2019

Business Edge Program – Intercultural Skills Lab 

Location:  Toronto, ON

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee populations
• The Need:  The majority of participants have landed in Canada less than three years before joining the program (the requirement is less than eight years) and are still finding their way here; in some cases, struggling so much that they may even be considering returning home.
• What's Promising:  Not only are internationally trained participants able to learn skills for advancing their careers, but are given the opportunity to build friendships, increase their sense of having a place in their new home, and express feelings of being supported, knowing that people care about their welfare and that they are accepted.
• Key Takeaway:  While bridging programs are important in helping newcomers find jobs, resources are also needed to help them retain those jobs, succeed, and thrive in their new workplaces and their new home.

Business Edge is a career advancement program for underemployed, internationally educated professionals living in the province of Ontario to explore and navigate cultural values, interaction styles and unwritten rules of the workplace. This transformative program positions individuals to leverage their international experience and to achieve their full potential in Canada. It also equips individuals with the techniques and strategies to make the most of the skills, experience and education that they bring to Canada. This program combines classroom sessions, one-to-one coaching, and online simulations in order to provide the skills and knowledge to achieve professional goals. In 2019, a digital version of the program was created and has been successfully implemented throughout the pandemic so that there was never a break in service, delay or cancellation.

Business Edge is part of University of Toronto’s Rotman School of Management’s Intercultural Skills Lab – a platform where employees can develop the self-awareness, adaptability and communication skills and competencies demanded by an increasingly globalized workforce.

The program includes sessions and coaching on emotional intelligence, mindfulness practices, difficult conversations, understanding and communicating your value and much more. Applicants often enter the program expressing feelings of isolation, not fitting in, lack of community, loss of confidence and in some cases anxiety and depression are evident. Over the six months that participants are together in the program they build friendships, increase their sense of having a place in their new home, and express feelings of being supported, knowing that people care about their welfare and that they are accepted- that they belong. 

In order to be eligible for the program, applicants must have completed all of their post secondary education outside of Canada and most of their work experience.  The majority of participants have landed in Canada less than three years before joining the program (the requirement is less than eight years) and are still finding their way here; in some cases, struggling so much that they may even be considering returning home.  Happily, it’s very rare that they end up leaving Canada once they join the program.  There are many excellent bridging programs to help newcomers find jobs but fewer resources to help them retain those jobs, succeed, and thrive in their new workplaces and their new home.  The culture shock can be painful and support is needing along the way.  Business Edge, funded by the Government of Ontario, is entirely about that part- staying, connecting, growing, and thriving. Learn more about Business Edge by watching this video or reach out to program staff for more information.  To attend a virtual information session you can register here.

Mennonite New Life Centre 

Location:  Toronto, ON

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee populations
• The Need:  In Canada in the 1970s, the Ontario Mennonite community was heavily involved in sponsoring Vietnamese refugees, and in the early 1980s they began to look for opportunities to support a new wave of refugees coming from Latin America. After an initial period of research and needs assessment with the Latin American community in Toronto, the Mennonite New Life Centre of Toronto was founded in 1983.
• What's Promising:  The Mennonite New Life Centre has a Community Mental Health Program as their core service, allowing to weave clients’ mental health considerations into all aspects of programming.
• Key Takeaway:  The Centre adopts a holistic approach to service delivery that is guided by the input from both staff and its clients. The ability to adapt and be flexible to emerging needs was evident in the approach to the integration of technology into its programs and services as an accelerated priority due to COVID-19.

The Mennonite New Life Centre (MNLCT) is a settlement agency supporting newcomer, immigrant, and refugees’ journeys towards making Canada home. For more than 35 years, the Centre has taken a holistic approach to service, seeing newcomers as whole human beings with lived experiences and global perspectives and recognizing and honouring them as individuals who feel, think, have agency, and contribute to their communities.

