MH problems

Question 1

why difficult to treat their MH problems 10

Answer 1

differences in language, cul-
ture, patterns of seeking help and ways of coping
specific stressors
associated with migration and resettlement like 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 sta-
tus and integration.

Question 2

The migration trajectory can be divided into three
components

Answer 2

premigration, migration and postmigration
resettlement. each phase is associated with specific risks
and exposure

Question 3

The prevalence of specific types of mental
health problems is influenced by …

Answer 3

the nature of the migra-
tion experience, in terms of adversity experienced before,
during and after resettlement.

Question 4

Clinical assessment and treatment effectiveness can be
improved with the use of … when linguistic and cultural differences impede
communication and mutual understanding.

Answer 4

trained interpreters and culture
brokers

Question 5

Rates of mental disorders vary in different migrant groups,
but these differences do not simply reflect the rates in the
countries of origin what is it then

Answer 5

prevalence of specific types of
problems and rates of health care use in particular groups can
be linked to migration trajectories in terms of adversity expe-
rienced before, during and after resettlement and to policies
and practices that determine who gains admittance to
Canada e.g. status in country, trauma, children

Question 6

Postmigration factors that moderate the
effects of premigration stress and that ensure … are especially important in ensuring good
health outcomes

Answer 6

employment and economic stability

Question 7

the health of immi-
grants tends to be better than that of the general population in
both the sending and receiving countries t or f

Answer 7

t (Rates in immigrants varied by region of origin,
with the highest rates found among immigrants from Europe
and the lowest among those from Africa and Asia?)

Question 8

why healthy imm effect

Answer 8

must pass through a variety of filters to achieve
immigrant status

Question 9

the health of immigrants tends to
worsen over time to match that of the general population.`

Answer 9

t

Question 10

exception to healthy immigrant rule

Answer 10

refugees are at substantially
higher risk than the general population for a variety of spe-
cific psychiatric disorders — related to their exposure to war,
violence, torture, forced migration and exile and to the
uncertainty of their status in the countries where they seek
asylum

Question 11

some groups of migrants have
an elevated incidence of psychotic disorders after migration who and why

Answer 11

suggesting that racism and discrimination
have a role in elevated incidence

Question 12

Migration involves three major sets of transitions: …

Answer 12

changes
in personal ties and the reconstruction of social networks, the
move from one socio-economic system to another, and the
shift from one cultural system to another

Question 13

The migration
trajectory can be divided into three components

Answer 13

premigra-
tion, migration and postmigration resettlement (sepcific risks and exposures at each stage

Question 14

pre risks ?

Answer 14

premigra-
tion period often involves disruptions to usual social roles and
networks.

Question 15

during risks ?

Answer 15

immigrants can experience pro-
longed uncertainty about their citizenship status as well as sit-
uations that expose them to violence e.g. asyulum seekers worse MH

Question 16

post risks ?

Answer 16

resettlement usually brings
hope and optimism, which can have an initially positive effect
on well-being. Disillusionment, demoralization and depression
can occur early as a result of migration-associated losses, or
later, when initial hopes and expectations are not realized and
when immigrants and their families face enduring obstacles to
advancement in their new home because of structural barriers
and inequalities aggravated by exclusionary policies, racism
and discrimination.

Question 17

give an example of pre, migration and post factors related to MH

Answer 17

Economic, educational and occupational
status in country of origin/ Trajectory (route, duration)/ Uncertainty about immigration or
refugee status

Question 18

main
domains of resettlement stress include …6

Answer 18

social and economic
strain, social alienation, discrimination and status loss, and
exposure to violence

Question 19

Risk factors
for mental health problems can differ for men and women give eg

Answer 19

language more impact on men MH

Question 20

how often do they seek help

Answer 20

less then can counterparts

Question 21

why less help seeking

Answer 21

structural and
cultural barriers, including the lack of mobility or ability to
take time away from work, lack of linguistically accessible
services, a desire to deal with problems on one’s own, the
concern that problems will not be understood by practitioners
because of cultural or linguistic differences, and fear of
stigmatization.

