Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: A systematic review

Old and present mental health systems tend to emphasize mental health service users as passive recipients of psychiatric care, which suppresses the idea that people who experience serious mental illness are able to comprehend their own sickness and recovery and therefore engage psychiatric experts about their care. This dissertation seriously interrogates the ways in which those who experience serious mental illness become agential, resist some of the control mechanisms, relationships of power, and infantilizing rituals found within the Canadian mental health system, and survive abject circumstances. Drawing on my own autoethnographic experiences with psychosis and psychiatric hospitalization, as well as 10 interviews with mental health service users, I argue that narrative approaches to inquiry and a post-anarchist praxis can reveal and liberate our agential capacities to recover and live through madness that otherwise become less known through biomedical approaches to mental health research. I identify some of the porous boundaries between the livable and unlivable forms of madness, and explore the complex relationships between service users and their caregivers whose penultimate goal is to help us live a manageable life. I conclude by discussing the contributions of this dissertation and reflect on some of the practical needs of the current mental health system.

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Stories of Madness: Exploring Resistance, Conformity, Resiliency, Agency, and Disengagement in Mental Health Narratives

This study examined Black masculinity, the representation of Black men, and by extension the Black community. Black men in North America historically have been racially targeted and profiled in employment and education (school/prison pipeline). Black masculinity scholarship has actively represented this demography through diverse scholarships. While this may be the case, the opposite is equally true; the scholarly lens does not provide the overall picture of Black men. This exploratory/descriptive qualitative Afrocentric Indigenous narrative study applied post-colonial, anti-colonial, and critical masculinity theoretical frameworks to argue that Black masculinity is implicated in epistemological violence and imperialism. The study encompassed semi-structured interviews with 10 participants (Kenyan men in Toronto), allowing for open expression of their experiences. The Kenyan story has been missing in action; that is, the Kenyan racial experiences in immigration, education, and labour remain expunged and absent. Black masculinity has not focused on accents as a racial and gendered concept of erasing Kenyan men from social and political processes. The study is framed around the limits of Black masculinity and looks at immigration, education, and labour policies in Canada and how they expel Kenyan men from the body politic. Kenyan men that were interviewed said that though they are Black they are also African based on the complex act of accent multiplier..

Re-imagining Black Masculinity: Praxis of Kenyan Men in Toronto

Studies have consistently found that fathers continue to be excluded from mainstream clinical social work practice when clinicians do not actively encourage their participation either because of lack of knowledge of how to engage fathers or biases against considering father involvement important. This holds especially true of immigrant and refugee fathers. With the majority of research studies focused on women and their children, a tremendous gap exists for male refugees and immigrants. Immigrant males and fathers in particular tend to be either forgotten or excluded from mainstream research. A significant gender bias exists in refugee research with less attention paid to boys, men, and fathers. This article provides an overview of the essential role of fathers in child development, the barriers that immigrant fathers face, their resilience through the immigration process, and how clinicians can establish a father-inclusive practice. A review will be presented on (1) the essential role of fathers ...

The essential role of the father: fostering a father-inclusive practice approach with immigrant and refugee families

Sexual and Reproductive Health Rights are fundamental human rights. Previous studies on gender and sexuality in displacement settings have often focused on sexual and gender-based violence and the reproductive health problems of women while underplaying their needs for sexual expression, pleasure and procreation. This paper examines the influence of conflict and displacement on gender relations, sexuality and natality of internally displaced women in Nigeria. It draws on data from a larger study in which focus group discussions and in-depth interviews were used to explore 52 women's gendered experiences with Boko Haram insurgency and displacement. A critical thematic analysis of data revealed that the women's relationships with their men were complex and ambiguous, characterised by both tensions and solidarity. The women saw their men as partners in their struggle against multi-level oppression, including the structural barriers that undermine their mutual sexual expressions and pleasure, as well as their desire to procreate and repopulate their decimated ancestral communities. We recommend collaborative efforts to promote and protect the Sexual and Reproductive Health Rights of displaced women which includes building physical structures and living conditions that promote healthy, safe and pleasurable sexual expressions, and socio-political structures that create access to the long term social security.

'Men don't have patience': Sexuality, pleasure and danger in displacement settings in Northcentral Nigeria.

Refugee men face unique mental health stressors in the pre- and post-migratory periods. However, there has been little in-depth research on the mental health of refugee men in Canada. Given this situation, the overall aim of this study is to explore the psycho-social experience of Sri Lankan Tamil refugee men in Canada. Particular objectives include better understanding any inter-relationship between war-trauma, migration, concepts of masculinity and mental health. The study employed a two-phase participatory action research design based on the grounded theory approach. Phase 1 involved an 8-month ethnography conducted in Sri Lanka. Phase 2 consisted of qualitative interviews with 33 Sri Lankan Tamil refugee men living in Canada. Consistent with grounded theory, analysis was conducted inductively and iteratively. Four specific themes emerged from the data (i) gendered helplessness of war: participants commonly reported ongoing negative rumination regarding experiences where they were unable to adequately protect loved ones from physical suffering or death; (ii) reduced capacity: participants frequently felt unable to fulfill culturally sanctioned duties, such as supporting their family, due to ongoing pre- and post-migratory stress; (iii) redundancy: many participants felt that they were useless in Canada, as they could not fulfill typical masculine social roles (e.g. provider) due to factors such as unemployment and underemployment; (iv) intimate criticism: some participants reported that their spouses would often attempt to 'shame' them into greater achievement by constantly reminding them of their 'failures'. Many found this distressing. These various failures culminated in a state that we label "depleted masculinity", which participants linked to emotional and behavioural problems. Participants reported that they actively tried to rebuild their masculine identity, for example by adopting leadership roles in community organizations, which fostered resiliency. Results suggest a need to review and rebuild masculine identity to support the mental health of refugee men.

Judy Jeyakumar

Papers

“If One Does Not Fulfil His Duties, He Must Not Be a Man”: Masculinity, Mental Health and Resilience Amongst Sri Lankan Tamil Refugee Men in Canada