Culturally Competent Care for Diverse Groups

CPA is pleased to have compiled a list of resources for psychologists interested in providing culturally competent care to diverse groups https://cpa.ca/practitioners/Cultural/ In light of recent immigration to Canada of Syrian refugees, many of the resources listed relate specifically to resources and needs of this group.

Psychological Services for Syrian Refugees

 

The Minister of Immigration, Refugees and Citizenship has designated Syrian refugees as a public policy group eligible for Type 1 benefits under the Interim Federal Health Program. Type 1 benefits include basic coverage, prescription drug coverage and supplemental coverage.

The supplemental coverage includes psychotherapy counselling or psychology counselling in a private clinic or addiction centre for a maximum of 10 sessions. Prior approval requests must be accompanied by a letter from a physician that indicates the diagnosis and prescription for psychotherapy/counselling. Therapists must be registered clinical psychologists, licensed by the provincial/territorial College of Psychologists (where applicable) and the following and the following fees apply for Initial & Subsequent Treatments, per hour:

ON $205 NS $140
AB $170 NB, NT, NU, YT $130
BC $160 QC $125
MB, PE, NL $150 SK $110

For additional details, please see the IFHF Supplemental Coverage Benefit Grid.

Becoming a Provider

If you are interested in becoming a registered provider with Medavie Blue Cross, please request an account for Medavie’s provider portal website. Once your provider registration request is received, it will be verified to determine whether you meet the criteria for the program. Once approved you will be assigned a provider number and will be able to submit claims electronically through the provider portal.

Additional information for health providers about the provisions of the Interim Federal Health Program can be found on Citizenship and Immigration Canada’s website.

Resources:

 

Resources Offering Webinars And Online Courses

 

Canadian Collaboration for Immigrant and Refugee Health (CCIRH)

  • URL: https://ccirhken.ca/ccirh_main/
  • Description: The Canadian Collaboration for Immigrant and Refugee Health (CCIRH), is a six year old interdisciplinary collaboration involving over 150 primary care practitioners, specialists, researchers, immigrant community leaders, and policy makers, that shines an evidence-based lens on the emerging new discipline of migrant health. Based on evidence gathered from around the world, CCIRH has developed evidence-based recommendations, e-learning opportunities, preventative care checklists, and other practical tools to help practitioners effectively meet the unfamiliar health needs of newly arriving immigrants and refugees.

Canadian Pediatric Society: Caring for Kids New to Canada – Helping Syrian Refugees

  • URL: http://www.kidsnewtocanada.ca/beyond/helping-syrian-refugees
  • Description: Caring for Kids New to Canada is a comprehensive resource for people who work with immigrant and refugee children, youth, and families. Developed by the Canadian Paediatric Society with input from a range of experts and organizations, the site has evidence-based information on medical conditions, mental health, child development, and much more. It also has a range of tools, webinars, checklists and links to local resources.

Centre for Addiction and Mental Health (CAMH): Refugee Mental Health Project

  • URL: https://www.porticonetwork.ca/web/rmhp/home (Français: https://www.porticonetwork.ca/web/psmr/home)
  • Description: The Refugee Mental Health Project (RMHP) aims to build settlement, social and health service providers’ knowledge and skills regarding refugee mental health and promote inter-sector and inter-professional collaboration. Resources include information on refugee mental health, evidence-based suggestions for refugees and mental health support providers, award-winning online courses for health care professionals and social service providers, and regular webinars on topics related to refugee mental health.

Georgetown University Center for Child and Human Development: National Center for Cultural Competence (NCCC)

  • URL: http://nccc.georgetown.edu/
  • Description: The mission of the NCCC is to increase the capacity of health care and mental health care programs to design, implement, and evaluate culturally and linguistically competent service delivery systems to address growing diversity, persistent disparities, and to promote health and mental health equity. The NCCC website contains numerous resources for health care providers, including distance learning opportunities and cultural competence self-assessment tools.