The Centre was born out of the pacifist tradition of the Mennonite Church and the forced international migration experiences of Mennonite communities throughout the centuries. In Canada in the 1970s, the Ontario Mennonite community was heavily involved in sponsoring Vietnamese refugees, and in the early 1980s they began to look for opportunities to support a new wave of refugees coming from Latin America. After an initial period of research and needs assessment with the Latin American community in Toronto, the Mennonite New Life Centre of Toronto was founded in 1983. Over the years, the founding vision of service and solidarity with refugees and displaced peoples has led the MNLCT to reach out to new refugee and immigrant communities, adapting and expanding its programs to respond to diverse needs and aspirations. At each step of the way, the Centre has worked to build a caring and inclusive community, where the ideas and contributions of newcomers are respected and valued. Together, newcomers and neighbours support each other, learn from each other, and take action together for a more just and compassionate society.

Right from the early days in the Centre’s history, it was recognized that newcomers needed not only integration services, but also supports to keep their mental health intact while they navigated how to live, work, play and learn in their new home. Back then, this programming was called “emotional support” and was offered to clients who were possibly grieving the life and family they left behind, or who were trying to cope with migration stress, adjustment disorders or Post-Traumatic Stress Disorder (PTSD), among other concerns.

Key mental health programs

Over the years, the emotional support programming evolved into a fully operational Community Mental Health (CMH) Program. That this service has been in existence for much of the Centre’s 37-year history speaks to how central meaningful and timely mental health counselling for newcomers is to the mission and vision of the Centre.

The Community Mental Health (CMH) Program offers culturally appropriate individual and family counselling to help newcomers navigate emotions related to their migration process – anxiety, depression, loss, grief, PTSD, and more –  or to offer support through other life circumstances like separation/divorce or involvement with the justice system. The CMH team also offers psychoeducational workshops, often through the engagement of internationally trained mental health professionals studying in the Bridge to Registration and Employment in Mental Health (BREM) Program and doing their placements at the Centre. Other offerings of the CMH Program include well-attended language-specific wellness groups. Last but certainly not least, CMH Program staff make presentations to clients in other Centre programs, such as bridging programs and LINC classes, and they receive internal referrals from these programs as well as settlement counsellors.

Having the Community Mental Health Program as a core service allows the Centre to weave clients’ mental health considerations into all aspects of its programming. A great example of mental health support integration is the Helping Our Newcomers Prepare for Employment Success (HOPES) Program, which focuses on helping those living with mental health challenges enter the labour force. Successful client outcomes are achieved not only through a robust network of community connections to Employment Ontario offices, educational institutions, and employers, but also due to a system of ongoing mental health supports within the program itself. By creating a create a circle of care for clients while they are trying to break into the labour market and find sustainable employment, they feel more optimistic about their future lives in Canada and are more able to achieve their short, medium, and long-term career and life goals.

Language Instruction Giving Hope to Trauma Survivors (LIGHTS) is another example of a whole-person approach to service delivery. Clients living with trauma can be further isolated by the lack of ability to communicate in one of Canada’s official languages, yet those same people are often challenged by the rigid structure of typical language classes – further perpetuating their difficulties. The LIGHTS program works with trauma survivors to build their functional language skills through flexible, trauma-informed, learner-centred programming provided collaboratively by a language instructor and a mental health professional. The results have been even more encouraging than expected, as immigrants with 10+ years in Canada have emerged from this transformative program with the confidence and language skills to truly begin to integrate into their no-longer-new communities.

Now in its 10th year, the aforementioned BREM Program is another longstanding program of the Centre. This bridging program was developed to create pathways to employment for internationally educated mental health professional in Ontario., and MNLCT has since welcomed and supported nearly 400 international professionals. Most recently the program expanded to help participants and other mental health professionals with a strong background in psychotherapy to meet the requirements for registration with the College of Registered Psychotherapists of Ontario (CRPO). By partnering with organizations in the mental health sector, BREM connects participants to on-the-job work experiences, community agencies to culturally competent, skilled professionals, and community members to local, culturally appropriate mental health support –an arrangement that everyone can benefit from.

