• Increased irritability & anxiety• Racing thoughts• Poor concentration• Anger• Feelings of sadness• Crying easily• Changes in relationships with family members or
peers, • Loss of interest or motivation in studies or work• Absenteeism from school or work
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WHAT IS MENTAL ILLNESS?
Mental illness is a medical condition that affects an individual’s thinking, mood and behaviour.
Mental illness is an illness similar to physical illness, but it is “invisible"
Mental illness is treatable and recovery is possible.
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Different Types of Mental Illnesses
Psychotic DisordersExamples: Schizophrenia, Delusional DisorderMood DisordersExamples: Depression, Bipolar Affective DisorderAnxiety DisordersExample: Post Traumatic Stress DisorderOthers
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How common are Mental Illness & Addiction Issues in Canada?
• 1 in 10 (aged 15 and over) – 2.7 million have symptoms consistent with a mood or anxiety disorder / alcohol or illicit drug dependence
• 1 in 20 met the criteria for a mood disorder, either major depression or bipolar 1 disorder
• 1 in 20 met the criteria for an anxiety disorder• 1 in 50 met the criteria for moderate risk or problem
gambling• 1 in 30 met the criteria for substance dependence
associated with either alcohol or illicit drug use
(The Human Face of Mental Health and Mental Illness in Canada 2006)
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Other Statistics & Facts(Source: Mood Disorder Society of Canada)
Chances of having a mental illness in your lifetime in Canada: One in fivePercentage of people with chronic depression who die from suicide: 15%Annual losses to the Canadian economy due to mental illness & substance abuse in the workplace: $33 billionPercentage of Canadian workers who experience a stress related illness per year: 20%Number of people with mental illness either turned down for a job for which they were qualified, or if employed, dismissed or forced to resign once it was known that they had mental illness 1/3 to 1/2
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So What do we do with this knowledge?
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MENTAL ILLNESS IS TREATABLE
RECOVERY IS POSSIBLE!
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Case Scenario• JJ is a 18-year old high school student• Immigrated to Canada 3 years ago, living with parents in
their 50’s. • Used to like studying and get along with parents until 7
months ago• Became withdrawn, lied in bed all day, not speaking to
parents, skipping classes• Ignoring personal hygiene, talking to self in his room,
said news reporter on TV is referring to him when watching news
• Parents upset about his changes and thought he could overcome his problem by pushing him to think and act differently
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Any symptoms that we detect in JJ that are of concerns?
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Treatment ApproachesPsychiatric Medication
ECTACTT
PsychotherapyAlternative Treatment
Psychosocial SupportGroup
Day ProgramVocational program
Peer SupportCase Management
Other Community Support
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What can we do in dealing with mental health challenges?
Early Identification Understand associated factors and taking early steps to changeAssessment & Early TreatmentExplore Strategies in promoting mental health & coping with stressOrganizational & Systemic Changes beyond the individual level
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Case Scenario: How do we provide support?• TK is a 35-year old female• Immigrated to Toronto 2 years ago from Mainland China• No English; university education• Living with 40-year old husband and 12-year old son• Couple were computer professionals in China• No job here and living on saving• Living on saving & tight finances• Poor marital relationship• Brother in Toronto & is supportive• Problems with Son’s behavior: seen as “rebellious”• TK is experiencing crying spells, loss of weight, poor sleep, social
withdrawal• TK is questioning the meaning of life and expressed thoughts of not
wanting to live
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Case Scenario: How do we provide support?
What is our assessment of his needs & areas to work on?
How do we intervene?
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How do we provide support?Questions to ask:AssessmentEarly Identification: What are the signs of mental health issues?- crying spells- loss of weight- poor sleep- social withdrawal- questioning meaning of life: Depressive thoughts, suicidal risk?
What are the associated factors & social determinants?- employment & financial stress- Unemployment & impact on self worth & self confidence- Marital problem- Problems in relationship with son & parenting possibly
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How do we provide support?Intervention: How do we approach TK?
Critical self awareness & reflectionAssumptions, biases, roles & boundaries“Listening” v.s. “Advising”What are the “pressing” needs/issues to be addressed?Should we address suicidal risks by “exploring openly”?“Working alone” or “Working in collaboration”- with whom?What goals are achievable & immediate?What are the positives?Working “with” v.s. working “for” the individual
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Mental Health System Mental Health System
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Key Legislations Related to Mental HealthKey Legislations Related to Mental Health
Balancing
Rights & Choices to TreatmentSafety of Self & Others
Confidentiality
Mental Health Legislations
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Key Legislations Related to Mental HealthKey Legislations Related to Mental Health
Mental Health ActMental Health Act””
““Involuntary AdmissionInvoluntary Admission””
““Health Care Consent ActHealth Care Consent Act””
Personal Health InformationPersonal Health Information Protection Protection Act (PHIPA)Act (PHIPA)
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Introduction to the Mental Health SystemIntroduction to the Mental Health SystemContinuum of Mental Health Related Services Continuum of Mental Health Related Services --
Different Levels Different Levels of Treatment Services & Community Resources:of Treatment Services & Community Resources:
• Specialized Hospitals (Psychiatric Hospitals)• General Hospitals with psychiatric inpatient unit• Community Treatment Program (e.g. Assertive
Community Treatment Team, Outpatient clinics)• Community Support Programs, e.g. case management,
vocational support, supportive housing• Alternative Treatment Programs• Other community or social service programs,
(e.g., settlement service, employment programs, educational / vocational programs)
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Linkage to Mental Health & Addiction Resources
CONNEXwww.connexontario.ca
Local CCAC211
Local CMHA
Only two ethno cultural specific community mental health organizations in the Toronto Region:
Across BoundariesHong Fook Mental Health Association
www.hongfook.ca
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Mental Health & Addiction Resources
Crisis ServiceGerstein Centre 416-929-5200
Scarborough Hospital Regional Mobile Crisis Program 416-289-2434
St. Elizabeth Health Care Integrated
Community Mental Health Crisis Response Program 416-498-0043
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Hong FookHong Fook’’s Continuum of Services s Continuum of Services FrameworkFramework
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Get involved in the Health Care System!
Cross-sector collaboration with others in our work
Get informed and take part in giving your voice
Learning and getting involved in LHIN (Local Health Integration Network
(Reference: www.lhins.on.ca)
Educate & Advocate for individuals we serve regarding their rights
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JOURNEY TO PROMOTE MENTAL HEALTH
An OCASI Staff Development Project 2008 - 2010
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JOURNEY TO PROMOTE MENTAL HEALTH
A partnership project with OCASI, funded by CICAn 18 month project providing cross sector knowledge exchange2 day training series for front line settlement sector staff Goal is to raise awareness of mental health and to lower the stigma on mental illnessDesign of training series is geared towards the learning needs of the participantsAn Advisory Committee to provide guidance to the Project
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Reflection for the Day…Feedback and Questions
Thank you & Have a nice day!
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