Thursday, Oct. 27
10:45 – 11:45 (1 hr)
Meeting Room: Sheraton Hall E (Lower Concourse)
G. Eric Jarvis*, MD; Lisa Andermann, MD; Kenneth Fung, MD; Jaswant Guzder, MD; Azaad Kassam, MD
Supported by the Transcultural Psychiatry Section

CanMEDS Roles:

1. Medical Expert
2. Health Advocate
3. Professional

At the end of this session, participants will be able to: 1) Identify minority groups at increased risk during the COVID-19 pandemic; 2) Address barriers to care due to the pandemic that disproportionately affect immigrant and minority communities; and 3) Learn practical clinical approaches under pandemic conditions that improve mental health care in at-risk populations.

Refugees, migrants, and members of minority groups have been disproportionately affected by the COVID-19 pandemic. Although migrants and their families may be fleeing war, persecution, or environmental disasters, all minority groups may experience sexual, religious, or ethnic discrimination and systemic racism in Canada. This combination of risk factors predisposes to unique barriers to mental health care that may disproportionately undermine mental health.

Objectives: This symposium will highlight challenging cultural and mental health issues faced by culturally diverse patients and their families during the COVID-19 pandemic and will demonstrate how they may be treated, even resolved, through the use of transcultural clinical strategies and tools available in the DSM-5.

Methods: Participants will present case formulations of patients in which pandemic complications have exacerbated their clinical presentations (post-traumatic stress disorder, psychosis, transgenerational issues, and the effects of racism on minority Canadians) and will make practice recommendations based on available evidence-based literature and tools.

Results: Refugee patients, migrant children and their families, and Asian and Black communities may suffer from systemic racism that has been exacerbated by COVID-19. The health of Indigenous populations has also been greatly affected by COVID-19 and impacted by racism. These systemic forces undermine access to mental health care with mental health consequences.

Conclusions: When mental health problems arise in migrant and minority patients under pandemic conditions, culturally informed assessment and treatment, augmented by the DSM-5 Outline for Cultural Formulation and Cultural Formulation Interview, will minimize postmigration stresses, mitigate the effects of racism, and optimize positive mental health outcomes.

References:

1. Sze S, Pan D, Nevill CR, et al. Ethnicity and clinical outcomes in COVID-19: a systematic review and meta-analysis. EClinicalMedicine 2020;29:100630.
2. Benjamen J, Girard V, Jamani S, et al. Access to refugee and migrant mental health care services during the first six months of the COVID-19 pandemic: a Canadian refugee clinician survey. Int J Environ Res Public Health 2021;18:5266.