In 2017, the MNLCT launched its social enterprise, the Toronto New Life Wellness Place (TNLWP), to provide multilingual, multicultural wellness services to anyone seeking support. With a diverse roster of Registered Psychotherapists, Registered Social Workers, a Registered Nurse, and other wellness professionals offering services in nearly 20 languages, the Wellness Place is able to support a broad range of newcomers and non-newcomers who seek culturally appropriate mental health support. TNLWP clients come through referrals from MNLCT as well as through other community and health organizations seeking supports for their own clients. The Wellness Place’s roster modal allows internationally trained mental health practitioners, such as graduates of the BREM Program, to establish and grow their practices within an organization that understands their unique needs. It also allows community members to get the help they need quickly as there is no waiting list.

In addition to ensuring mental health considerations in client service offerings, the Centre emphasizes wellness for staff, placement students, and volunteers – many of whom are immigrants or refugees themselves. Prior to the pandemic, the Centre hosted annual in-person, full-day Wellness events for all staff, students, and volunteers, and because the activities and learning sessions were developed based on the people’s self-identified needs, they were highly engaged and gave positive feedback. When the pandemic necessitated that staff work from home, Centre leadership viewed staff not only as employees but also as humans experiencing an unprecedented global emergency, with all the uncertainty and stress that entails. Internal communications, policies, and practices ensured that staff knew they were valued and supported. The Centre ran a series of weekly mental health workshops, led by Wellness Place practitioners, to help staff navigate their new realities and it recently created a Wellness Committee to supplement the work of the Health & Safety Committee in ensuring an ongoing commitment to a holistically healthy workforce. One of the first tasks of the Wellness Committee is to transition the in-person Wellness Day event to a meaningful online event that meets the existing and emerging mental wellbeing needs of staff. Staff that feel supported are more resilient and better positioned to be able to continue helping clients now and, in the years, to come.

Shifting to virtual service provision

The Centre’s holistic approach was evident yet again when it started to think about integrating technology into its programs and services – an accelerated priority due to COVID-19. In addition to the technical aspects, internal processes and client readiness were carefully considered in order to make sure the introduction of technology would indeed enhance service delivery and provide clients with a safe and protected environment in which they could receive meaningful support, including secure, confidential mental health counselling. While some of the tech solutions had been in the planning phase for some time, the urgent need to keep clients and staff safe during the pandemic gave the Centre the energy and focus to make these plans a reality very quickly. Two notable launches include the implementation and roll-out of the MNLCT iCent Newcomer Support Mobile Application with objective of providing clients, partners and other stakeholders with 24/7 access to information related to COVID-19 and government support programs, settlement, mental health and community supports. We also adopted a fully online, end-to-end encrypted virtual counselling platform called VirtualCare which allowed Community Mental Health practitioners to provide mental health services through video and secured text and phone services.

As a result of the Centre’s wide adoption of technology solutions throughout its operations, at present, most Centre programs and services are being offered completely online. The only exception is in-person individual appointments for vulnerable newcomers – such as those who have been trafficked, who do not have reliable access to the internet or a private space for a conversation – or for clients who need printed copies of forms, documents for translation, etc.

Tips for success

As with everything the Centre does, providing imbedded mental health supports and adapting to the challenges of the pandemic have drawn on the flexibility, collaboration, and creative thinking of staff. Without their input and guidance, solutions would not be as client-driven and holistic as they are.

It is essential to have in-house mental health talent, and to have them involved in cross-program collaborative work, in order to provide a consistent mental health perspective on program development and delivery.

All staff should understand the factors that contribute to good mental health – their own, their clients’, and their colleagues’ – and be supported in making suggestions and implementing solutions that support this outcome.

Newcomers’ Health and Well-Being program 

Location:  York Region/South Simcoe, Ontario

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee populations
• The Need:   In recent years, this particular area of Ontario has seen a growth in the numbers of immigrants and refugees settling – and mental health service provision has been particularly lacking for these populations.
• What's Promising:  The Newcomers’ Health and Well-Being program combines the expertise of mental health providers such as CMHA and Cedar Centre with the knowledge of the settlement process that the Welcome Centres has.
• Key Takeaway:  It is important for organizations to establish partnerships across sectors to provide a more holistic and wrap-around approach to supporting the mental health of immigrants and refugees.

