Published on November 14th, 2014 | from CAMH
The mental health of young people of South Asian origin – a neglected group in Toronto.
By Gursharan Virdee, Research Analyst, Schizophrenia Division, Complex Mental Illness Program at CAMH
Toronto, the cultural mosaic, provides for a rich and diverse community life. A significant proportion of Toronto’s residents are immigrants, with 12% identifying as South Asian, 11% as Chinese and 9% as African Caribbean (City of Toronto, 2013). For some this is an environment which provides everything needed to thrive, but sadly a significant number are excluded and overlooked from these resources.
Mental health services are often inaccessible and irrelevant to many communities in Toronto, who opt for community agencies where being understood and a sense of belonging are prime factors for their prevalence as a key resource. My research and clinical work in these areas over the past year has got me thinking about what this means for organizations like CAMH and what we can do to build upon and extend our ability to provide equitable psychological services to our diverse Toronto communities.
Work with young Canadian born South Asian adults (mostly Punjabi) in Peel has bought to light a number of issues. Presenting with high levels of anxiety, their experiences in seeking help are made worse by the struggles in accessing culturally appropriate and relevant psychological support. With lives firmly embedded within a religious framework, it became difficult to engage with their religious and spiritual practice as their symptoms worsened. Through this line of work I have begun developing an integrated model of psychological therapy that incorporates the principles of mindfulness within a faith informed framework.
Mindfulness has been a great fit for this community group. Not only has it helped reduce anxiety but it has provided a bridge between their distress and religious and spiritual beliefs, and in turn, a route to re-engaging with their practice.
Being of South Asian origin, I have some lived-experience of these contextual pieces that permeate the help seeking process, which has been helpful in my research.
There are pros and cons to therapist-client matching by ethnicity, but the literature states that it’s ultimately about a client being able to choose a therapist that fits their needs. For many of these young South Asians, however, they didn’t have a choice. They couldn’t access a therapist from a similar ethnic group or gender. And when they found one, there was difficulty with transport links, or the therapist was working in private practice where sessions were costly.Low cost or free therapy options were fraught with issues such as long waiting lists, lack of diversity in staffing, and fears about disclosure.
A lot of this echoes research completed by the Peel Services Collaborative who have been working with service providers in Peel to address these issues at a system level.
There is a body of work on the mental health of young South Asians that comes from the UK, but with the differences that exist in the healthcare system, and patterns and experiences of immigration, it is difficult to generalize those findings to the Canadian context. This line of work needs to continue and spread across Toronto to include mainstream mental health services like CAMH as well as focusing on other marginalized groups.
We know that similar issues exist in the experiences of women with psychosis living in Toronto (Kidd et al, 2013). It is time to start building services that are inclusive and tailored to the needs of these communities. To move the system forward, we need to continue working towards equitable access to services, and develop and adapt our evidence-based clinical services so they are more in line with the ways South Asian communities in Toronto conceptualize mental health and treatment. CAMH, having developed cutting edge practices that address diversity such as Rainbow Services and Aboriginal Services is in an excellent position to advance these important areas of work, and I am looking forward to continuing this conversation as we become more involved in their development.
You can hear Gursharan speak more about advancing mental health services for South Asian communities at the following events in November:
Schizophrenia Research Seminar; ‘Broadening our Horizons: Building Culturally Relevant Services for South Asians with Severe Mental Illness’
Wednesday November 19, 12-1pm, 101 Stokes St, CAMH Queen Street campus.
Psychology Rounds; Advancing psychological therapies: a focus on young South Asian adults
Wednesday, November 26, 1-2:30pm, Training Room A, CAMH Queen Street campus.