Stigma, shame behind ethnic delays in seeking help for mental illness

2016/08/19 Leave a comment

Not the first study that I have seen but appears to be one of the more comprehensive.

Noteworthy in that it applies to both first and second-generation immigrants:

Chinese and South Asian patients experience more severe mental health problems by the time they seek professional help, says a new study that looked at severity of psychotic symptoms and ethnicity.

“When compared to patients from other populations, Chinese and South Asian patients were on average much sicker by the time they got to hospital,” said Dr. Maria Chiu, lead author of the study, “Ethnic Differences in Mental Health Severity,” to be released Wednesday.

“Cultural factors play a big role in these findings. While Asian people tend to have stronger family support, they are also faced with a higher level of stigma and it prevents people from seeking help early. Families may try to cope and keep the illness within the family until there is no choice but to go to hospital.”

Based on the Ontario Mental Health Reporting System database, researchers with Toronto’s Centre for Addiction and Mental Health and the Institute for Clinical Evaluative Sciences examined information on more than 133,000 patients — including 2,582 Chinese and 2,452 South Asians — hospitalized for psychiatric conditions, such as schizophrenia, bipolar disorder and depression, between 2006 and 2014.

Chinese and South Asian patients represented 2 per cent and 1.9 per cent respectively of the in-patient population in the study, while they respectively account for 5.6 per cent and 7.9 per cent of the overall Ontario population.

Researchers assessed the severity of the subject groups based on four measures: if they were admitted to hospital voluntarily, whether they demonstrated aggressive behaviour, and the number and frequency of psychotic symptoms (hallucinations, delusions and abnormal thought process) they presented.

The study found that involuntary admissions were significantly more common among Chinese (67.1 per cent) and South Asian (59.7 per cent) patients than among the general population (46 per cent).

Both groups were also more likely to demonstrate aggressive behaviour at 20.4 per cent for Chinese and 16.3 per cent for South Asian patients, compared to just 14 per cent among other patients.

Patients from these two groups were also significantly younger than other populations being hospitalized and were more likely to experience multiple psychotic symptoms (55 per cent of Chinese versus 49 per cent of South Asian patients versus 38 per cent of other populations.)

Although immigration experience has often been linked to stress and mental health challenges, the study found both immigrants and Canadian-born patients of Chinese and South Asian descent shared similar illness severity when admitted to hospital.

“We need to consider Chinese or South Asian ethnicity, independent of immigration and diagnosis, as an important determinant of multiple dimensions of illness severity,” said the study published in the August edition of the Journal of Clinical Psychiatry.

The report suggests Chinese and South Asian communities may be more reluctant to seek help due to shame and stigma as well as cultural differences in the recognition and conceptualization of mental illness and mental health care.

Those challenges, it said, can be further compounded by language barriers and culturally insensitive health services.

“The longer mental illness goes without treatment, the more difficult it can be to get people back on track,” said Dr. Paul Kurdyak, psychiatrist and researcher with CAMH’s mental health policy research and lead scientist for the ICES mental health and addictions research program.

“This study highlights that ethnicity and culture are factors that should be considered when developing outreach strategies and treatment approaches, particularly at earlier stages before a patient’s illness worsens and hospitalization becomes necessary.”

Source: Stigma, shame behind ethnic delays in seeking help for mental illness | Toronto Star

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Study examines mental health in common ethnic minorities in Ontario

2016/06/25 Leave a comment

Not surprising, both the increased prevalence and the lower use of mental services:

Ethnocultural minorities are more likely to report suffering from mental health issues but are less likely to access treatment, a study out of York University using Ontario Health Study (OHS) survey data has found.
Participation in the OHS includes an extensive online survey that asks each user to review a list of ethnocultural groups and check those they thought they belonged to. The survey also included questions related to common mental health problems such as depression, anxiety and social isolation. Researchers looked at self-reported data from some of Ontario’s most common minority groups, such as South Asian, East Asian, Southeast Asian and Black Ontarians, and measured them against a comparable group of OHS participants who identified as white.

“Minority groups were much more likely to report mental health problems and stressful life events,” said Professor Sherry Grace, also of the University Health Network. “And with the exception of Aboriginal Ontarians, we also found that they were less likely to use the mental health services that we have here. This is unfortunate because there are proven treatments for depression and anxiety that really work.”

The stresses of adapting to a new country could be one of the reasons driving this, suggests Professor Grace.

“Most people who immigrate are very healthy, but studies show that being away from family, as well starting over in one’s career, and the financial repercussions of this, are tough” she says.

Study examines mental health in common ethnic minorities in Ontario

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A new mental health plan could be ‘turning point’ in PS renewal

2016/06/02 Leave a comment

Quite the list:

Wilkerson said executives and managers will be the key players in leading a change to rid the workplace of the management and organization practices and policies that contribute to stress and depression of employees:

1. The bureaucracy ‘treadmill. Public servants jumping from job to job with no ‘overall picture” of why and what it means.