Brenton Diaz, Clinical Coordinator and Therapist, Adult Program, Cedar Centre, writes:

Cedar Centre

Cedar Centre was established over 30 years ago to work with people who had experienced childhood sexual abuse. In recent years, the non-profit agency’s mandate has expanded to include all forms of childhood interpersonal trauma (abuse of all kinds, neglect, bullying). Cedar Centre provides Trauma-specific services to our participants from ages 3 to 99+ years old, and provides consultation and training to other community providers in the areas of working with trauma.  

The partnership

Canadian Mental Health Association (CMHA) York Region/South Simcoe was recently able to secure federal funding to launch programs to support the mental and physical health of refugees and newcomers. As such, CMHA recognized that many newcomers to our region were coming from war-torn areas, and that people experience difficult issues related to settlement in Canada often leading to further stress. This partnership between CMHA, Cedar Centre and the Welcome Centres is so important because it offers a wrap-around, holistic service to refugees and newcomers. It combines the expertise of mental health providers such as CMHA and Cedar Centre with the knowledge of the settlement process that the Welcome Centres possess. By improving the partnership and access that the settlement services have with the mental health services of CMHA and Cedar Centre, our community response to the needs of newcomers and refugees will be better met.   

The program

The Newcomers’ Health and Well-Being Program, which includes CMHA of York Region/South Simcoe, Cedar Centres, and the Welcome Centres of York Region, was established to fill a gap in the services to refugees and newcomers to our region. York Region/South Simcoe is experiencing much growth in the numbers of newcomers and refugees settling in our area, and access to mental health and health care has been lacking for these unique populations. This joint program fills this yawning gap in service provision for our newcomer and refugee communities. CMHA felt that offering a Trauma-specific component to the program would help the program to have a more holistic service to refugees and newcomers. Therefore, CMHA invited Cedar Centre, as a respected and innovative centre, to come on board and provide the trauma-specific component of the program.  

The program will support the mental health of our newcomers and refugees by providing culturally-appropriate services that will focus on the strengths of our clients. We will offer services that will serve not to pathologize our clients, but support them as they continue the daunting task of adjusting to life in Canada. We are able to offer a variety of mental health supports to deal with aspects such as anxiety, depression, managing stress, trauma, improving access to psychiatric services (if needed) and supporting other mental health concerns. The program features mental health therapists, groups and workshops to provide support and psychoeducation to clients who indicate a need to help with improving their mental health and functioning. The program also features a nurse practitioner who will be able to address any health concerns that the clients might indicate. The program is delivered in partnership with Welcome Centres, and, as such, our services will be delivered, when needed, though the context of the Welcome Centres, helping to improve the access of refugees and newcomers to our support.  

We would like to see other such partnerships occur across sectors to provide a more holistic service to newcomers and refugees, to ensure that these populations have access to help across the country, when needed. Hopefully our program can inspire other communities to unite to provide a wrap-around approach service to support our newcomers and refugees to ensure their access to services and promote their well-being as they adjust to life in Canada.

Living Well in Times of Self-Isolation online program

Location:  Online

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee populations
• The Need:   In a recent study by Statistics Canada it was reported that the mental health of more than half of recent immigrants has worsened since the implementation of physical distancing.
• What's Promising:  The "Living Well in Times of Self-Isolation" online sessions were planned to support immigrants and refugees during this difficult time and to provide practical tools to manage stress and worry. 
• Key Takeaway: It is important for organizations to be flexible in their service delivery and to actively reach out to clients.

Juliana Pelinsom Marques, Coordinator, Newcomer Community Wellness Program, Immigrant Services Association of Nova Scotia writes:

Living Well in Times of Self-Isolation is an online session created to address the mental health of immigrants and refugees during the COVID-19 pandemic. In the current situation, it is more important than ever to focus on taking care of yourself. This situation is stressful for everyone and it is important to normalize the stress and worry. 

