Multiple Traumas, Health Problems and Resilience among Haitian Asylum Seekers in Canada’s 2017 Migration Crisis: Psychopathology of Crossing

Impacts of local, provincial, and federal immigration policies on health and social services access among women with precarious immigration status

OBJECTIVES

Im/migrant women (e.g., non-status immigrants, refugee claimants, students, temporary foreign workers, visitors, and other migrants) face structural barriers to health and social services access. While immigration is an increasingly recognized social determinant of health, there remains a gap in literature on how structural determinants such as immigration policies and practices (e.g., 'status-checking', immigration status) shape im/migrant women's experiences navigating health and social services. This study aimed to examine the ways in which local, provincial, and federal immigration policies shape health and social services access among im/migrant women with precarious status.

METHODS

Between December 2018 and February 2020, we conducted and thematically analyzed qualitative in-depth interviews with im/migrant women (N = 51), and service providers (N = 10) across Metro Vancouver. Data were collected as part of the IRIS study, which is a community-based, mixed-methods study of im/migrants' healthcare access prior to and during the COVID-19 pandemic.

RESULTS

Despite policies that purportedly aim to grant access to health and social services in Vancouver regardless of immigration status, participants routinely described ineligibility and fear of detention and/or deportation as pervasive barriers to accessing services, including routine, preventive, and emergency health services, and enrolment of children in schools. Women described social isolation and exclusion as key consequences of federal immigration policies that produced precariousness through temporary and undocumented status. Overall, participants recommended for the elimination of immigration law enforcements and 'status-checking' practices in health and social settings.

CONCLUSION

Sanctuary City policies are recommended to advance im/migrants' human rights, reduce instances of delayed or denied care, untreated illnesses, and social isolation. Full implementation of Sanctuary principles at the local level (i.e., reduced collaboration between local service providers and federal immigration enforcement) is needed to improve access to health and other services based on need, regardless of immigration status. At the provincial level, elimination of 'status checking' in health settings and expansion of eligibility criteria for health, social, and education programs (e.g., Medical Services Plan, subsidized housing, and BC's School Act) to include all im/migrants should be considered. At the federal level, increased funding for programs that address inequities in health and social services produced by restrictive immigration policies and ensure pathways to more secure immigration status are recommended. Together, these policy reforms have the potential to address the structural barriers to im/migrant women's health and social services access, and ultimately improve overall public health outcomes.

Mental Health Risk and Protective Factors of Nigerian Male Asylum Seekers Hosted in Southern Italy: a Culturally Sensitive Quantitative Investigation

This study provides a culturally sensitive quantitative investigation aimed at assessing the post-traumatic symptomatology, post-migratory difficulties, and resilience of 36 Nigerian male asylum seekers hosted in the province of Caserta, South Italy. A survey composed by the Harvard Trauma Questionnaire-Revised (HTQ-R), the Post-Migratory Checklist (PLMD), and the Connor-Davidson Resilience Scale (CD-RISC) was administered to participants. Descriptive and correlation analyses were made in order to describe the mental health risk and protective factors and understand the relation between these. A linear regression analysis was used to evaluate the influence of post-migratory difficulties and resilience on PTSD. Stratified bivariate analyses were also computed to detect PTSD group and no-PTSD group differences about post-migration difficulties and resilience levels. Regression analysis showed that PMLD numbers significantly increased the risk of having PTSD. No significant effect emerged for the level of resilience. Statistically significant differences between the PTSD group and non-PTSD group in relation to post-migratory difficulties were also found. No differences in the resilience factors emerged. The results offer a glimpse into a specific ethnic group of asylum seekers and its mental health risks and protective factors, taking into consideration the specificities of their past and current life-story experiences. Clinical implications for professionals working in the field of forced migration will be outlined.

