Sheeba Narikuzhy - Newcomer youth mental health needs, barriers & best practices


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Sheeba Narikuzhy - Newcomer youth mental health needs, barriers & best practices

  1. 1. Newcomer Youth Mental Health -a discussion on needs, barriers and promising practices Sheeba Narikuzhy, M.A (Psychology) Oleg Valin, OCT
  2. 2. Why focus on newcomer youth mentalhealth? Strengthen & expand our existing models of care Early Intervention & Treatment  Economic cost of mental illness in Canada- $7.3 billions in 1993 & $57 billion in 2010 (CAMH study 2010) Growing newcomer population in Canada  1996 - Immigrants represent 17% of total population in Canada (Stats Canada)  1996 - 42% of all Toronto residents were immigrants
  3. 3. Mental Health Problems inNewcomer Youth Increased somatoform disorders in Asian children ( Jawed, BJP 1991) possibly due to parental readiness to detect & acknowledge physical problems Increase in depression, self harm/suicide rates Bullying/ Cyber bullying
  4. 4. Major Themes identified fromworking with Newcomer Families Undiagnosed/unidentified mental health problems Stigma Lack of knowledge about mental health problems & available services Post traumatic symptoms related to violence/war & trauma
  5. 5. Determinants of mental health fornewcomer youth  Social, cultural and economic status  Parental psycho pathology  Family discord  Ineffective parenting/harsh disciplines  Children prematurely assuming adult roles  Adjusting to Canadian education system  Stigma related to ESL classes Shakya, Canada 2008
  6. 6. Determinants of mental health fornewcomer youth, continued…. Traumatic experiences in their native country Experiences during their journey to the new country Settlement related difficulties in the new country
  7. 7. Increased psychological stress forimmigrant youth Rapid physical development and deep emotional changes during adolescence Increased vulnerability to stress Accentuated stress for immigrant youth
  8. 8. Role of Family in AdolescentMental Health Supportive Family Networks buffer against effects of stress ( Maynard. J et. al, 2010) Social Support, Peer & Community relations Quality of Family Interactions Socio economic status Family structure/traditions/values Role Modeling
  9. 9. Protective Factors for NewcomerYouth Mental Health Supportive Family Networks buffer against effects of stress ( Maynard. J et. al, 2010) Ethnic Density- People reside in neighbourhoods of higher own group density experiences buffering effects from social risk factors of psychosis (Munshi J. et. Al, BJP 2012 )
  10. 10. Protective Factors- contd… Social Support, Peer & Community relations Quality of Family Interactions & Frequency of Family Activities Socio economic status Family structure/traditions/values- extended family support
  11. 11. Stats Mental health problems account for half of all disability among young people between the age of 10-24 45% of youth disability is related to depression, bipolar disorder, schizophrenia and substance abuse Study by WHO - June 6, 2011
  12. 12. Stats continued… 10-20% of Canadian youth are affected by mental illness In Canada 1 in 5 kids have mental health problems and only 1 out of 5 children who need mental health services receives them Approximately 4,000 youth die prematurely each year by suicide Stats Canada
  13. 13. Stats contd…  Low income rate for newcomer youth is 3 times higher than for Canadian born youth.  Unemployment rate for newcomers is 15.4% compared to 12.5% for Canadian born youth. Census Canada (2009)
  14. 14. Immigrant kids who arrive late morelikely to drop out of high school 15% boys & 11% girls who come to Canada after the age of 9 ultimately dropped out of high school compared to Canadian average 10.3 & 6.6 % respectively 21.6% (more than 1 in 5) kids who come to Canada at age 15 dropped out of school - Corak’s study (2011) , based on Census Canada 2006
  15. 15. High risk for emotional problemsfor Immigrant children in Toronto Immigrant children (from Hong Kong, China & Philippines) living in Toronto are at high risk for emotional problems Possible reasons include: Poor home –school relationships and marginalization Dr. Beiser, 2010 ( New Canadian Children and Youth Study)
  16. 16. Challenges in Engaging Parents ofNewcomer Youth for Mental Health Services Family’s belief system/previous experience may impede their youth’s treatment and recovery Stigma and lack of awareness/knowledge on mental health issues/services Language barrier & cultural shock Challenges in ethnic identity formation
  17. 17. Case ExampleClient Y, a 15 yr old female Family came to Toronto as refugees Language barrier & financial problems Referral to EMYS from hospital for individual & family work, had multiple admissions for psychotic episodes; symptoms stabilized with medication Parents deeply concerned & reaching out for support
  18. 18. Case Example Challenges Parents believed someone “casted eye” on Y Family took Y to faith healer who suggested a sugar free diet and special prayers & to stop taking medication Y stopped taking medication & had a relapse Treatment outcomes:  Y was placed at residential program  Parents agreed with treatment plan after many sessions of intensive family therapy/ psycho education sessions  Y was transitioned to adult mental health system
  19. 19. Challenges continued… Parents’ mental health issues Emotional and social unavailability of parents Unidentified mental health issues Long waitlist for services Limited linguistically appropriate services Lack of understanding about, and trust for available resources
  20. 20. Newcomer Youth Program- EMYS Acculturation and Mental Health “Out of the Box Approach” Statistics on our program External partnerships Concerns and challenges
  21. 21. Promising Practices for NewcomerFamily Engagement Psycho education Cultural competent services Provision of linguistically appropriate services Mental Health Awareness through various media e.g. ethnic newspapers/ radio stations, Facebook etc. Education of Family Physicians
  22. 22. Promising Practices – contd… Facilitating Leadership involving family & community members from minority groups Collaboration between agencies for cultural consultation & interpretation School based screening/ skills training for identified youth Building social/peer support system for youth
  23. 23. Promising Practices- contd…. Creative/ ‘out of the box’ approach to engaging women e.g. Women’s sewing or cooking groups, girls soccer team etc. Connecting Families with ethno specific social/recreational groups Involving Family in therapeutic process as much as possible
  24. 24. Promising Practices- contd…. Information sessions on appropriate parenting practices at settlement agencies/other agencies serving newcomers Information on available resources e.g. kids helpline, mobile crisis unit Collaboration with religious leaders/institutions to support and enhance youth/family engagement
  25. 25. Questions or Comments?Sheeba NarikuzhyClinical SupervisorEast Metro Youth ServicesE-mail: