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Mental Health Consultation Among Ontario’s Immigrant Populations

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Abstract

To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario’s adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008–2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644). Amongst those who reported past-year mental health consultation, 57.89% of Ontario immigrants contacted their primary care physician, which was significantly higher than the proportion who consulted their family doctor from Canadian-born populations (45.31%). The factors of gender, age, racial/ethnic background, education level, working status, food insecurity status, self-perceived health status, smoking status, alcohol drinking status, years since immigration, and age at time of immigration were significantly associated with past-year mental health consultation for immigrant populations. Ontario’s adult immigrant populations most commonly consult their family doctor for mental health care. Potential exists for expanding the mental health care role of primary care physicians as well as efforts to increase accessibility of specialized mental health services. Integrated, coordinated care where primary care physicians, specialized mental health professionals, social workers, and community educators, etc. working together in a sort of “one-stop-shop” may be the most effective way to mitigate gaps in the mental health care system. In order to effectively tailor mental health policy, programming, and promotion to suit the needs of immigrant populations initiatives that focus on the connection between physical and mental health and migration variables such as length of stay in Canada, years since immigration, and other important migration variables (beyond the scope of the CCHS which require further study) need to be developed. Examination of the social determinants of mental health is critical to understand how we can best serve the mental health needs of Ontario’s immigrant populations.

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References

  • Agic, B. (2003). Health Promotion Programs on Mental Health/Illness and Addiction Issues in Ethno-Racial/Cultural Communities: A Literature Review. Centre for Addiction and Mental Health, 2003. Retrieved from http://www.camh.ca/en/education/Documents/www.camh.net/education/ethnocult_healthpromores02.pdf.

  • Ali, J. (2002). Mental health of Canada’s immigrants. Health Reports, 13(Suppl.), 1–11.

    Google Scholar 

  • Andersen, R. F., & Newman, J. F. (1973). Societal and individual determinants of medical care utilzation in the United States. Milbank Quarterly, 51, 95–124.

    Article  CAS  Google Scholar 

  • Aycan, Z., & Berry, J. W. (1996). Impact of employment-related experiences on immigrants’ psychological well-being and adaptation to Canada. Canadian Journal of Behavioural Science, 28(3), 240–251.

    Article  Google Scholar 

  • Badger, L. W., De Gruy, F. V., Hartman, J., Plant, M. A., Leeper, J., Ficken, R., Maxwell, A., Rand, E., Anderson, R., & Templeton, B. (1994). Psychosocial interest medical interviews, and recognition of depression. Archives of Family Medicine, 3, 899–907.

    Article  PubMed  CAS  Google Scholar 

  • Banerjee, A. T., Landry, M., Zawi, M., Childerhose, D., Stephens, N., Shafique, A., & Price, J. (2017). A pilot examination of a mosque-based physical activity intervention for South Asian muslim women in Ontario, Canada. Journal of Immigrant and Minority Health, 19(2), 349–357.

    Article  PubMed  Google Scholar 

  • Bergeron, P., Auger, N., & Hamel, D. (2009). Weight, general health and mental health: Status of diverse subgroups of immigrants in Canada. Canadian Journal of Public Health, 100(3), 215–220.

    PubMed  Google Scholar 

  • Bland, R. C., Newman, S. C., & Orn, H. (1997). Help seeking for psychiatric disorders. Canadian Journal of Psychiatry, 42, 935–942.

    Article  PubMed  CAS  Google Scholar 

  • Centre for Addiction and Mental Health. (2012). Best practice guidelines for mental health promotion programs: Refugees. Retrieved from http://knowledgex.camh.net/policy_health/mhpromotion/Documents/BPGRefugees.pdf.

  • Centre for Research on Inner City Health (CRICH). (2012). The mental health and well-being of immigrants in toronto: A report to the ministry of health and long-term care. Toronto: Li Ka Shing Knowledge Institute. Keenan Research Centre. St. Michael’s Hospital.

