Mental Health First Aid training for leaders from spiritual communities


Building Bridges for Inclusive Care is an initiative being implemented by the Peel Service Collaborative which has dedicated itself to building bridges between the formal and informal (e.g. faith-based) mental health and addiction support systems in PeelThe Peel region has one of the highest religious affiliation rates in the Greater Toronto area and for many believers, their spiritual community is one of the first places to turn to for help.  In recognition of the informal support faith communities play in mental health care, community leaders are invited to take part in Mental Health First Aid training.
During the first week of March 2014, ten leaders from spiritual communities completed a 2-day course on Mental Health First Aid for adults who work with youth.  The leaders were a diverse group including Buddhist Venerables, a Muslim Imam, and Anglican priests, amongst others. To date, 33 leaders from faith communities have been trained through the 14-hour Mental Health First Aid program.  An initiative of the Mental Health Commission of Canada, the Mental Health First Aid program has been shown to reduce stigma, raise awareness, and provide tools to support and connect community members in need with formal mental health support.  
For more information on the Mental Health First Aid program offered throughout Canada, please visit:
If you are a leader from a spiritual community in the Peel region and you are interested in taking an upcoming course in Mental Health First Aid, offered at no cost, please contact Sarah Waldman at or call 416-535-8501 X 36608


Joseph P. Gone on Cultural Competence

“We are all embedded in cultural processes and practices… we have a lot of assumptions and orientations that are cultural themselves these are not always shared with the people we work with.”

Joseph P. Gone, PhD, Associate Professor of Psychology (Clinical Area) and American Culture (Native American Studies) at the University of Michigan in Ann Arbor talks about cultural competence: what is it, what is the relationship between evidence-based practice and cultural competence and how does cultural competence relate to mental health care and mental health care for Indigenous populations in particular?

For more information on Dr. Gone, please visit his website

Podcast: Towards Culture-Conscious Mental Health Services in Saskatchewan

Dr. Sadeq Rahimi provides a review of Saskatchewan’s state of legal policy and strategies. He concludes that given the rapid pace of migration-induced demographic changes in Saskatchewan, there is an urgent need for government policies that address mental health requirements of a culturally diverse population. He states that there is an absence of cultural awareness in Saskatchewan policies and identifies an acute need for culturally competent services and expertise across the province. He suggests a reformulation of health policies and regulations in a culture-conscious fashion.   

New book: Cultural Consultation

The MMHRC is pleased to share news of the release of a new book edited by members of the MMHRC steering comittee. Cultural Consultation: Encountering the Other in Mental Health Care is edited by Laurence Kirmayer, Jaswant Guzder, and Cécile Rousseau and is published by Springer.

Cultural diversity is a global challenge for mental health services. The changing demography of communities requires rethinking approaches to cultural competence for health professionals and institutions. Cultural consultation is a way to improve the quality of mental health care by providing a nuanced understanding of the predicaments that prompt diverse clients to seek help, and the social contexts of their mental health problems, to guide clinical assessment and intervention.

Cultural Consultation explores the practice of cultural consultation as a strategy to improve the quality of mental health care for diverse populations. The contributors, who have worked together at an innovative clinical service, frame best practices in psychiatry clinical psychology, and social work in relation to empathy, human rights, and culturally responsive and ethically sound care. A detailed model of the process of cultural consultation, from initial intake, through assessment, to recommendations and referrals, provides guidelines for clinical practice. Expert contributors examine specialized settings (medical, psychiatric emergency, inpatient, social/legal services), populations (remote, indigenous, child and youth), and contextual issues in the care of people with a wide range of mental health problems.

Numerous case examples, charts, and tools add depth for readers interested in developing similar services or enhancing existing practice. Among the key areas covered:

  • Working with interpreters and culture brokers.
  • Family systems in cultural consultation.
  • Gender, power, and ethnicity in cultural consultation.
  • Consultation and mediation with racialized and marginalized communities. Collaborative care and primary care consultation.
  • Cultural consultation with refugees.

A unique guide to challenges and opportunities in contemporary practice, Cultural Consultation will be immediately useful for health care professionals, clinical psychologists, and cultural consultants and provide a versatile knowledge source for years to come.

Introduction: The Place of Culture in Mental Health Services.- Development and Evaluation of the Cultural Consultation Service.- The Process of Cultural Consultation.- Cultural Consultation in Child Psychiatry.- Working with Interpreters.- Culture Brokers, Clinically Applied Ethnography and Cultural Mediation.- Family Systems in Cultural Consultation.- Gender, Power & Ethnicity in Cultural Consultation.- Community Consultation and Mediation with Racialized and Marginalized Minorities.- Addressing Cultural Diversity Through Collaborative Care.- Consultation to Remote and Indigenous Communities.- Cultural Consultation for Refugees.- Consultation to Youth Protection and Legal Settings.- Cultural Consultation in General Hospital Psychiatry.- Cultural Consultations in Medical Settings.- Conclusion: The Future of Cultural Consultation.
To review sample pages of the book, please visit the book’s website.

Cécile Rousseau: A Relational Story


“It’s not only about the migrants, it’s about the migrants and us as a majority… just like in a couple we’re part of the equation.”

Cécile Rousseau, Director of the Transcultural Child Psychiatry Clinic at the Montreal Children’s Hospital proposes a widening of focus when we think of immigrants and mental health to include the majority population. How does a host population feel about immigrants? Is the host community welcoming to this group? Dr. Rousseau discusses inter-community tensions between immigrant groups and the majority population and the tendency, when either group is feeling threatened, to close inwards, exacerbating tensions. Integration and adaptation into a new community is an important factor in the mental health of new Canadians and Dr. Rousseau stresses that all Canadians, new and established, play a part in it.