The Gory Details: Asylum, Sexual Assault, and Traumatic Memory

For asylum seekers to be granted asylum, they must convince immigration officials that they have been persecuted or that they fear they will be persecuted if returned to their home country. This article discusses the reluctance of asylum seekers to be forthcoming about sexual assault as a form of persecution and the ways in which traumatic memory can affect narratives of persecution for rape survivors. Many asylum seekers, particularly those who have been sexually assaulted, show symptoms consistent with trauma survivors. Consequently, their narratives of persecution are often shaped by partial and incomplete memory recall. The result is that how asylum seekers who have been sexually assaulted tell their stories of persecution is the antithesis of the expectations of credibility. This article is based on qualitative research in Los Angeles, California, and New York City, New York, in the United States. It includes interviews with asylum seekers, immigration attorneys, immigrant service providers, asylum officers, and immigration judges; observations of immigration court hearings; and content analysis of asylum applications. I use these sources to argue that the harm of rape and its long-lasting effects evidenced by symptoms of traumatic memory impacts how asylum seekers articulate stories of persecution. How these stories are told can have devastating effects for asylum seekers that may jeopardize their ability to gain asylum if immigration officials do not view them as credible applicants.

Cognitive performance in children and adolescents with psychopathology traits: A cross-sectional multicohort study in the general population

Psychopathology and cognitive development are closely related. Assessing the relationship between multiple domains of psychopathology and cognitive performance can elucidate which cognitive tasks are related to specific domains of psychopathology. This can help build theory and improve clinical decision-making in the future. In this study, we included 13,841 children and adolescents drawn from two large population-based samples (Generation R and ABCD studies). We assessed the cross-sectional relationship between three psychopathology domains (internalizing, externalizing, dysregulation profile (DP)) and four cognitive domains (vocabulary, fluid reasoning, working memory, and processing speed) and the full-scale intelligence quotient. Lastly, differential associations between symptoms of psychopathology and cognitive performance by sex were assessed. Results indicated that internalizing symptoms were related to worse performance in working memory and processing speed, but better performance in the verbal domain. Externalizing and DP symptoms were related to poorer global cognitive performance. Notably, those in the DP subgroup had a 5.0 point lower IQ than those without behavioral problems. Cognitive performance was more heavily affected in boys than in girls given comparable levels of psychopathology. Taken together, we provide evidence for globally worse cognitive performance in children and adolescents with externalizing and DP symptoms, with those in the DP subgroup being most heavily affected.

The challenging journey from trauma to post-traumatic growth: Lived experiences of facilitating and hindering factors

BACKGROUND

Many people experience psychological trauma during their lifetime, often negatively affecting their mental and physical health. Post-traumatic growth is a positive psychological change that may occur in an individual after having processed and coped with trauma. This journey, however, has not been studied enough.

AIM

The purpose of this phenomenological study was to explore people's experience of suffering psychological trauma, the personal effects of the trauma and the transition from trauma to post-traumatic growth.

METHODS

A purposeful sample of seven women and five men, aged 34-52, were selected whose backgrounds and history of trauma varied, but who had all experienced post-traumatic growth. One to two interviews were conducted with each one, in all 14 interviews.

RESULTS

This study introduces a unique mapping of the challenging journey from trauma to post-traumatic growth through lived experiences of people who have experienced trauma as well as post-traumatic growth. Participants had different trauma experience, but their suffering shaped them all as persons and influenced their wellbeing, health and view of life. Participants described post-traumatic growth as a journey, rather than a destination. There was a prologue to their journey which some described as a hindering factor while others felt it was a good preparation for post-traumatic growth, i.e. to overcome difficulties at an early age. Participants described six main influencing factors on their post-traumatic growth, both facilitating and hindering ones. They also described the positive personal changes they had undergone when experiencing post-traumatic growth even though the epilogue also included heavy days. A new theoretical definition of post-traumatic growth was constructed from the findings.

CONCLUSION

The results suggest that the journey to post-traumatic growth includes a recovery process and certain influencing factors that must be considered. This information has implications for professionals treating and supporting people who have suffered traumas.

