Immigrant, refugee youth end up in ER for mental health care more than others: study

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A new study has found that immigrant and refugee youth in Canada are more likely to visit the emergency room (ER) for mental health reasons than those born within the country.

The study, published in the Canadian Medical Association Journal, says that the emergency room is the “first point of contact” for many immigrant and refugee youth aged 10 to 14.

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The research, conducted by the Institute for Clinical Evaluative Sciences and the Hospital for Sick Children, found that these populations often don’t access more primary health care practitioners for mental health assistance prior to a crisis.

It noted that the problem is most pronounced among newcomer youth and immigrants from Africa and Central America.

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The study looked at 118,851 youth who visited an ER for mental health concerns between 2010 and 2014 in Ontario. That included 2,194 refugees and 6,680 non-refugee immigrants.

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Just over 61 per cent of refugee youth had their first mental health care contact at the ER, compared to 57.6 per cent of non-refugee immigrant youth and 51.3 per cent of Canadian-born youth.

Dr. Natasha Saunders, who is a lead author of the study, explained to Global News that all of these numbers are higher than they should ideally be for all categories.

“For the Canadian-born population, the rates are still pretty poor and there is opportunity for improving those too,” she explained.

Saunders said that the study only looked at primary health care providers, so there is a possibility that newcomers are looking elsewhere for assistance prior to the ER.

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“One possibility is that immigrants are using the health care system differently, in that they are having less physician care,” Saunders said.

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“If newcomers are in fact using more faith-based support, or community services like settlement agencies, those groups will need to be trained on recognizing mental illness early,” Saunders noted.

She added that part of that would mean referring newcomers to the appropriate health care provider.

The study explained that another barrier preventing newcomers from getting physician support early on could be stigma.

“Efforts are needed to reduce stigma and identify mental health problems early, before crisis, among immigrant populations,” the study read.

Saunders explained that the responsibility to reduce stigma and make sure patients are comfortable lies in part with health care providers.

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Dr. Kwame McKenzie, who works with the Centre for Addiction and Mental Health (CAMH), explained that there are several other barriers at play as well.

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In addition to stigma, newcomers can face problems when it comes to accessing mental health assistance, such as financial constraints, language barriers and trouble navigating the health care system.

“There’s a bit of the impact of poverty, there’s a bit of the impact of culture, there’s a bit of the impact of where the services are, and then there’s the impact of who offers the services and whether they speak your language,” McKenzie said.

He added that several Canadian studies over the past decade have had the same results as this recent one. There have also been studies on how these barriers can be removed.

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“The problem isn’t that we don’t know what to do, the problem is trying to get the government to be interested in doing it,” McKenzie said, noting that mental health care access needs to be a greater priority.

“Unless we get a hold of this and start dealing with people’s mental health in an equitable way, we are stowing up problems for the future.”

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911. For mental health programs and services around Canada, please refer to the list here


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