Kelty Mental Health Resource Centre: Refugee Mental Health Project

  • URL: http://keltymentalhealth.ca/r/refugee-mental-health-project
  • Description: The Refugee Mental Health Project aims to build health, social and settlement service providers’ knowledge and skills regarding refugee mental health and promote inter-sector and inter-professional collaboration. Online courses, webinars, and toolkits are available through the website for health professionals.

Mental Health and Psychosocial Support Network (MHPSS)

  • URL: http://mhpss.net/
  • Description: The MHPSS Network is a growing global platform for connecting people, networks and organizations, for sharing resources and for building knowledge related to mental health and psychosocial support both in emergency settings and in situations of chronic hardship. The MHPSS Network hosts and advertises various resources related to culturally competent care, including print resources, webinars, and online courses.

Multicultural Mental Health Resource Centre (MMHRC)

  • URL: http://www.multiculturalmentalhealth.ca/
  • Description: The MMHRC seeks to improve the quality and availability of mental health services for people from diverse cultural and ethnic backgrounds, including immigrants, refugees, and members of established ethnocultural communities. This website presents resources designed for laypeople, patients and their families, community organizations, health professionals, and policy makers, planners and administrators. Materials hosted and listed on this site include cultural competence training materials (print and online), training videos, and podcasts from leading Canadian experts in the field of culturally competent care.

Refugee Health Technical Assistance Center (RHTAC): Webinars

  • URL: http://refugeehealthta.org/webinars/
  • Description: The RHTAC provide web-based information and resources related to refugee health, including webinars on such topics as refugee women’s health, refugee youth, mental health screening and care, and providing culturally and linguistically appropriate services to refugees.

Victorian Refugee Health Network: Refugee Health Online Modules

  • URL: http://refugeehealthnetwork.org.au/engage/refugee-health-online-modules/
  • Description: The Victorian Refugee Health Network was established to facilitate greater coordination and collaboration amongst health and community services to provide more accessible and appropriate health services for people of refugee backgrounds. This collection of online modules from Australia, North America, and the U.K. covers a number of topics relevant to those supporting the mental health needs of refugees, including ethical issues, therapeutic approaches, working with different refugee populations, and cultural competency.

 

Print And Online Resources For Mental Health Care Workers

 

American Psychological Association: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

  • URL: http://www.apa.org/pi/oema/resources/policy/provider-guidelines.aspx
  • Description: Psychological service providers need a sociocultural framework to consider diversity of values, interactional styles, and cultural expectations in a systematic fashion. These Guidelines represent general principles that are intended to be aspirational in nature and are designed to provide suggestions to psychologists in working with ethnic, linguistic, and culturally diverse populations.

American Psychological Association: Working with Refugee Children and Families: Update for Mental Health Professionals

  • URL: https://www.apa.org/pubs/info/reports/refugees-health-professionals.pdf
  • Description: This 2009 publication highlights the importance of psychologists in their roles as clinicians, researchers, educators, and advocates in the lives of refugee children and their families. It contains evidence-based principles for mental health care among refugee children and families, suggestions for addressing common ethical issues when providing such care, information on factors influencing the psychosocial adjustment of refugee children, and mental health resources for care providers and their clients.

Canadian Collaborative Mental Health Initiative: Establishing Collaborative Initiatives Between Mental Health and Primary Care Services for Ethnocultural Populations

  • URL: http://www.shared-care.ca/files/EN_CompanionToolkitforEthnocultural.pdf
  • Description: The purpose of this toolkit is to assist service providers and other key stakeholders to work collaboratively to meet the mental health needs of ethnocultural populations. Highlights of the toolkit include: ten key issues for consideration when planning and implementing an initiative; descriptions of two positive practice initiatives; and a list of key websites.

Centers for Disease Control and Prevention: Guidelines for Mental Health Screening During the Domestic Medical Examination for Newly Arrived Refugees

  • URL: http://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/mental-health-screening-guidelines.html
  • Description: Given the nature of life-threatening experiences prior to and during flight from their home countries or country of asylum/host country, as well as the difficult circumstances of existence in exile, refugees may be at particularly high risk for psychiatric symptoms. Although this document cannot provide solutions to these challenges, it provides suggestions and resources for primary clinicians for mental health screening during the initial domestic medical examination.