The impact of the COVID-19 pandemic can be experienced in many different ways, including feelings of depression, grief, fear, panic, stress and anxiety, which can be normal responses to situations where day-to-day routines are disrupted, and circumstances are uncertain and perceived as potentially risky. In a recent study by Statistics Canada, it is reported that the mental health of more than half (52%) of recent immigrants has worsened since the implementation of physical distancing.  The "Living Well in Times of Self-Isolation" online sessions were planned to support immigrants and refugees during this difficult time and to provide practical tools to manage stress and worry. 

The "Living Well in Times of Self-Isolation" session also raised awareness about mental health and the need to cope with stress and anxiety during this and other difficult times among clients. They asked for more sessions, and then the Online Wellness Support Group was created. It has already been 6 sessions, and clients are happy to have a safe space to talk about their emotions. 

In addition, the initial idea was to deliver only the "Living Well in Times of Self-Isolation" group session to different groups of clients. A list of vulnerable clients was developed, and they were individually contacted by an interpreter and invited to the session. We noticed many of them didn't feel comfortable with technology or didn't possess resources/equipment to partake in the session. We then offered to talk with them individually. This individual session was crucial, and many of them ended up being referred to other Mental Health service providers in the community, as they were experiencing a high risk of developing mental health disorders. 

In the “Living Well in Times of Self-Isolation” online session, clients learn about:

• The impact of stress on the body, family, and relationships
•  Healthy strategies to cope with stress
• New tools, habits, and resources for navigating uncertainty, including stress reduction exercises
• Services and resources at ISANS and in the community that can support and address individual issues
• A few practical tools used during the sessions include the following: grounding techniques (such as check-ins and five senses exercises), worry management techniques, gratitude exercises, mental health continuum checklist, planning/finding balance in their routines, breathing techniques, and positive self-talk. 

Here are some tips for other service providers who may be interested in implementing a similar model:

• Sessions of Living Well in Times of Self-Isolation were offered to immigrants who can communicate in English (CLB 4 or higher) and also to language specific groups, with the presence of an interpreter (Example: Arabic group).
•  Sessions in English took around 1 hour to be completed; the sessions targeting language specific groups with the presence of an interpreter took around 1 hour and 20 minutes.
• The sessions were delivered using the ZOOM platform, and the facilitator engaged clients with questions and encouraged comments, using their own microphones or the chat box. The possibility of sharing ideas and comments, and even making questions throughout the whole session were extremely important to the success of this initiative.
• It was noted that this online session was useful for normalizing stress and mental health, besides creating rapport and trust with the facilitator. Some clients even contacted the Facilitator later on looking for one-on-one support
• When reaching out to clients inviting them to the sessions, a few of them mentioned to not feel comfortable with online sessions (many due to lack of computer literacy or equipment) and asked to be seen one-on-one. They were interested to talk about their stress and learn new tools to navigate this difficult time – just the invitation to the sessions was enough to open the door to the mental health discussion with the Wellness Coordinator, who then delivered one-on-one sessions remotely over the phone.
• The sessions with CLB 4 or higher group were so successful that it became a bi-weekly Online Wellness Support Group, where the Wellness Coordinator leads discussions on how to balance clients’ emotional wellbeing. These sessions started with the attendance of 8-10 clients, and after 4 sessions, our numbers have grown to over 20 clients per session. Some examples of topics discussed in this group are Routine During Self-Isolation; How to keep your kids busy (and learning) during the COVID-19 pandemic; Self-Compassion; Goal Setting, The Mental Health Continuum; Mental Health Resources in the Community. 

For more information, we have a website for the overall Newcomer Wellness Program. The "Living Well in Times of Self-Isolation" online group sessions are part of this program.