    Google Scholar 

  • Chen, A. W., & Kazanjian, A. (2005). Rate of mental health service utilization by Chinese immigrants in British Columbia. Canadian Journal of Public Health, 96(1), 49–51.

    PubMed  Google Scholar 

  • Chen, A. W., & Kazanjian, A. (2009). Do primary care providers who speak Chinese improve access to mental health care of Chinese immigrants?. Open Medicine, 3(1), e1

    PubMed Central  Google Scholar 

  • Chen, A. W., Kazanjian, A., & Wong, H. (2009). Why do Chinese Canadians not consult mental health services: Health status, language or culture? Transcultural Psychiatry, 46, 623–641.

    Article  PubMed  Google Scholar 

  • Coyne, J. C., Schwenk, T. L., Fechner-Bates, S. (1995). Nondetection of depression by primary care physicians reconsidered. General Hospital Psychiatry, 17, 3–12.

    Article  PubMed  CAS  Google Scholar 

  • Diaz-Granados, N., Georgiades, K., & Boyle, M. H. (2010). Regional and individual influences on use of mental health services in Canada. Canadian Journal of Psychiatry, 55(1), 9–20.

    Article  PubMed  Google Scholar 

  • Donnelly, T. T., et al. (2011). If i was going to kill myself, i wouldn’t be calling you. i am asking for help: Challenges influencing immigrant and refugee women’s mental health. Issues in Mental Health Nursing, 32(5), 279–290.

    Article  PubMed  Google Scholar 

  • Durbin, A., Durbin, J., Hensel, J. M., & Deber, R. (2013). Barriers and enablers to integrating mental health into primary care: A policy analysis. Journal of Behavioural Health Services Research, 43, 127–139.

    Article  Google Scholar 

  • Durbin, A., Lin, E., Moineddin, R., Steele, L. S., & Glazer, R. H. (2014). Use of mental health care for nonpsychotic conditions by immigrants in different admission classes and by refugees in Ontario, Canada. Open Medicine, 8(4), e136.

    PubMed  PubMed Central  Google Scholar 

  • Fang, L. (2010). Mental health service utilization by chinese immigrants: Barriers and opportunities. Canadian Issues 70–74. Retrieved from http://www.metropolis.net/pdfs/immi_health/Immigrant%20Mental%20Health%20-%20pgs70-74.pdf.

  • Fenta, H., Hyman, I., & Noh, S. (2006). Mental health service utilization by Ethiopian immigrants and refugees in Toronto. Journal of Nervous and Mental Disorders, 194(12), 925–934.

    Article  Google Scholar 

  • Fung, K., & Wong, Y.-L.R. (2007). Factors influencing attitudes towards seeking professional help among east and Southeast Asian immigrant and refugee women. International Journal of Social Psychiatry, 53(3), 216–231.

    Article  PubMed  Google Scholar 

  • Gadalla, T. M. (2010). Ethnicity and seeking treatment for depression: A Canadian national study. Canadian Ethnic Studies, 41(3), 233–245.

    Article  Google Scholar 

  • Graham, A., Hasking, P., Brooker, J., Clarke, D., & Meadows, G. (2017). Mental health service use among those with depression: An exploration using Andersen’s behavioral model of health service use. Journal of Affective Disorders, 208, 170–176.

    Article  PubMed  Google Scholar 

  • Guzder, J., Yohannes, S., & Zelkowitz, P. (2013). Helpseeking of immigrant and native born parents: A qualitative study from a Montreal child day hospital. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(4), 275–281.

    PubMed  PubMed Central  Google Scholar 

  • Islam, F. (2015). Immigrating to Canada during early childhood associated with increased risk for mood disorders. Community Mental Health Journal, 51(6), 723–732.

    Article  PubMed  Google Scholar 

  • Karoly, L. A. (2010). Working paper: Toward standardization of benefit cost analyses of early childhood interventions. Rand Corporation. Cited in Roberts, G., et. al. (2011) op. cit.

