Podcast: Common mental health problems among immigrants

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In this podcast, Dr. Laurence J. Kirmayer describes the key points of the common mental health problems review of the Canadian Collaboration for Immigrant and Refugee Health Evidence-based clinical guidelines.

Key points:

  • Among immigrants, the prevalence of common mentalhealth problems is initially lower than in the generalpopulation, but over time, it increases to become similar tothat in the general population.
  • Refugees who have had severe exposure to violence often have higher rates of trauma-related disorders, including post-traumatic stress disorder and chronic pain or other somatic syndromes.
  • Assessment of risk for mental health problems includes consideration of premigration exposures, stresses and uncertainty during migration, and postmigration resettlement experiences that influence adaptation and health outcomes.
  • Clinical assessment and treatment effectiveness can be improved with the use of trained interpreters and culture brokers when linguistic and cultural differences impede communication and mutual understanding.

This podcast was made with reference to the following paper:

Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J., . . . Pottie, K. (2010). Common mental health problems in immigrants and refugees: general approach in primary care. Can Med Assoc J. doi: cmaj.090292 [pii]
10.1503/cmaj.090292

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.