CMAS: Caring for Syrian Refugee Children: A Program Guide for Welcoming Young Children and Their Families

  • URL: http://cmascanada.ca/2015/12/12/caring-for-syrian-refugee-children-a-program-guide-for-welcoming-young-children-and-their-families/
  • Description: To help support your program in giving Syrian children (and their families) the best possible care, CMAS brought together a team of experts in the sector to create this comprehensive resource. It provides you and your staff with the knowledge and tools they’ll need to better understand and respond to the unique experiences and needs of Syrian refugee children. The resource also includes tip sheets filled with practical strategies that are designed to be taken straight off the page and put into practice. These can be quickly and easily printed out to share with your team.

Migration Policy Institute: The Educational and Mental Health Needs of Syrian Refugee Children

  • URL: http://www.migrationpolicy.org/research/educational-and-mental-health-needs-syrian-refugee-children
  • Description: This 2015 report examines the experiences and resulting educational and mental health needs of Syrian children living as refugees, drawing on the results of a study conducted in Islahiye camp in southeast Turkey, which assessed children’s levels of trauma and mental health distress. It also reviews intervention programs in the Middle East, Europe, and the United States, and offers recommendations for best practices to address the mental health of this vulnerable child population.

National Child Traumatic Stress Network: Refugee Trauma

  • URL: https://www.nctsn.org/what-is-child-trauma/trauma-types/refugee-trauma
  • Description: The National Child Traumatic Stress Network was established to improve access to care, treatment, and services for traumatized children and adolescents exposed to traumatic events. This page contains information, suggestions, and resources pertaining to child refugee mental health for clinicians, other care providers, and researchers.

Psychological Assessment of Culturally and Linguistically Diverse Children and Adolescents: A Practitioner’s Guide

  • URL: http://www.springerpub.com/psychological-assessment-of-culturally-and-linguistically-diverse-children-and-adolescents.html
  • Description: Shifting demographics, socioeconomic contexts, and resulting policies have highlighted the needs and opportunities to better understand and serve culturally and linguistically diverse populations at the heart of school communities. In its 10 chapters, this book provides comprehensive evidence-based research to guide its conceptual framework, and its extension into practice. Ranging from the learner’s development within the family dynamics, to facets of assessment that leads to effective interventions, the book integrates a tapestry that can be used to facilitate effective consultations and services.

United Nations High Commissioner for Refugees (UNHCR): Assessing Mental Health and Psychosocial Needs and Resources: Toolkit for Humanitarian Settings

  • URL: http://www.unhcr.org/509bb3229.html
  • Description: This document provides an approach and a toolkit to help those designing and conducting an assessment of mental health and psychosocial needs and resources in major humanitarian crises. These could include major natural and human-made disasters and complex emergencies (for example armed conflicts).

United Nations High Commissioner for Refugees (UNHCR): Assessment and Management of Conditions Specifically Related to Stress

  • URL: http://www.unhcr.org/537377329.html
  • Description: This Mental Health Gap Action Programme (mhGAP) Intervention Guide module contains assessment and management advice related to acute stress, post-traumatic stress, and grief in non-specialized health settings.

United Nations High Commissioner for Refugees (UNHCR): Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians – A Review for Mental Health and Psychosocial Support Staff Working with Syrians Affected by Armed Conflict

  • URL: http://www.unhcr.org/55f6b90f9.pdf
  • Description: This 2015 report aims to provide information on the sociocultural background of the Syrian population as well as cultural aspects of mental health and psychosocial wellbeing relevant to care and support. It is based on an extensive review of the available literature on mental health and psychosocial support, within the context of the current armed conflict in Syria.

United Nations High Commissioner for Refugees (UNHCR): Rapid Assessment of Alcohol and Other Substance Use in Conflict-affected and Displaced Populations: A Field Guide

  • URL: http://www.unhcr.org/50b4cf5e9.html
  • Description: An increase in alcohol and other substance use is among the many health and social issues associated with conflict and displacement. Problems with substance use are prevalent in a variety of conflict-affected situations, including camps for refugees and internally displaced people. This guide is written for those who plan to include in their work rapid assessments of alcohol and other substance use among conflict-affected and displaced populations.

