JGH Psychiatry Research Day | Building better bridges to improve the immigrant experience

Participants in the 14th annual JGH Department of Psychiatry Research Day include, from left, Dr. Eric Jarvis; Dr. Phyllis Zelkowitz, the department’s Director of Research; Dr. Cécile Rousseau; Dr. Laurence Kirmayer; Dr. Jaswant Guzder; and Dr. David Dunkley, who organizes the event with support from the Gustav Levinschi Foundation.

In the not-so-distant past, when diversity was widely accepted as a positive characteristic, new immigrants were recognized as deserving protection and supportive services.

This vision has been upended in the current political environment however, says Dr. Cécile Rousseau, a Senior Investigator at the Lady Davis Institute and expert on the impact of migration policies. As a result, people who were once seen as at risk have come to be viewed as a risk.

This shift in public perception has repercussions, because society’s receptiveness to new immigrants goes a long way to determining how successfully they integrate and adapt to their new country. In this context, the diagnosis and treatment of mental health problems faced by immigrant populations were the timely focus of the fourteenth annual JGH Department of Psychiatry Research Day.

“We are witnessing a ‘compassion inversion,’” Dr. Rousseau said to the gathering of mental health clinicians and researchers, as well as front-line social workers and other healthcare professionals. “Whereas the refugee was traditionally considered the vulnerable party, now the host society is being defined as vulnerable. Consequently, the trauma that a refugee experiences does not end when they gain asylum.”

“Being stateless is profoundly unsettling,” added Dr. Laurence Kirmayer, Director of the Culture and Mental Health Research Unit at the JGH. Host societies often see helplessness as a predisposition to accepting a refugee. Paradoxically, however, a refugee must have a certain level of self-sufficiency and control in defining their own path in order to build their resilience.

New immigrants frequently face bias and hostility, often stemming from a misunderstanding of their cultural background. This rejection can, in turn, harm their mental health.

Even among mental health professionals, “an immigrant’s cultural beliefs may be misinterpreted as psychosis,” noted Dr. Eric Jarvis, Director of the Cultural Consultation Service and the First Episode Psychosis Program at the JGH. Unusual behaviour on the part of a recent immigrant can often be misinterpreted, especially when they are unable to communicate with ease in English or French. Knowledge of their culture can provide a deeper understanding into their situation. Ultimately, a mental health specialist’s awareness of that cultural context can radically alter a mental health diagnosis.

That’s why healthcare services should be delivered by professionals who have a sensitivity to cultural factors. “The idea of otherness lies at the very creation of the Jewish General Hospital,” pointed out Dr. Jaswant Guzder, the recently retired Chief of Child Psychiatry at the JGH. “It is in the DNA of the JGH to welcome members of different cultural communities with the dignity and respect that is so often absent over the course of the immigrant’s journey.”

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