TY - JOUR
KW - Canada/epidemiology
KW - Cultural Characteristics
KW - Emigrants and Immigrants
KW - Health Status Indicators
KW - Humans
KW - Language
KW - Mental Disorders/diagnosis/epidemiology/therapy
KW - Prevalence
KW - Primary Health Care
KW - Refugees
KW - Risk Factors
AU - L. J. Kirmayer
AU - L. Narasiah
AU - M. Munoz
AU - M. Rashid
AU - A. G. Ryder
AU - J. Guzder
AU - G. Hassan
AU - C. Rousseau
AU - K. Pottie
AU - Canadian Collaboration for Immigrant and Refugee Health
A1 - 
AB - BACKGROUND: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. METHODS: We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. RESULTS: The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. INTERPRETATION: Systematic inquiry into patients' migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
BT - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
C5 - Healthcare Disparities
CP - 12
CY - Canada
DO - 10.1503/cmaj.090292
IS - 12
JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
N2 - BACKGROUND: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. METHODS: We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. RESULTS: The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. INTERPRETATION: Systematic inquiry into patients' migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
PP - Canada
PY - 2011
SN - 1488-2329; 0820-3946
EP - 67
EP - E959+
T1 - Common mental health problems in immigrants and refugees: general approach in primary care
T2 - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
TI - Common mental health problems in immigrants and refugees: general approach in primary care
U1 - Healthcare Disparities
U2 - 20603342
U3 - 10.1503/cmaj.090292
VL - 183
VO - 1488-2329; 0820-3946
Y1 - 2011
ER -