Jaswant Guzder on Child Cultural Consultations

Jaswant Guzder, head of Child Psychiatry at the Jewish General Hospital, talks about Cultural Consultation sessions with children. What are the principles of child cultural competence, what are some typical agendas during child cultural consultations, and what are some themes of concern?

Lost in Translation: Mental Health of Newcomers

Lost in Translation: Mental Health of Newcomers – New Canadian Media

An interview with Dr. Jaswant Guzder on issues of access to mental health care for immigrants and refugees and the importance of interpreters. Includes discussion of suicide, psychosis, depression, and cultural consultation.

Invisible Children

For many illegal immigrants who have children, one of their main concerns is access to schooling. Without valid documentation, the parents are often forced to pay school fees for their children, which is not always possible. Some parents decide not to send their children to school, out of fear of being identified. In the cases where the school admits a child without papers, they do not receive a student number (“permanent code” in Quebec), which affects their access to a diploma at the end of their studies. Doubly vulnerable due to their their illegal status and their age, these children are effectively invisible within the education system.
A group formed of organizations such as the Centre des travailleurs immigrants, La Mission communiautaire de Montréal and La Commission des droits de la personne, along with other researchers and smaller community organizations combined their efforts with the goal of obtaining access to education for all children in Quebec, regardless of status.
Before the new school year began in Fall 2013, the group was met with their first achievement: the Ministry of Education put forward certain measures to allow more children without status into Quebec schools and to be given a permanent code. This access is limited to only certain categories of youth, but the group is buoyed by their progress and by the opening of dialogue with the government.
A feature in French about Francesca Meloni, one of the members of the group working for access to education for children without status, can be found on the Sherpa Recherche site here. You can also read Meloni’s PhD thesis in English, Living with Uncertainty: An Ethongraphic Study on the Agency and Belonging of Undocumented Youth in Canada here.

François Crépeau, Rapporteur spécial de l’ONU sur les migrants : « les migrants ont aussi des droits » | Radio des Nations Unies

Sorry, this entry is only available in French. For the sake of viewer convenience, the content is shown below in the alternative language. You may click the link to switch the active language.

François Crépeau, Rapporteur spécial de l’ONU sur les migrants : « les migrants ont aussi des droits » | Radio des Nations Unies.

François Crépeau cite notamment le paiement d’une caution ou un système d’assignation à résidence ou la présentation périodique de ces migrants aux autorités judiciaires. « Il y a d’autres moyens de traiter ces migrants particulièrement à l’égard des enfants car la détention des enfants est une violation de leurs droits de façon systématique dans la mesure où c’est toujours contraire à leurs meilleurs intérêt », a-t-il souligné. De façon générale, il insiste sur l’appartenance de ces migrants à la société quel que soit leur statut administratif. « Ils n’ont peut-être pas le droit d’être là s’ils sont sans statut ou s’ils vivent dans des conditions de grande précarité, mais ces migrants font partie de la société. Nous sommes tous collectivement responsables d’eux comme nous sommes tous responsables de chacun des membres de cette société ».

Working with Vietnamese Americans: Clinical Manual

Working with Vietnamese Americans: A Clinical Training Manual for Mental Health Professionals
Thomas T. Nguyen
University of St. Thomas, Minnesota

Vietnamese Americans are among the most recent immigrants to the United States (Min, 2006). There is a higher need of mental health services for those who have witnessed traumatic events (i.e., war trauma and forced migration) and those struggling with acculturative stress. Unfortunately, there is a significant deficit of culturally appropriate mental health service providers in working with this specific population (U.S. Department of Health and Human Services, 2010). Despite efforts within the field in recent years to identify barriers to mental health services among Vietnamese Americans, mental health service utilization remains low and rates of early termination remains high. For many Vietnamese, low services utilization does not equate to a lesser need, but it reveals the many barriers (e.g., misunderstanding the Western concept of mental health, language communication, and cultural beliefs and practices) that prevent them from seeking mental health services. Further, a higher early termination rate is likely the result of the clinicians’ lack of cultural awareness and training. Thus, there is a need for a clinical training curriculum for mental health professionals working with this target group. The curriculum will address culturally appropriate interventions (i.e., multicultural awareness, understanding the Vietnamese cultural perception of mental illness, working with language interpreters, and intervention skills) to ensure that clinicians are better equipped with the knowledge and the skills to assist Vietnamese Americans, and also the ever-increasing diverse community.


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/appi.ps.201100280

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.

Dr. Cécile Rousseau on how identity affects mental health

The CBC speaks with Dr. Cécile Rousseau about psychiatry’s move toward integrating culture in training and psychiatric practices. Listen here for a fascinating dialogue about how this important aspect of identity is impacting the Canadian mental health context.  Dr. Rousseau is a professor in the Division of Social and Transcultural Psychiatry at McGill University in Montreal where she directs the Transcultural Child Psychiatry Clinic. She is also a member of the MMHRC steering committee.