Abstract
Background
Youth comprise a significant portion of the total immigrant population in Canada. Immigrant and refugee youth often have different migration trajectories and experiences, which can result in different mental health outcomes. Research is emerging in this area, but study findings have not yet been consolidated.
Research Question
What is known from the existing literature about mental health issues and concerns among immigrant and refugee youth in Canada?
Method
We searched Embase, Health Star, Medline, CINAHL, PsycINFO, and Social Science Abstracts databases for the period 1990–2013 for Canadian studies related to the mental health of youth born outside Canada. Seventeen studies met inclusion criteria.
Results
Determinants of mental illness included pre-migration experiences, number of years since immigration to Canada, post-migration family and school environment, in- and out-group problems, discrimination, and lack of equitable access to health care. Only a few common categories of mental illness were identified, and the burden of mental illness was shared differently across gender and immigration status, with female youth experiencing more mental health problems than male youth. Some studies identified fewer emotional and behavioural problems among refugee youth; others reported higher rates of psychopathology among refugee youth compared with their Canadian-born provincial counterparts. Pre-migration experiences and the kinds of trauma experienced were important for refugee youth’s mental health. Findings also indicated the importance of family involvement, school settings as points of care and services, and in terms of timing, focusing on the first year of arrival in Canada.
Practice Implications
Professionals must work across health, social, and settlement sectors to address the various pre- and post-migration determinants of mental health and illness, and provide more timely and effective services based on how and when these determinants affect different groups of youth.
Key Words: Canada, immigrant youth, mental health, mental illness, refugee youth, scoping review
Résumé
Contexte
Les jeunes représentent une part importante de la population immigrante au Canada. Les jeunes immigrants et réfugiés ont souvent des trajectoires et des expériences migratoires différentes, ce qui peut entraîner des différences dans leurs résultats de santé mentale. La recherche en ce domaine commence à émerger, mais les constatations des études n’ont pas encore été regroupées.
Question de Recherche
Que dit la littérature actuelle sur les problèmes et les préoccupations de santé mentale des jeunes immigrants et réfugiés au Canada?
Méthode
Nous avons interrogé les bases de données Embase, Health Star, Medline, CINAHL, PsycINFO et Social Sciences Abstracts pour la période de 1990 à 2013 afin de répertorier les études canadiennes portant sur la santé mentale des jeunes nés à l’extérieur du Canada. Dix-sept études ont répondu à nos critères d’inclusion.
Résultats
Les déterminants de la maladie mentale étaient les expériences pré-migratoires, le nombre d’années depuis l’immigration au Canada, le milieu familial et scolaire post-migration, les problèmes intra- et extra-groupe, la discrimination et le manque d’accès équitable aux soins de santé. Seul un petit nombre de catégories courantes de maladies mentales ont été répertoriées, et le fardeau de la maladie mentale était inégalement réparti selon le sexe et le statut d’immigration, les jeunes filles éprouvant davantage de troubles de santé mentale que les jeunes garçons. Certaines études font état d’un moins grand nombre de problèmes émotionnels et comportementaux chez les jeunes réfugiés; d’autres observent des taux supérieurs de psychopathologies chez les jeunes réfugiés comparativement à leurs homologues provinciaux nés au Canada. Les expériences prémigratoires et les types de traumatismes vécus sont importants pour la santé mentale des jeunes réfugiés. Les constatations indiquent aussi l’importance de l’implication familiale, du milieu scolaire en tant que point d’intervention et de service, et de la première année suivant l’arrivée au Canada.
IMPLICATIONS PRATIQUES
Les professionnels doivent travailler à la fois dans le secteur sociosanitaire et avec les services d’établissement pour aborder les divers déterminants pré- et post-migratoires de la santé et de la maladie mentales; ils doivent également offrir des services plus rapides et plus efficaces, fondés sur la façon dont ces déterminants affectent différents groupes de jeunes et sur le moment où ils les affectent.