Refugee Mental Health: Trauma and Resilience

Dr. Laurence Kirmayer was interviewed by Dr. Sofie Bäärnhielm, Director, Transkulturellt Centrum, Stockholms läns landsting, Stockholm February 2012.

Background Reading:

Adeponle, A. B., Thombs, B. D., Groleau, D., Jarvis, E., & Kirmayer, L. J. (2012). Using the cultural formulation to resolve uncertainty in diagnoses of psychosis among ethnoculturally diverse patients. Psychiatric Services, 63(2), 147-153. doi: 10.1176/

Afana, A.-H., Pedersen, D., Rønsbo, H., & Kirmayer, L. J. (2010). “Endurance is to be shown at the first blow”: Social representations and reactions to traumatic experiences in the Gaza strip. Traumatology, 16(4), 73-84.

Beiser, M. (2009). Resettling refugees and safeguarding their mental health: lessons learned from the Canadian Refugee Resettlement Project. Transcultural Psychiatry, 46(4), 539-583. doi: 46/4/539 [pii] 10.1177/1363461509351373

Cleveland, J., Rousseau, C., & Guzder, J. (2013). Cultural consultation for refugees. In L. J. Kirmayer, J. Guzder & C. Rousseau (Eds.), Cultural Consultation: Encountering the Other in Mental Health Care (pp. 245-269). New York: Springer.

Kidron, C. A. (2012). Alterity and the particular limits of universalism: Comparing Jewish-Israeli and Canadian-Cambodian genocide legacies. Current Anthropology, 53(6), 723-754.

Kinzie, D. (2007). PTSD among traumatized refugees. In L. J. Kirmayer, R. Lemelson & M. Barad (Eds.), Understanding Trauma: Biological, Psychological and Cultural Perspectives (pp. 194-206). New York: Cambridge University Press.

Kirmayer, L. J. (1996). Landscapes of memory: Trauma, narrative and dissociation. In P. Antze & M. Lambek (Eds.), Tense Past: Cultural Essays on Memory and Trauma (pp. 173-198). London: Routledge.

Kirmayer, L. J. (1996). Confusion of the senses: Implications of ethnocultural variations in somatoform and dissociative disorders for PTSD. In A. J. Marsella, M. J. Friedman, E. T. Gerrity & R. M. Scurfield (Eds.), Ethnocultural Aspects of Post-Traumatic Stress Disorders: Issues, Research and Clinical Applications (pp. 131-164). Washington: American Psychological Association.

Kirmayer, L. J. (2001). Failures of imagination: The refugee’s narrative in psychiatry. Anthropology & Medicine, 10(2), 167-185.

Kirmayer, L. J. (2002). The refugee’s predicament. L’Évolution Psychiatrique, 67, 724-742.

Kirmayer, L. J., Guzder, J., & Rousseau, C. (Eds.). (2013). Cultural Consultation: Encountering the Other in Mental Health Care. New York: Springer.

Kirmayer, L. J., Kienzler, H., Afana, A. H., & Pedersen, D. (2010). Trauma and disasters in social and cultural context. In D. Bhugra & C. Morgan (Eds.), Principles of Social Psychiatry (2 ed., pp. 155-177). New York: Wiley-Blackwell.

Kirmayer, L. J., Lemelson, R., & Barad, M. (Eds.). (2007). Understanding trauma: Integrating biological, clinical, and cultural perspectives. New York: Cambridge University Press.

Kirmayer, L., Narasiah, L., Muñoz, M., Rashid, M., Ryder, A., Guzder, J., . . . Rousseau, C. (2011). Common mental health problems in immigrants and refugees: General approach to the patient in primary care. Canadian Medical Association Journal, 183(12), E959-967. doi: 10.1503/cmaj.090292

Kirmayer, L. J., Rousseau, C., & Crepeau, F. (2004). Research ethics and the plight of refugees in detention. Monash Bioethics Review, 23(4), 85-92.

Kirmayer, L. J., Rousseau, C., & Measham, T. (2010). Sociocultural considerations. In D. Benedek & G. H. Wynn (Eds.), Clinical Manual for the Management of Posttraumatic Stress Disorder. Washington: American Psychiatric Publishing, Inc.

Lemelson, R., Kirmayer, L., & Barad, M. (2007). Trauma in context: Integrating cultural, clinical and biological perspectives. . In L. Kirmayer, R. Lemelson & M. Barad (Eds.), Understanding trauma, Integrating biological, clinical, and cultural perspectives (pp. 451-474). New York: Cambridge University Press.

McFarlane, C. A., & Kaplan, I. (2012). Evidence-based psychological interventions for adult survivors of torture and trauma: A 30-year review. Transcultural Psychiatry, 49(3-4), 539-567. doi: 10.1177/1363461512447608

Quirk, G. J., Milad, M. R., Santini, E., & Lebrón, K. (2007). Learning not to fear: A neural systems approach. In L. J. Kirmayer, R. Lemelson & M. Barad (Eds.), Understanding Trauma: Integrating Biological, Clinical, and Cultural Perspectives (pp. 60-77). New York: Cambridge University Press.

Rousseau, C., & Measham, T. (2007). Posttraumatic suffering as a source of transformation: A clinical perspective. In L. J. Kirmayer, R. Lemelson & M. Barad (Eds.), Understanding Trauma: Biological, Psychological and Cultural Perspectives (pp. 275-294). New York: Cambridge University Press.

Silove, D. (2007). Adaptation, ecosocial safety signals, and the trajectory of PTSD. In L. J. Kirmayer, R. Lemelson & M. Barad (Eds.), Understanding Trauma: Biological, Psychological and Cultural Perspectives (pp. 242-258). New York: Cambridge University Press.