U.S. Department of Health and Human Services Office of Mental Health: National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care: A Blueprint for Advancing and Sustaining CLAS Policy and Practice

  • URL: https://thinkculturalhealth.hhs.gov/assets/pdfs/enhancedclasstandardsblueprint.pdf
  • Description: This 2013 document offers a user-friendly format for providing comprehensive — but by no means exhaustive — information on each Standard for Culturally and Linguistically Appropriate Services. The Blueprint is an implementation guide for advancing and sustaining culturally and linguistically appropriate services within health and health care organizations. The Blueprint dedicates one chapter to each of the 15 Standards. These chapters review the Standard’s purpose, components, and strategies for implementation. In addition, each chapter provides a list of resources that provide additional information and guidance on that Standard.

World Health Organization (WHO) Department of Mental Health and Substance Abuse: Mental Health and Psychosocial Support in Emergencies

  • URL: http://www.who.int/mental_health/emergencies/en/
  • Description: The target group for WHO work on mental health and psychosocial support in emergencies is any population exposed to extreme stressors, such as refugees, internally displaced persons, disaster survivors and terrorism-, war- or genocide-exposed populations. The WHO Department of Mental Health and Substance Abuse regularly publishes evidence-based recommendations for those providing mental health and psychosocial support to such populations.

 

Peer-Reviewed Journal Articles

 

Barnes, R., & Josefowitz, N. (2019). Indian residential schools in Canada: Persistent impacts on Aboriginal students’ psychological development and functioning. Canadian Psychology/Psychologie canadienne, 60(2), 65–76.

Gould, B., MacQuarrie, C., O’Connell, M. E., & Bourassa, C. (2020). Mental wellness needs of two Indigenous communities: Bases for culturally competent clinical services. Canadian Psychology/Psychologie canadienne. Advance online publication.

Ansloos, J., Stewart, S., Fellner, K., Goodwill, A., Graham, H., McCormick, R., Harder, H., & Mushquash, C. (2019). Indigenous peoples and professional training in psychology in Canada. Canadian Psychology/Psychologie canadienne, 60(4), 265–280.

Goodwill, A., & Giannone, Z. (2017). From research to practice: Bridging the gaps for psychologists working in indigenous communities affected by gangs. Canadian Psychology/Psychologie canadienne, 58(4), 345–353.

Mushquash, C. (2014). A brief description of an early alcohol use intervention for first nations adolescents. Canadian Psychology/Psychologie canadienne, 55(1), 48–49.

Amawi et al. (2014). An Annotated Bibliography on Trauma, Mental Health, and Primary Health Care in the Middle East

  • URL: https://web.archive.org/web/20170314070807/http://hprt-cambridge.org/wp-content/uploads/2014/08/Amawi-et-al-Annoted-Bibliography-Trauma-Middle-East-2014.pdf
  • Description: The references in this 2014 bibliography, prepared by The Harvard Program in Refugee Trauma, are organized by content areas referring either to the nature of the study or to the object in analysis. Studies were selected primarily on the basis of their original contribution to the field, the significance of major findings in the study, the fact that they were written primarily by Arab authors about the Middle East. The specific focus of this project was to identify scientific studies by Arab researchers in the Middle Eastern region that linked traumatic life experiences to Mental Health and to Health, with a specific focus on Mental Health programs, institutions, and the Primary Health Care system.

Bhugra et al. (2011): WPA Guidance on Mental Health and Mental Health Care in Migrants

  • URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048516/
  • Description: The purpose of this 2011 guidance is to review currently available evidence on mental health problems in migrants and to present advice to clinicians and policy makers on how to provide migrants with appropriate and accessible mental health services. The concepts of cultural bereavement, cultural identity and cultural congruity are discussed. The epidemiology of mental disorders in migrants is described. A series of recommendations to policy makers, service providers and clinicians aimed to improve mental health care in migrants are provided, covering the special needs of migrants concerning pharmacotherapies and psychotherapies.

