Post-disaster mental distress relief: Health promotion and knowledge exchange in partnership with a refugee diaspora community

AUTHORS    Laura Simich, Lisa Andermann, Joanna Anneke Rummens and Ted Lo

LOCATION   Toronto and National


Little attention has been devoted to  understanding the mental health effects of far-flung disasters or to  devising  an  appropriate  public  and  mental  health  response  to  support  affected  diaspora  populations  whose psychological ties to the homeland may be strong. Psychiatric epidemiology and studies of the effects of  disasters have noted heightened vulnerability for women, children, and ethnic minorities with prior exposure to community violence and disparities in the availability and accessibility of mental health care. They have concluded that community-based interventions are most effective.  Experts have also confirmed that psychosocial support interventions following disasters are best provided by understanding cultural  context  and  how  cultural  factors  can  shape  social responses and healing strategies. Our own participant observation in the LDRN initiative, begun as a way of addressing the psychosocial needs of the Sri Lankan Tamil community in Toronto after the tsunami, confirms that culturally appropriate and community-based distress relief can be successful when such initiatives support communities and unite the strengths of many actors. This article briefly describes the development the LDRN, and then describes the content of a joint workshop that was organized to exchange knowledge about distress relief models and practices  that  can  promote  recovery  in  both local and transnational contexts.

How does this research apply to my work?

The desire to provide distress relief after the tsunami (which is the particular disaster that the article references) raised questions such as these: What should be the role of trauma counselling in  good  mental  health  practice  after emergencies? What does this approach entail for diaspora and ethnocultural communities in Canada? What are the implications for public health, hospital, and community mental health practice in acute and post-emergency phases?

The network established to address these questions was based on an established working relationship between researchers and community members that was rooted in trust and mutual respect. This made it possible to identify pressing needs and to focus on feasible tasks.  It was important to let those affected within the community tell those willing to assist what they felt was most needed, and to support the community’s own initiatives as  much  as  possible.  It was also important to share responsibilities to ensure efficiency, and to ensure response capacity before proceeding in order to meet heightened expectations. Although the network was started by a handful of colleagues, it belonged to everyone. The network thus strove to become a “coalition of leaders.” Individual efforts and expertise contributed to a whole that was greater than the sum of its parts. This serves as a model of successful and effective partnering, which can be replicated across Canada.

What should I take away from this research?

Participants highlighted the following key components of providing mental health services to those in Canada whose families and communities had been affected by disasters in their homeland:

  • Joint recommendations for culturally competent mental distress relief, including contingency planning and assessment
  • Long-term development of mental health services and collaboration among agencies
  • Appropriate and adequate training, supervision and monitoring
  • Importance of relationships with the larger society, other cultural communities and transnational ties

What’s the next step?

Participants offered several recommendations as strategic research priorities. Above all, they recommended that research initiatives be responsive to community needs and that communities be directly and meaningfully involved in any research, service, and policy-making initiatives that concern them. To enable collaborative research, they suggested grounding research in the principles of community development and providing funding and guidelines to support academic/community partnerships.  They  also recommended increasing cultural competence by developing  culturally appropriate  assessment  tools,  undertaking social intervention research in the area of cultural competence  and  mental  health,  conducting  more  evaluation-based research of distress relief initiatives, and ensuring that research findings are translated into concrete products and services  that  can  be  used  to  address  existing  community needs.  Directions included researching specific issues within both diaspora and homeland communities to provide comparative data, for example, researching mental illnesses.

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