The Transcultural Community Resilience Scale: Psychometric Properties and Multinational Validity in the Context of the COVID-19 Pandemic

Few instruments assess community resilience. In the midst of the COVID-19 pandemic, the capacity of communities to support resilience of members deserves to be assessed to develop programs for improving mental health of affected populations. This article presents the development of the Ottawa-Community Resilience Scale (O-CRS), its underlying factorial structure and transcultural validity with a multilingual (English, French, Creole, Kinyarwanda), multinational (DR Congo, Haiti, Rwanda, Togo) and multicultural sample affected by this pandemic. A sample of 1,267 participants (40.9% women) were recruited in the four countries: DRC (n = 626, 43.4% women), Haiti (n = 225, 42.0% women), Rwanda (n = 174, 40.5% women), and Togo (n = 242, 33.2% women), with a mean age of 32 (SD = 10.1). They completed measures assessing individual resilience, depression and the O-CRS. Exploratory and confirmatory Factor Analyses, Cronbach alpha, coefficient H and the McDonald's Omega, and bivariate regression were used to estimate the underlying components of the O-CRS, its internal consistency and concurrent validity. Parallel factorial analysis and confirmatory factor analysis results revealed an excellent fit 3-factor structure. Internal consistency coefficients varied between 0.82 and 0.95. The O-CRS showed a good construct validity with a positive association with individual resilience and negative association with depression score. Developed with a collaborative approach involving researchers, practitioners, and clients/patients, the O-CRS and its three factors (community strengths and support, community trust and faith, and community values) demonstrated excellent psychometric properties for assessing community resilience among adults during the COVID-19 pandemic.

What links can be made from narratives of migration and self-perceived health? A qualitative study with Haitian migrants settling in Quebec after the 2010 Haiti earthquake

In January 2010, Haiti was hit by a terrible earthquake that pushed thousands of people to migrate. Many of them chose to settle in Quebec, Canada. Years after the earthquake, many Haitians continue to migrate to the Quebec province. Several studies however have shown that this population's socioeconomic status is lower than the provincial average. Given the potential multiple stressors that affect Haitian migrants in Quebec, there are concerns about their health status. Located at the intersection of international migration studies and global public health, this paper offers an in-depth qualitative investigation of Haitian migrants' representations of both their situation and self-perceived health in Montreal, Quebec. Our perspective on migrant health was inspired by the World Health Organisation's framework on the social determinants of health and recent studies in the field of migrant health. We collected and analysed qualitative data from 23 key informants (i.e., 12 women and 11 men, aged 21-76 years old) from diverse socioeconomic backgrounds. The analysis of the data from these people's narratives revealed the importance of structural determinants such as social position, and intermediate determinants such as living and working conditions. Our analysis also highlighted several interrelations between those determinants. Specifically, participants reported coping with issues related to migration status, income, occupation, language, challenging living and working conditions, and chronic stress. This study also shows that racism and social support each relate to both the structural and intermediate levels of the social determinants of health. The importance of social support brought by relatives, friends, as well as community-based organisations and religious practice, was underscored. Our findings were coherent with available literature looking at the determinants of health of racialized and migrant minorities in other high-income regions of the world. Our conclusive remarks featured reflections on three cross-cutting issues and their practical implications for policy and practices.

Socio-ecological determinants of distress in Filipino adults during COVID-19 crisis

The present study examined the socio-ecological factors that influenced psychological distress (combined index of depression and anxiety symptoms) among Filipino adults during the COVID-19 crisis. The study involved 401 adult participants currently residing in the Philippines. Data were collected using a self-reported online questionnaire administered to the participants. Findings revealed that one individual level factor, such as individual resilience, and two family level factors, such as safety at home and being a parent, negatively influenced psychological distress. On the other hand, a family level factor, family’s financial difficulties, positively predicted psychological distress. Societal level factor such as national resilience, but not the community level factor, community resilience, positively predicted psychological distress in Filipino adults. Findings identified individual resilience, national resilience, and financial difficulties as the strongest predictors of psychological distress among Filipino adults during the COVID-19 crisis. Implications, limitations, and future directions are discussed.

Asylum seekers working in Quebec (Canada) during the COVID-19 pandemic: Risk of deportation, and threats to physical and mental health

• Asylum seekers experienced childhood adversity, domestic violence, extreme poverty and precariousness, armed violence, rape, and detention. • In the context of the COVID-19 pandemic, Quebec (Canada), asylum seekers are on the frontlines, risking their lives to save the lives of others. • In addition to the anxiety associated with COVID-19, these asylum seekers are also concerned about being deported. • Regulation measures should be taken to prevent long-term mental health problems related to anxieties and worries generated by both COVID-19 and asylum status, particularly the fear of deportation.