Immigration, settlement process and mental health challenges of immigrants/ refugees: Alternative care thinking

Abstract

This paper discusses progressive thinking and clinical views on improving mental health practice for immigrants and refugees. It addresses policy, care delivery, professionals’ attitudes, and immigrants’ access to mental health care — all factors especially pertinent for practice in major immigration hubs. The data was gathered from invited presentations and discussions among participants at an international multidisciplinary symposium, including health and social scientists from Toronto (Canada) and Paris (France), major urban centres attracting large numbers of immigrant and refugees who constantly encounter challenges for their successful settlement. The focus is on alternative care thinking and innovative approaches for better care and understanding of these populations’ health behavior. Recommendations on how to advance knowledge relevant for these two urban hubs of immigration were documented, underpinned by the consensus that economic disparities, societal and political forces, as well as cultural and linguistic factors, influence immigrants’ and refugees’ vulnerability regarding mental health stability.

Inequities in Mental Health Care Facing Racialized Immigrant Older Adults With Mental Disorders Despite Universal Coverage: A Population-Based Study in Canada

“…From a care delivery perspective, mental health professionals should respond adequately and collaboratively to racialized immigrant older adults with mental disorders who had entered the mental health care system to receive a medical diagnosis. It is not solely a matter of training clinicians to be culturally responsive in a way that incorporates ethnocultural brokerage or ethnoracial pairing to create a safe therapeutic space, but also a call for engaging with a “structural competence approach” ( Bourgois et al, 2017 ; Metzl & Hansen, 2014 ) that could intervene in broader systemic conditions affecting many racialized immigrants’ choices and behaviors ( Zanchetta et al, 2021 ). It is essential to implement upstream interventions in dealing with fundamental social causes of health/illness ( Link & Phelan, 1995 ; Phelan & Link, 2005 ), such as housing insecurity ( Chen et al, 2022 ), for older racialized immigrant clients with mental disorders.…”