Question 22

MH of adol and children?

Answer 22

dif findings of risk for disorders (worse for refugees distress and dep), post mig= accul-
turative stress and family poverty
earn a new
language, renegotiate their cultural identity, and deal with
social isolation, racism, prejudice and discrimination. 83 As
youth acculturate, many come into conflict with parents and
relatives

Question 23

ow to support youth

Answer 23

Postmigration factors, includ-
ing the quality of reception and support in the country of asy-
lum, are important predictors of long-term outcome

Question 24

women issues?

Answer 24

The many roles and responsibilities of immigrant women in
the home and the workplace can impede their access to men-
tal health services, more postpartum
Refugee women seen in specialized clinics have high rates
of exposure to violence and post-traumatic stress disorder

Question 25

senior issues/ risks?

Answer 25

female sex, less education, unemployment, poor self-rated
health, chronic diseases (heart disease, diabetes, asthma),
widowhood or divorce, and lack of social support or living
alone
join fam = slower rates of learning the language and accul-
turation; separation from extended family, peers and familiar
surroundings; decreased social support and isolation because
extended family and community networks are lost; increased
dependency on others because of language and mobility diffi-
culties; fewer opportunities for meaningful work and produc-
tivity; and loss of status as a respected elder in the new cul-
tural context.

Question 26

Which clinical strategies are effective?

Answer 26

generally same strat but communication, cultural shap-
ing of symptoms and illness behaviour, the effect of family
structure and process on acculturation and intergenerational
conflict, and the receiving society’s facilitation of or imped-
ance of adaptation and social integration

Question 27

Culture
can profoundly influence every aspect of illness and adapta-
tion, including ….

Answer 27

interpretations of and reactions to symptoms;
explanations of illness; patterns of coping, of seeking help
and response; adherence to treatment; styles of emotional
expression and communication; and relationships between
patients, their families and health care providers

Question 28

Place of origin can affect …3

Answer 28

exposure to endemic diseases,
childhood immunization and health care experiences

Question 29

they think such stressors are inap-
appropriate topics for medical attention or they believe that their
situation will not be understood how to overcome

Answer 29

elicited by enquiring
about the effect of the physical symptoms or other presenting
concerns on activities of daily living, stressors, social supports,
functioning in work and family, or community contexts

Question 30

medication issues

Answer 30

need to ask if using other trad remedies questions about previous or ongo-
ing consultations with a physician, healer or helper from
their own or other communities can uncover medication use
or other health concerns that can affect adherence, treatment
response and coping

Question 31

… has been identified as one of the most important barri-
ers to accessing services for newcomers

Answer 31

Failure to use inter-
preters (professional not casual)

Question 32

Except in urgent situations where there is no alternative,
family members or untrained lay people should not be used as
interpreters t or f

Answer 32

t

Question 33

family members should be excluded for prpivacy

Answer 33

f It is important to acknowledge and
welcome family members who accompany the patient. provide support build trust etc

Question 34

the cultural legiti-
macy of …. For counselling and treating youth, interventions
should be framed in ways that avoid alienating family mem-
bers or aggravating intergenerational conflicts

Answer 34

parental authority over adolescents should be taken
into account

Question 35

Becoming familiar with existing … can help practitioners identify
and mobilize psychosocial support and other resources
when needed

Answer 35

community org

Question 36

Migrant youth living in communities with a high proportion
of immigrants from the same background are worse off

Answer 36

f better
adjusted, partly because they have positive role models, a
stronger sense of ethnic pride and social support, which can
help them deal with the stressors of poverty, discrimination
and racism

Question 37

In urban centres with large immigrant populations, com-
munity resources can be divided into two broad categories:
multiethnic organizations that offer services related to settle-
ment and integration, and groups specific to various ethnic
backgrounds that provide a sense of belonging and support
for a particular ethnocultural identity. why important

Answer 37

must understnad what they identify with before referral