Common mental health problems in immigrants and refugees: General approach in primary care

AUTHORS    Lawrence Kirmayer, Lavanya Narasiah, Marie Munoz, Andrew Ryder, Jaswant Guzder, Ghayda Hassan, Cecile Rousseau, & Kevin Pottie

LOCATION   National


Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. This article aims to identify: (1) risk factors and exposures associated with the different phases of the migration trajectory and (2) strategies in the approach to mental health assessment, prevention and treatment of common mental health problems for immigrants and refugees in primary care.

How does this research apply to my work?

A systemic inquiry into a client’s migration trajectory and a follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow for the recognition of problems in adaptation and for the implementation of timely mental health promotion, disease prevention and treatment interventions. In addition, this article discusses strategies that may lead to better outcomes, including the use of interpreters and culture brokers, and working with families and community organizations.

What should I take away from this research?

  • Among immigrants, the prevalence of common mental health problems is initially lower than in the general population, but over time, it increases to becomes similar to that in the general population
  • Refugees who have had severe exposure to violence often have higher rates of trauma-related disorders, including post-traumatic stress disorder and chronic pain or other somatic syndromes.
  • Assessment of risk for mental health problems includes consideration of pre-migration exposures, stresses and uncertainty during migration, and post-migration resettlement experiences that influence adaptation and health outcomes
  • Clinical assessment and treatment effectiveness can be improved with the use of trained interpreters and culture brokers when linguistic and cultural differences impede communication and mutual understanding

What’s the next step?

Further research is needed to develop and evaluate primary care strategies for promotion mental health and preventing mental illness that respond to the increasing diversity of immigrants and refugees in Canada.

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