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Immigrant and Refugee Youth Mental Health in Canada: A Scoping Review of Empirical Literature

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Book cover Today’s Youth and Mental Health

Part of the book series: Advances in Mental Health and Addiction ((AMHA))

Abstract

Introduction

The overall health of new immigrants appears generally better than mainstream Canadians. Longer duration of stay in Canada and effects of lower quality of social determinants of health may lead to loss in this health advantage. In what ways does this health advantage pattern extend to mental health of immigrant and refugee youth?

Methodology

Using an intersectionality approach and adopting Arksey and O’Malley’s five-stage framework (2005) for scoping reviews, we reviewed published peer-reviewed primary studies on immigrant and refugee youth mental health in Canada from January1995 to December 2015. The purpose of the review was to explore the effects of multiple intersecting social identities, such as gender, race/ethnicity, culture, age, migrant status and social class on migrant youth mental health at individual, family and societal level. Using a combination of search terms, six electronic databases were searched. Fourteen studies met the eligibility criteria.

Discussion

Three broad themes were identified: (1) determinants of mental health, (2) coping and adaptation and (3) racism and discrimination. School adjustment, parent–child and peer relationship, intra-personal conflict and perceived discrimination significantly influenced for migrant youth mental health and well-being. Family, school and cultural connectedness reduced settlement stress, promoted resilience and improved mental health.

Implications on Policy and Practice

To respond to the mental health needs of migrant youth and their families, there is a need to (1) take a ‘whole community approach’, (2) increase access and support to school-based programs and (3) promote, fund and integrate (into school, health and social systems) a diversity of values and beliefs—cultural and language competencies, anti-racist and anti-oppressive policies.

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Author information

Authors and Affiliations

  1. Faculty of Health, York University, Toronto, ON, Canada

    Attia Khan MBBS, MSPH, PhD (c) & Nazilla Khanlou RN, PhD

  2. Carleton University, Ottawa, ON, Canada

    Jacqueline Stol & Vicky Tran

Authors
  1. Attia Khan MBBS, MSPH, PhD (c)
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  2. Nazilla Khanlou RN, PhD
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  3. Jacqueline Stol
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  4. Vicky Tran
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Corresponding author

Correspondence to Attia Khan MBBS, MSPH, PhD (c) .

Editor information

Editors and Affiliations

  1. School of Social and Community Services, Humber College, Toronto, Ontario, Canada

    Soheila Pashang

  2. Faculty of Health, York University, Toronto, Ontario, Canada

    Nazilla Khanlou

  3. School of Social Work, Ryerson University, Toronto, Ontario, Canada

    Jennifer Clarke

Appendices

Response 1

  • Jacqueline Stol

  • Carleton University, Ottawa, ON, Canada

In 2015, in response to a need in the child and youth mental health sector, the Centre published a policy-ready paper, Taking action on health equity and diversity: Responding to the mental health needs of children, youth and families new to Canada. The Centre works with Ontario child and youth mental health agencies to strengthen services and build effective and accessible systems of care. One of the Centre’s core services is to help agencies bring youth and family engagement practices and principles into all mental health service planning and delivery. In the formation of this policy-ready paper, we recognized that engaging youth and families in the process was an essential piece of delivering a meaningful and evidence-informed resource to decision-makers. Youth engagement in mental health is about creating partnerships and meaningful opportunities that engage youth in improving mental health outcomes. This paper was one avenue to provide a positive space and opportunity for young people and their families to meaningfully share their voices, build skills and contribute to an issue that they feel is important. In addition, youth and families have a right to have a say in responding to the issues that affect their lives. The Centre supports that outcomes for young people, agencies, communities and systems are stronger when youth are engaged. As this current scoping study shows, engaging youth in positive spaces, opportunities and relationships to make meaningful connections with their own identities, families, peers, schools and communities can enhance the mental health protective factors in their lives.

Collaborating with youth and families on several projects at the Centre continued to affirm for me that young people have important insights, contributions and skills to share and grow that often go unheard in adult-driven contexts. The factors that impact the mental health of young people and their families new to Canada are complex, interrelated and wide-ranging. De-constructing complex systemic issues, barriers and opportunities that affect mental health outcomes requires many people around the table having significant roles towards collective impact. Opening possibilities for collaboration and partnership with youth and families who live these experiences each day in order to shape responses to complex needs has benefits for all those involved who seek to work together to build a more responsive system of care. Evidence-informed policies and practices that include research, service provider and service user voice are essential for shaping the mental health system.

The ongoing process of embedding youth and family engagement into all service planning and delivery can seem daunting, exciting or even intimidating. The process requires fluidity, flexibility and open-mindedness, but it also needs to be systematic, structured and evidence-informed. Youth and their family members take on many different roles, depending on their contexts, interests and needs, including being consulted, leading an initiative or having a role on a Board. Those being engaged are diverse, compensated for their time and are invited to safer spaces where ongoing efforts are made to redress power imbalances. It is an ongoing learning journey with many moving parts. All those working with or interacting with youth have a stake in understanding how they contribute to meaningful engagement and providing possibilities that support positive youth development.

Response 2

  • Vicky Tran

  • Carleton University, Ottawa, ON, Canada

During my time as a youth advisor for the policy-ready paper at the Centre and a member of the Ethno-Cultural Youth Advisory Committee (EYAC), I was given a space to freely express and explore my identity as a second-generation immigrant to Canada. These two pieces were important in fostering a strong sense of self in connection to my ethnic background. I grew up in many supportive environments, schools and relationships that contributed to my positive mental health. I was often encouraged as a student, athlete, young woman and leader. However, I did not encounter the same support in terms of my cultural differences. Based on experience working with ethno-cultural youth in the Ottawa community, it is common that many students who share similar experiences group together as means to meet social needs. This type of support and bonding would be effective in youth-adult partnerships where young immigrants or refugees feel like there are not only peers, but adults who are in their corner.

It was not until I became a member of EYAC that I was able to meet and discuss with other ethno-cultural youth who had relatable experiences to my own that I grew more confident in both my national and ethnic identity. The youth advisory committees supported by YSB have been transformative in the empowerment of those who have volunteered with them. EYAC is a youth-led group that aims to represent the voices and needs of ethno-cultural youth in the community by facilitating diversity workshops, participating in round-tables, conducting focus groups, facilitating an immigrant youth employment programme, organizing community events geared specifically towards ethno-cultural youth and families and other activities. Through our work I have been able to talk about mental health and how it interacts within different cultural contexts. Many of the results point towards the implications discussed in this chapter. When considering a whole community approach, school-based programmes and the integration of values and beliefs, the process by which those are implemented should always involve the perspectives of ethno-cultural youth and their families. The policy-ready paper incorporated youth voices in its content and ultimately showed to me that my voice, as an ethno-cultural youth was important in the discussion. Effective ways to address mental health amongst immigrant and refugee youth involve consultation with individual and families who carry with them lived experiences. Engaging and empowering these individuals by providing a space in which they are valued and heard is not only beneficial for the process in which recommendations are created, but also for those individuals themselves.

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Khan, A., Khanlou, N., Stol, J., Tran, V. (2018). Immigrant and Refugee Youth Mental Health in Canada: A Scoping Review of Empirical Literature. In: Pashang, S., Khanlou, N., Clarke, J. (eds) Today’s Youth and Mental Health. Advances in Mental Health and Addiction. Springer, Cham. https://doi.org/10.1007/978-3-319-64838-5_1

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