2.  Giving employees lots of responsibility, but little discretion.

3. Too much work and not enough resources to do it.

4. Heavy and ‘destructive’ reliance on emails and texting to the exclusion of personal conversations.

5.  A workplace where ‘everything is a priority.’

6. Unclear expectations among employees of what they are responsible for and ambiguity around who is charge.

7.  Employees skills and the jobs people they are asked to do are not well-matched.

8 Employees are discouraged from and feel they have “no voice to question workload or priority-setting”

9. The loss of capacity to execute projects.

10. A pervasive sense of erratic management and perpetual delegation from the top down to the rank and file, which diffuses accountability and erodes faith in managers.

The plan comes as the public service faces a massive generational turnover with the departure of the baby boomers and Wilkerson estimates 85 per cent of new jobs demand “cerebral” not manual skills.

As the country’s largest employer, Wilkerson said the public service is a microcosm of the Canadian workforce and tackling the stresses there will give policy-makers a blueprint for preventing mental illness among all Canadians.

He said the Canada’s health care system has failed all Canadians, including public servants, facing mental illness with 75 per cent unable to get access to the services or care they need.

“Understanding the experience of their own employees –  senior government officials will escape the blinders of budgetary policy-making to see just how devastating the under-funding of mental health care in this country really is,” said Wilkerson. With that, Wilkerson argue Canada could be international model and press to make  mental health a “global development priority’ when it hosts the G7 meetings in 2018

Source: A new mental health plan could be ‘turning point’ in PS renewal

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Canada’s head bureaucrat makes mental health in the workplace a top priority

2016/04/06 Leave a comment

Curious to see how will this be measured beyond the regular public service survey, given the performance management commitment:

Canada’s top bureaucrat is making mental health in the workplace a top management priority in this year’s performance contracts for all deputy ministers.

Privy Council Clerk Michael Wernick has notified deputy ministers that they will be assessed on the health and well-being of their departments. That means a portion of their performance pay will be tied to how well their departments are faring in building a “respectful” workplace.

It’s the second year in a row that the public service’s top bureaucrat has made mental health a management priority, which advocates say is key to driving the rollout of a much-anticipated strategy on how to make the public service a healthy workplace.

It’s unclear when the new strategy will be completed but officials say within months.

Mental illness — particularly depression — is now recognized as one of the most significant public-health issues of the 21st century. It is the leading cause of disability worldwide, hitting working populations in their prime.

The federal government has faced rising rates of mental illness among employees over the past decade. Mental-health claims, driven by depression and anxiety, account for nearly half of all health claims.

Mental Health International chairman Bill Wilkerson, who is heading a pan-European campaign on depression in the workplace, has been an outspoken critic of the federal government as one of the country’s worst employers for chronic job stress.

But Wilkerson said he believes the government has reached a “turning point,” and will come up with a plan to rid the workplace of the management and organization practices and policies that contribute to stress and depression of employees.

“Putting this in performance agreements is an important step forward because it will force deputy ministers to address the performance issues that are adversarial to good mental health for the people working in government,” Wilkerson said in an interview.

Source: Canada’s head bureaucrat makes mental health in the workplace a top priority | National Post

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Report calls for a ‘humanized’ public service

2015/12/04 Leave a comment

A good initiative of the previous government:

The report, which recommends implementing the Mental Health Commission’s national psychological standard across government, concludes that the way the public service is managed must shift from an “output-focused environment to one that is more people-focused.”

The recommendations revolve around fixes in key areas: leadership, engagement, education on mental health, training and workplace practices, communication, and promotion and accountability.

“We must humanize the workplace … A more people-focused environment contributes to a high-quality federal public service (and) compassion is fundamental to this shift,” said the report.

Treasury Board President Scott Brison said the report shows the government and unions have “common ground” where they can work together.

“Humanizing is consistent with our government agenda to create a culture of respect for the public service,” said Brison.

“Mental health is part of that, ensuring public servants have a healthy workplace,” he said. “It is the right thing and healthy workplaces are more productive.”

The task force grew out of the bargaining demand PSAC tabled nearly a year ago. It asked the government to adopt the Mental Health Commission’s national psychological standard across government and enshrine it in all collective agreements.

Clement took the extraordinary step of taking the proposal off the table, and setting up a task force to examine the standard and identify the toxic factors in the workplace that are making workers sick.

“The unions deserve credit … and I give full marks to Tony Clement for having helped to initiate this,” said Brison. “I told the unions that it this is just the beginning.”

Brison stressed the committee’s work won’t be used as a bargaining chip in “any way, shape or form” when Treasury Board negotiators and the 18 unions resume collective bargaining on sick leave in January.

The cost of mental illness, from absenteeism to productivity, has been on the government’s radar for the past decade, with mental health claims accounting for 47 per cent of all disability claims.

The 2014 public service survey found employees’ engagement was falling and one in five said they were harassed, mostly by co-workers or bosses.  Studies of executives and their health showed similar trends.

Last year, 40 per cent of all calls to the hotline for the Employee Assistance Program were about mental health.

Source: Report calls for a ‘humanized’ public service | Ottawa Citizen

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