Multicultural Women’s Peer Mentoring Group 

Location:  Vancouver, BC

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee women
• The Need:  For immigrant and refugee women especially, the need to offer more social programs that help and encourage them to feel a sense of belonging was acknowledged.
• What's Promising:  The Multicultural Women’s Peer Mentoring Group provides an engaging, welcoming and safe environment that encourages all women to be more actively and positively present in society. The program emphasizes multiculturalism, provides opportunities to improve language skills, allows for community capacity building and assists in establishing peer support networks.
• Key Takeaway:  By providing an opportunity for newcomers to participate in collective activities this can positively impact their mental health by alleviating certain stressors and barriers to integration and by empowering participants to use their own agency, thoughts and skills to contribute to a new community.

Kwangyoung Conn, Multicultural Settlement and Labour Market Program Worker writes:

The Multicultural Women’s Peer Mentoring Group is one of the community connection programs offered at the South Vancouver Neighbourhood House. The program was developed in 2007 by a Multicultural Settlement and Labour Market Program Worker, Kwangyoung Conn and a group of long-term residents.

There was a growing concern about mental health issues and social isolation; for immigrant and refugee women especially, we acknowledged the need to offer more social programs that help and encourage them to feel a sense of belonging. The program is designed for immigrant women who have unfortunately felt isolated in their community due to language barriers or a lack of welcoming resources that give them the safety and acceptance that they need.  Undoubtedly, every woman has her own skills and strengths that should be recognized and utilized.  Also, women need to be empowered to explore their thoughts and ideas regardless of their ethnicity or their literacy level. This program creates an engaging and welcoming environment that encourages all women to be more actively and positively present in our society.

The program is based on many components that highlight what Canada is all about.  The program emphasizes a practice of multiculturalism, where the women can exchange information about their lives and cultural experiences, as well as make contributions with their own skills and ideas, given their unique cultures, which can be incorporated into group activities.  Newcomers are able to make social connections with long-term residents, while also improving their English language skills at the same time, which can help with their settlement in Canada.  Our long-term residents are able to find ways of supporting newcomers by gaining an understanding of the challenges and settlement issues that newcomers face upon arrival in Canada.  The program helps the women to build a mutual support network and to gain both cultural and educational learning experiences.  Furthermore, by collaborating within our various group activities and events, in partnership with various community organizations, women are able to contribute towards building our community capacity. In addition, the group participants are able to build a peer support network by sharing their life experiences, resulting in an exchange of strengths and skills, as well as community resources.  Newcomers have shared that they feel confident and supported because of the encouragement and emotional support that they receive through their collaborative work with other women. 

Newcomer women are given the opportunity to participate in various program activities, such as:

• Community engagement consultations and event projects: The group has participated in research/consultation projects with different community partners such as post-secondary schools (UBC and Langara College) and local libraries, regarding immigration and refugee policies and support systems. The group participants have an opportunity to share their settlement experiences, in addition to their settlement challenges and issues, which might be taken into consideration when making policy changes to support services for newcomers.  The group has also held an annual community event through funding from Neighbourhood Small Grants (please check out our story - https://neighbourhoodsmallgrants.ca/ ).  The group has been successfully funded each year, and they have hosted numerous events as a result of this funding, mainly addressing multiculturalism, diversity, and environmental issues.
•  Guest speakers for learning about Canadian society: The group has invited professionals such as local politicians (like the Vancouver South MP (Harjit Sajjan), a local community policing officer, mental health workers, and public health nurses.  The group had meetings with each in separate sessions, and asked questions about important issues affecting their daily lives, as well as shared their concerns.  The topics were mainly on marijuana legalization, community safety, and mental health.  These events provided newcomers with knowledge and understanding about the Canadian government and social welfare systems, in order for them to fully participate in Canadian society.  There were also volunteer trainers from the Canadian Red Cross.  The City of Vancouver offered First Aid Training and an earthquake preparation workshop.  The group obtained hands-on information and resources to help them to respond to various emergency situations.
• Field trips to local venues: The group has participated in various field trips that have helped the women (especially the newcomers) to learn about local attractions and community resources such as The CBC Radio’s Annual Food Bank and Open House, Science World’s Open House events, local community garden sites, public libraries, etc.
• Group Discussion activities: The group shared their thoughts on important issues in small breakout exercises.  This allowed them to learn about the similarities and differences within the group, which helps to minimize misunderstandings around cultural behaviours and practices.  It also helps newcomer women to improve their English-speaking skills by sharing and exchanging their own resources and skills-based on their own life experiences, which empowers them to be self-reliant and better able to cope with difficult times.
• Cultural celebration events and activities to promote multiculturalism: The women participated in various group activities to celebrate their own cultures and special holidays such as the lunar New Year, Vasaki, Nowruz, Halloween, etc.  This not only helped the women to have a better understanding of diverse cultural and religious practices but also helped to create a safe and welcoming place to live in their community.  These events also help newcomers to create a great network and support system that allows them to develop friendships and mutual support