  • Kirmayer, L. J., Weinfeld, M., Burgos, G., du Fort, G. G., Lasry, J. C., & Young, A. (2007). Use of health care services for psychological distress by immigrants in an urban multicultural milieu. Canadian Journal of Psychiatry, 52(5), 295–304.

    Article  PubMed  Google Scholar 

  • Lesage, A., Vasiliadis, H. M., Gagné, M. A., Dudgeon, S., Kasman, N., & Hay, C. (2006). Prevelance of mental illnesses and related service utilization in Canada: An analysis of the Canadian community health survey. Mississauga: Canadian Collaborative Mental Health Initiative; 2006.

    Google Scholar 

  • Lou, Y., & Beaujot, R. (2005). What happens to the ‘healthy immigrant effect: The mental health of immigrants to Canada. Discussion paper no. 05–15. London: Population Studies Centre, University of Western Ontario.

    Google Scholar 

  • McKenzie, K. (2009). Improving mental health services for immigrant, refugee, ethno-cultural and racialized groups: Issues and options for service improvement. Ottawa: Mental Health Commission of Canada. Retrieved from http://www.mentalhealthcommission.ca/SiteCollectionDocuments/News/en/IO.pdf.

  • McKenzie, K. J., Tuck, A., & Agic, B. (2014). Mental health care policy for refugees in Canada. In L. Simich & L. Andermann (Eds.), Refuge and resilience (pp. 181–294). New York: Springer.

    Chapter  Google Scholar 

  • Mental Health Commission. (2009). Toward Recovery and Well-Being: A Framework for a Mental Health Strategy in Canada. Retrieved from: https://www.mentalhealthcommission.ca/English/system/files/private/FNIM_Toward_Recovery_and_Well_Being_ENG_0.pdf.

  • Mental Health Commission of Canada. (2012). Changing directions, changing lives: The mental health strategy for Canada. Calgary, AB: Author. Mental Health Commission of Canada.

    Google Scholar 

  • Mental Health Commission of Canada. (2013). Making the Case for Investing in Mental Health in Canada. Retrieved from http://www.mentalhealthcommission.ca/English/document/5210/making-case-investing-mental-health-canada-backgrounder-key-facts#sthash.XOMvZ13Q.dpuf.

  • Ng, E., & Omariba, W. R. (2010). Is there a healthy immigrant effect in mental health? Evidences from population-based health surveys in Canada. In Canadian Issues Summer 2010: Immigrant Mental Health. Montreal: Association for Canadian Studies.

    Google Scholar 

  • O’Mahony, J. M., & Donnelly, T. T. (2007). The influence of culture on immigrant women’s mental health care experiences from the perspectives of health care providers. Issues in Mental Health Nursing, 28(5), 453–471.

    Article  PubMed  Google Scholar 

  • Ochocka, J., & Janzen, R. (2008). Immigrant parenting: A new framework for understanding. Journal of Immigrant and Refugee Studies, 6(1), 85–111.

    Article  Google Scholar 

  • Ochocka, J., Moorlag, E., Marsh, S., Korsak, K., & Mutta, B. (2010). Taking culture seriously in community mental health: A five-year study bridging research and action. Canadian Issues, 59–64.

  • Parikh, S. V., Lin, E., & Lesage, A. D. (1997). Mental health treatment in Ontario: Selected comparisons between the primary care and speciality sectors. Canadian Journal of Psychiatry, 42(8), 802–812.

    Google Scholar 

  • Patterson, B., Kyu, H. H., & Georgiades, K. (2013). Age at immigration to canada and the occurrence of mood, anxiety, and substance use disorders. Canadian Journal of Psychiatry, 58(4), 210–217.

    Article  PubMed  Google Scholar 

  • Puyat, J. H., Hanley, G. E., Cunningham, C. M., Law, M. R., Wong, S. T., Sutherland, J. M., & Morgan, S. G. (2011). Ethnic disparities in antipsychotic drug use in British Columbia: A cross-sectional retrospective study. Psychiatric Services, 62(9), 1026–1031.