Mots Clés: Canada, jeunes immigrants, santé, mentale, maladie mentale; jeunes réfugiés, étude de champ
Footnotes
Acknowledgements: This study was supported by a grant from the Ministry of Health and Long-Term Care (Grant # 06662). The first author also acknowledges financial support for her work from the Institute of Gender and Health of Canadian Institutes of Health Research in the form of a New Investigator Award.
Conflict of Interest: None to declare.
References
- 1.Statistics Canada. NHS Profile, Canada, 2011. Ottawa, ON: Statistics Canada; 2013. [Google Scholar]
- 2.Department of CitizenshipImmigration Canada FactsFigures 2013 . Immigration Overview. 2015. [Google Scholar]
- 3.Wilson RM, Murtaza R, Shakya YB. Canadian Issues: Immigrant Mental Health. 2010. Determinants of mental health for newly arrived refugees in Toronto; pp. 45–50. [Google Scholar]
- 4.Hynie M, Guruge S, Shakya YB. Family Relationships of Afghan, Karen and Sudanese refugee youth. Can Ethn Stud. 2013;44(3):11–28. doi: 10.1353/ces.2013.0011. [DOI] [Google Scholar]
- 5.Beiser M, Simich L, Pandalangat N. Community in distress: Mental health needs and help-seeking in the Tamil community in Toronto. Int Migr. 2003;41(5):233–45. doi: 10.1111/j.0020-7985.2003.00268.x. [DOI] [Google Scholar]
- 6.Guruge S, Khanlou N. Refugee Youth, Gender and Identity: On the Margins of Mental Health Promotion. Not Born a Refugee Woman. New York, NY: Berghahn Books; 2008. pp. 173–79. [Google Scholar]
- 7.Shakya YB, Guruge S, Hynie M, Akbari A, Malik M, Htoo S, et al. Aspirations for higher education among newcomer refugee youth in Toronto: Expectations, challenges, and strategies. Refuge. 2010;27(2):65–78. [Google Scholar]
- 8.Pumariega AJ, Rothe E, Pumariega JB. Mental health of immigrants and refugees. Community Ment Health J. 2005;41(5):581–97. doi: 10.1007/s10597-005-6363-1. [DOI] [PubMed] [Google Scholar]
- 9.Beiser M, Hou F, Hyman I, Tousignant M. Poverty, family process, and the mental health of immigrant children in Canada. Am J Public Health. 2002;92(2):220–27. doi: 10.2105/AJPH.92.2.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.O’Mahony JM, Donnelly TT. The influence of culture on immigrant women’s mental health care experiences from the perspectives of health care providers. Issues Ment Health Nurs. 2007;28(5):453–71. doi: 10.1080/01612840701344464. [DOI] [PubMed] [Google Scholar]
- 11.Levac D, Colquhoun H, O’Brien KK. Scoping studies: Advancing the methodology. Implement Sci. 2010;5:69. doi: 10.1186/1748-5908-5-69. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Mays N, Roberts E, Popay J. Synthesizing research evidence. In: Fulop N, Allen P, Clarke A, Black N, editors. Studying the Organisation and Delivery of Health Services: Research Methods. London, UK: Routledge; 2001. p. 194. [Google Scholar]
- 13.Arksey H, O’Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. doi: 10.1080/1364557032000119616. [DOI] [Google Scholar]
- 14.*Hyman I. Post-migration stresses among Southeast Asian refugee youth in Canada: A research note. J Comp Fam Stud. 2000;31(2):281–93. [Google Scholar]
- 15.*Jorden S, Matheson K, Anisman H. Supportive and unsupportive social interactions in relation to cultural adaptation and psychological distress among Somali refugees exposed to collective or personal traumas. J Cross Cult Psychol. 2009;40(5):853–74. doi: 10.1177/0022022109339182. [DOI] [Google Scholar]
- 16.*Khanlou N, Crawford C. J Immigr Minor Health. 2006. Post-migratory experiences of newcomer female youth: Self-esteem and identity development; pp. 45–56. [DOI] [PubMed] [Google Scholar]
