Mental Health and Help-Seeking among
Refugee Children and Families in Hamilton, Ontario
Researchers: Amanda Sim1, Kathy Georgiades1, Afreen Ahmad1, Lina Hammad1, Sara Omar1, Rula Karam1, Yasmine Shalaby1, Rashed Afif2, Marion Trent-Kratz3, Eve Puffer4, Aroub Soubh5, Becky Katz6, Colina Maxwell6, Sarah Wayland7
Affiliation: Offord Centre for Child Studies, McMaster University1, Wesley Urban Ministries2, Children’s Services and Neighbourhood Development, City of Hamilton3, Duke University4, Peer Researcher5, Centre3 for Artistic + Social Practice6, Hamilton Immigration and Partnership Council7
Research Partners: Wesley Urban Ministries, Centre3 for Artistic + Social Practice, Hamilton Immigration and Partnership Council, and Children’s Services and Neighbourhood Development, City of Hamilton
Keywords: refugees, children, youth, families, resilience, wellbeing, mental health, health promotion and prevention, interventions, community based participatory research, mixed methods, art, knowledge mobilization, Hamilton, Ontario
Jump to: Full infographic, Methodology, Findings, Recommendations, Video, Publications & Reports
Summary
Overview: This study explored government-assisted refugee (GAR) families’ experiences of resettlement stressors and access to mental health supports in Hamilton, Ontario. In the knowledge mobilization phase of the study, parents and children shared their experiences of resettlement through an arts workshop, a public art exhibit, and a video.
Objectives: To understand refugee parents’ experiences of resettlement stressors in Canada, how they perceive the relationship between resettlement stressors and mental health, and the strategies and resources they use to cope.
Research Justification: The mental health of recently resettled refugee parents is not well understood despite evidence indicating higher risk of poor mental health. The ways refugee parents cope with and adapt to challenges and opportunities in their new environments are also less researched.
Infographic Excerpt
Methodology
The research team conducted a mixed methods survey with 40 Arabic-speaking government-assisted refugee (GAR) parents who had settled in Hamilton, Ontario within the past 4 years. Participants were the primary caregiver to at least one child between the ages of 4 and 17. Researchers ran exploratory regression models to examine associations between demographic characteristics, health status, resettlement stressors, and family conflict with the outcome of parental psychological distress. Semi-structured individual and group interviews were also conducted with 33 leadership and frontline staff from 14 organizations in the health, education, settlement, and social service sectors in Hamilton to understand barriers and facilitators to mental health care for refugee families.
In partnership with Centre3 for Artistic + Social Practice, the research team conducted 3 art workshops with 48 refugee parents and children who participated in the study. Workshop participants used a variety of methods (e.g. paint, collage, stickers, embroidery, printmaking) to reflect on their experience of leaving their countries of origin and settling in Canada, using a map of Hamilton as their canvas. With permission from participants, the research team and the Hamilton Immigration Partnership Council (HIPC) hosted an exhibition of the families’ artwork at Hamilton City Hall.
Findings
Refugee parents experience significant mental health challenges due to resettlement stressors. Children described leaving friends and loved ones and feeling a deep sense of isolation.
- Poor parental health, exposure to resettlement stressors, and higher levels of inter-adult family conflict were associated with greater psychological distress in parents.
- Difficulties learning and communicating in English were described by almost all parents as having pervasive negative impacts on their ability to access healthcare, seek employment, navigate government benefits, and form social connections.
- All refugee parents described how the high cost of living in Hamilton, lack of affordable housing, inadequate income support from the government, and difficulty obtaining employment resulted in intense financial hardship and pressure.
- Most parents attributed their high-levels of distress to current resettlement-related stressors with only a few mentioning ongoing psychological impacts of past exposure to war trauma.
- Levels of psychological distress appeared to increase with length of stay in Canada, highlighting the urgent need for prevention and early intervention.
Despite these stressors, most parents rated themselves as coping well or very well and described various coping strategies such as positive reframing, problem solving, planning, and turning to religion.
- Family and faith were most important sources of resilience for parents.
- Parents and children agree that strong family relationships are the key to preventing and addressing mental health challenges.
Most refugee parents and children have not accessed mental health supports and know little about what services are available, indicating a need for greater investments in mental health promotion and prevention.
- Refugee parents and youth indicate a strong preference for family-based interventions that integrate service navigation and opportunities for social connection.
- Service providers call for a fundamental “reimagining” of how mental health supports are designed and delivered for newcomer children and families, with more emphasis on collaborative models of culturally responsive, family-centred, and prevention-focused care.
Recommendations
- Policies and programs are needed to provide comprehensive social and economic supports to refugees beyond the first one to two years after arrival. Specifically, more cost-of-living support is needed for refugee families.
- Policymakers and service providers should create more opportunities for newcomer social connection, especially sports and recreational activities that bring together newcomers and community members.
- More services to help refugee children and parents cope with stress and loss in ways that celebrate their strength, culture, and resilience are needed.
- Services should meet newcomer families where they are, both physically and psychologically. Embedding mental health supports in community settings such as schools and ethnocultural associations could reduce transportation barriers and alleviate stigma by placing services in spaces where newcomer children and families feel safe with trusted providers or community members.
- Parents should be engaged in identifying and responding to children’s mental health needs to ensure that care does not clash with cultural values, thereby causing or exacerbating intergenerational conflict.
- Overtly mental health-focused interventions can be stigmatizing and intimidating for children and youth, instead, discussions of mental health and help-seeking should be paired with engagement and trust-building through recreational activities such as sports or creative arts.
Video (Click to play)
Thriving Together – Research Findings on Newcomer Mental Health and Well-being in Hamilton
This video shares the project’s research findings and the artwork created by the newcomer families who participated in the knowledge mobilization component of the study.
Publications & Reports
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