Mental Health Consultation Among Ontario’s Immigrant Populations

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.

Respect for Religiosity: Review of Faith Integration in Health and Wellbeing Interventions with Muslim Minorities

“…In several studies, the delivery of either intervention information or delivery in Islamic ways were compromised because of the lack of competent persons. For example, in four studies, there was religious competency because interventions were delivered by Imams (King et al 2017;Padela et al 2019;Vu et al 2018), and in other studies, there was intervention content competency when delivered by health and welfare professionals (Banerjee et al 2017;Darko et al 2020;Islam et al 2018a;Siddique and Mitchell 2013). However, only a few studies engaged convergent design in the delivery of health interventions, training or workshops in which Imams and professionals both design and deliver the interventions together (Abu-Ras et al 2008;Ghafournia 2017;Padela et al 2018b).…”

“…The content in the interventions were mostly delivered by local Imams (King et al 2017;Padela et al 2019;Vu et al 2018). Several studies mentioned employing general dental practitioners, general medical practitioners, psychiatrists, community health workers, diabetes specialist nurses, physiotherapists and hospital doctors for conducting trainings or workshops (Banerjee et al 2017;Darko et al 2020;Islam et al 2018a;Siddique and Mitchell 2013). While Imam-led sermons/classes were found to be effective in promoting women's health, most investigators agreed that Imams should have health-related knowledge to make the interventions successful (Vu et al 2018).…”

“…Few interventions considered short-length sessions, such as two-hour sessions (Padela et al 2018b); fourhours training for Imams (Zoellner et al 2018), whereas maximum interventions were implemented from 5 to 15 weeks period, involving 5 to 15 sessions (Chaudhary et al 2019;Hassan et al 2021;Tse 2002). The duration of each session was also varied in the interventions, for instance (Padela et al 2018c) described intervention sermons lasting 30-45 min, while the intervention described by Islam et al (2018a) consisted of a two-hour group educational session and 90 min one-on-one catch-up.…”

Primary Care and Access to Mental Health Consultations among Immigrants and Nonimmigrants with Mood or Anxiety Disorders: Soins de première ligne et accès aux consultations en santé mentale chez les immigrants et les non-immigrants souffrant de troubles de l’humeur ou anxieux

“…1 Almost one quarter of Canadians with mood or anxiety disorders report that they did not access mental health services within the previous 12 months. 2 Immigrants to Canada and members of racialized communities may be even less likely to access mental health services [3][4][5][6][7][8] and may experience barriers including cost, language, culturally inappropriate services, lack of awareness of services, and transportation issues. [9][10][11][12][13][14][15][16] In Canada, most people with anxiety and depression access services through primary care, 17,18 and primary care plays a gatekeeping role in accessing specialized mental health services.…”

“…Evidence suggests that patterns of primary care service use differ between immigrants and nonimmigrants in Canada. 4,7,21,22 Immigrants report unmet care needs and may underuse health care services due to not knowing where to access health care services, the perception that they would receive inadequate care, transportation barriers, and language barriers. 23 Immigrants are also less likely to have a regular doctor 24 and more likely to visit urgent care or walk-in clinics or emergency departments for care.…”