- 17.*Lay C, Nguyen T. The role of acculturation-related and acculturation nonspecific daily hassles: Vietnamese-Canadian students and psychological distress. Can J Behav Sci. 1998;30(3):172–81. doi: 10.1037/h0087060. [DOI] [Google Scholar]
- 18.*Pak AW, Dion KL, Dion KK. Social-psychological correlates of experienced discrimination: Test of the double jeopardy hypothesis. Int J Intercult Relations. 1991;15(2):243–53. doi: 10.1016/0147-1767(91)90032-C. [DOI] [Google Scholar]
- 19.*Persson TJ, Rousseau C. Adolesc Psychiatry (Hilversum) 2012. The association between migratory factors and emotional and behavioural symptoms in very recently arrived immigrant and refugee adolescents; pp. 46–51. [Google Scholar]
- 20.*Rousseau C, Drapeau A. Parent-child agreement on refugee children’s psychiatric symptoms: A transcultural perspective. J Am Acad Child Adolesc Psychiatry. 1998;37(6):629–36. doi: 10.1097/00004583-199806000-00013. [DOI] [PubMed] [Google Scholar]
- 21.*Rousseau C, Said TM, Gagné MJ, Bibeau G. Resilience in unaccompanied minors from the north of Somalia. Psychoanal Rev [Internet] 1998;85(4):615–37. [PubMed] [Google Scholar]
- 22.*Rousseau C, Drapeau A. Scholastic achievement of adolescent refugees from Cambodia and Central America. Adolescence. 2000;35(138):243–58. [PubMed] [Google Scholar]
- 23.*Rousseau C, Drapeau A, Platt R. Can J Psychiatry. 2000. Living conditions and emotional profiles of Cambodian, Central American, and Québécois youth; pp. 905–11. [DOI] [PubMed] [Google Scholar]
- 24.*Rousseau C, Drapeau A, Rahimi S. The complexity of trauma response: A 4-year follow-up of adolescent Cambodian refugees. Child Abuse Negl. 2003;27(11):1277–90. doi: 10.1016/j.chiabu.2003.07.001. [DOI] [PubMed] [Google Scholar]
- 25.*Rousseau C, Drapeau A, Platt R. Family environment and emotional and behavioural symptoms in adolescent Cambodian refugees: Influence of time, gender, and acculturation. Med Confl Surviv. 2004;20(2):151–65. doi: 10.1080/1362369042000234735. [DOI] [PubMed] [Google Scholar]
- 26.*Rousseau C, Benoit M, Gauthier L, Lacroix M-F, Alain N, Viger Rojas M, et al. Classroom drama therapy program for immigrant and refugee adolescents: A pilot study. Clin Child Psychol Psychiatry. 2007;12(3):451–65. doi: 10.1177/1359104507078477. [DOI] [PubMed] [Google Scholar]
- 27.*Rousseau C, Hassan G, Measham T, Lashley M. Prevalence and correlates of conduct disorder and problem behavior in Caribbean and Filipino immigrant adolescents. Eur Child Adolesc Psychiatry. 2008;17(5):264–73. doi: 10.1007/s00787-007-0640-1. [DOI] [PubMed] [Google Scholar]
- 28.*Rousseau C, Hassan G, Measham T, Moreau N, Lashley M, Castro T, et al. From the family universe to the outside world: Family relations, school attitude, and perception of racism in Caribbean and Filipino adolescents. Health Place. 2009;15(3):721–30. doi: 10.1016/j.healthplace.2008.12.004. [DOI] [PubMed] [Google Scholar]
- 29.Rousseau C, Armand F, Laurin-Lamothe A, Gauthier R, Saboundjian M-F. A pilot project of school-based intervention integrating drama and language awareness. Child Adolesc Ment Health. 2012;17(3):187–90. doi: 10.1111/j.1475-3588.2011.00629.x. [DOI] [PubMed] [Google Scholar]
- 30.Tousignant M, Habinama E, Biron C, Malo C, Sidoli-LeBlanc The Quebec adolescent refugee project: Psychopathology and family variables in a sample from 35 nations. J Am Acad Child Adolesc Psychiatry. 1999;38(11):1426–32. doi: 10.1097/00004583-199911000-00018. [DOI] [PubMed] [Google Scholar]