Campbell (2012). Social determinants of mental health in new refugees in the UK: Cross-sectional and longitudinal analyses

  • URL: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60383-9/fulltext?version=printerFriendly
  • Description: The mental health of resettled refugees is poorer than that of the general population. Resettlement to a new country and culture can present social challenges, such as building new social support networks and gaining suitable employment. Social factors in resettlement represent modifiable targets for public health policies and interventions to improve refugee mental health. Despite implicating individual social factors, previous research has failed to adjust for potential confounding by investigating many social determinants simultaneously. Additionally, there is a dearth of research causally and temporally linking social determinants and mental health with longitudinal analysis. This study investigated the effect of social determinants on mental health in new refugees with adjusted cross-sectional and longitudinal analysis.

Delara (2016). Social determinants of immigrant women’s mental health

  • URL: http://www.hindawi.com/journals/aph/2016/9730162/
  • Description: Migration is a population movement with enormous challenges for immigrant women that influence their mental health. Mental health is a social issue and its determinants need to be recognized for health policy making. This paper reviews and consolidates findings from the existing literature on social determinants of immigrant women’s mental health within a socioecological framework. Findings of this review revealed that mental health of immigrant women is an outcome of several interacting determinants at social, cultural, and health care system levels and hence calls for many different ways to promote it. Recommendations for mental health promotion of immigrant women with respect to research, education, practice, and policy are explored.

Kirmayer et al. (2011) Common mental health problems in immigrants and refugees: General approach in primary care

  • URL: http://www.cmaj.ca/content/183/12/E959.full
  • Description: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. This 2011 report aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care.

Murray, Davidson, & Schweitzer (2010): Review of Refugee Mental Health Interventions Following Resettlement: Best Practices and Recommendations

  • URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727171/
  • Description: Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. This 2010 review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction.

Pfortmueller et al. (2016). Adult asylum seekers from the Middle East including Syria in Central Europe: What are their health care problems?

  • URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0148196
  • Description: Forced displacement related to persecution and violent conflict has reached a new peak in recent years. The primary aim of this study was to provide an initial overview of the acute and chronic health care problems of asylum seekers from the Middle East, with special emphasis on asylum seekers from Syria. The most common reason for presentation was surgical (381, 43.3%), followed by medical (321, 36.5%) and psychiatric (137, 15.6%). Patients from Syria were significantly more likely to suffer from a post-traumatic stress disorder than patients of other nationalities. Overall a remarkable number of our very young group of patients suffered from psychiatric disorders and unspecified somatic symptoms. Asylum seekers should be carefully evaluated when presenting to a medical facility and physicians should be aware of the high incidence of unspecified somatic symptoms in this patient population.

Pottie et al. (2016). Caring for a newly arrived Syrian refugee family

  • URL: http://www.cmaj.ca/content/188/3/207.full
  • Description: This article uses the fictional case of a young Syrian family arriving in Canada to illustrate the specific steps that health care professional should take to assess and provide care for all members of the family. The article includes a number of resources recommended for use in the assessment of physical, mental, and sociocultural needs of Syrian refugees. In addition, the authors provide recommendations for best practice for all members of the health care spectrum when providing care to Syrian refugees.

The Harvard Program in Refugee Trauma: An Annotated Bibliography on Trauma, Mental Health, and Primary Health Care in the Middle East

  • URL: http://hprt-cambridge.org/wp-content/uploads/2014/08/Amawi-et-al-Annoted-Bibliography-Trauma-Middle-East-2014.pdf
  • Description: The references in this 2014 bibliography are organized by content areas referring either to the nature of the study or to the object in analysis. Studies were selected primarily on the basis of their original contribution to the field, the significance of major findings in the study, the fact that they were written primarily by Arab authors about the Middle East. The specific focus of this project was to identify scientific studies by Arab researchers in the Middle Eastern region that linked traumatic life experiences to Mental Health and to Health, with a specific focus on Mental Health programs, institutions, and the Primary Health Care system.

 

Refugee Health Clinics And Centres

 

British Columbia

Alberta

Saskatchewan

Manitoba

Ontario

Québec

New Brunswick

Nova Scotia

Prince Edward Island

Newfoundland & Labrador