    Article  PubMed  Google Scholar 

  • Reitmanova, S., & Gustafson, D. L. (2007). Concepts and determinants of St. John’s immigrants’ mental health report for mental health decision makers, organizations and services providers in Newfoundland and Labrador. Division of Community Health and Humanities, Faculty of Medicine, Health Sciences Centre: St. John’s, Newfoundland; 2007. Retrieved from http://www.nlcahr.mun.ca/research/reports_search/Immigrant_mental_health_reitmanova.pdf.

  • Sarafin, C. (2008). The weighting strategy of the Canadian Community Health Survey [powerpoint]. Retrieved from ms.mcmaster.ca/canty/seminars/Sarafin.ppt.

  • Sareen, J., Cox, B. J., Afifi, T. O., Yu, B. N., & Stein, M. B. (2005). Mental health service use in a nationally representative Canadian survey. Canadian Journal of Psychiatry, 50(12), 753–761.

    Article  PubMed  Google Scholar 

  • Statistics Canada. (2008). Canadian demographics at a glance (catalogue no. - 91-003-X).Retrieved from http://www5.statcan.gc.ca/olc-cel/olc.action?objId=91-003-X&objType=2&lang=en&limit=0.

  • Statistics Canada. (2010). Canadian Community Health Survey (CCHS) Household weights documentation. Retrieved from http://www23.statcan.gc.ca/imdb-bmdi/pub/document/3226_D57_T9_V1-eng.htm.

  • Statistics Canada. (2012). Canadian community health survey – annual component (CCHS)Retrieved from: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SurvId=3226&SurvVer=1&InstaId=15282&InstaVer=8&SDDS=3226&lang=en&db=imdb&adm=8&dis=2.

  • Statistics Canada. (2014). Immigration and ethnocultural diversity in Canada (catalogue no. 99-010-X). Retrieved from http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-010-x/99-010-x2011001-eng.cfm.

  • Statistics Canada. (2016). Canadian community health survey - annual component (CCHS). Retrieved from http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226.

  • Thomas, S., & Wannell, B. (2009). Combining cycles of the Canadian community health survey. Component of statistics Canada catalogue no. 82-003-X. Health Reports, 20(1), 1–6.

  • Tiwari, S. K., & Wang, J. (2008). Ethnic differences in mental health service use among white, Chinese, South Asian and South East Asian populations living in Canada. Social Psychiatry and Psychiatric Epidemiology, 43(11), 866–871.

    Article  PubMed  Google Scholar 

  • Vasiliadis, H. M., Lesage, A., Adair, C., et al. (2005). Service use for mental health reasons: Cross-provincial differences in rates, determinants, and equity of access. Canadian Journal of Psychiatry, 50, 614–619.

    Article  PubMed  Google Scholar 

  • Vasiliadis, H. M., Tempier, R., Lesage, A., & Kates, N. (2009). General practice and mental health care: Determinants of outpatient service use. Canadian Journal of Psychiatry, 54(7), 468–476.

    Article  PubMed  Google Scholar 

  • Wang, J., & Patten, B. (2007). Perceived effectiveness of mental health care provided by primary-care physicians and mental health specialists. Psychosomatics, 48, 123–127.

    Article  PubMed  Google Scholar 

  • Wang, J., & Patten, B. (2007). Perceived effectiveness of mental health care provided by primary-care physicians and mental health specialists. Psychosomatics, 48, 123–127.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would gratefully like to acknowledge funding provided by the LaMarsh Centre for Child and Youth Research, York University and the La Barge Graduate Scholarship in Multiculturalism, York University. We would like to thank Melissa Moyser, Peter Kitchen, and James Chowhan for their statistical support at the Statistics Canada Research Data Centre. While the research and analysis are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada.

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Islam, F., Khanlou, N., Macpherson, A. et al. Mental Health Consultation Among Ontario’s Immigrant Populations. Community Ment Health J 54, 579–589 (2018). https://doi.org/10.1007/s10597-017-0210-z

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