Program activities that take place in a collective environment help newcomer women to connect with other women, to share their life experiences, and to build a positive support network.  Newcomer women are able to increase their self-confidence and employability through group participation.  They also learn about community resources through interactive discussions and from guest speakers.  This helps them to navigate Canadian systems for their settlement.  The program provides the participants with a great opportunity to improve their English communication skills, as well as opportunities to engage in community-based events where they are invited to participate in planning and deliberation.

Traditional Embroidery as a Settlement Mental Health Modality with Arabic Speaking Refugee Women 

Location:  Toronto, ON

Quick Facts

• Audience:  Settlement, social, and health service providers
• Population of Interest: Immigrants and refugees, Arabic-speaking refugee women
• The Need:  With the influx of Syrian Refugees in 2016, Access Alliance was on the front line providing health and settlement services. Due to experiences of trauma and loss within the community, there became an urgent need for accessible mental health programs.
• What's Promising:  Access Alliance has successfully incorporated Expressive Arts in many settlement programs through the medium of traditional embroidery. Demonstrating an accessible and culturally relevant approach, this program models how art therapy can support the settlement and mental health of refugees and newcomer populations.
• Key Takeaway:  Combining expressive arts and settlement can be an incredibly helpful to support the mental health and well-being on newcomers to Canada. It is important to incorporate the skills of Settlement, Mental Health and Creative professionals in order to maximize the support for clients.

Access Alliance has a long history of incorporating arts in its settlement and mental health programing. Arts based programs, ranging from choral singing, to dancing, to crafting, are used across the agency. Access Alliance’s diverse communities have bonded and benefited greatly from making art together. Our first structured Expressive Arts initiative reaches back to 2005 when we deliberately engaged art therapists in our trauma-informed care with refugee women who had experienced violence. Evaluation results indicated that this program contributed significantly in reducing both physical and emotional isolation, overcoming barriers in communication, as well as forging cross-cultural friendships and networks. Since then we have successfully incorporated Expressive Arts in many settlement programs across age, ethnicity and gender groups, helping countless refugees and immigrants overcome barriers.

With the influx of Syrian Refugees in 2016, Access Alliance was on the front-line providing health and settlement services. Due to experiences of trauma and loss within the community, there became an urgent need for accessible mental health programs. Clients had experienced stress related to death and loss of loved ones, war and violence as well as loss of their homes, homeland and personal items. In Canada, clients were also experiencing language barriers, lack of childcare, challenges with system navigation and social isolation. The combination of these stressors was leading to mental health impacts such as depression, anxiety and Post Traumatic Stress Disorder.

Access Alliance answered the call using the evidence-based modality of Art Therapy and the medium of traditional embroidery. Demonstrating an accessible and culturally relevant approach, this program models how art therapy can support the settlement and mental health of refugees and newcomer populations.

Expressive arts is a modality that uses nonverbal language of art for personal growth, insight and transformation and is a means of connecting what is inside us – our thoughts, feelings, and perceptions – with our outer realities and life experiences.  It is based on the belief that art can help us understand who we are and enhance life through self-expression. It is not about the art therapist or facilitator imposing ideas or beliefs on participants – it is a process for participants to gently learn about themselves and come to conclusions with the facilitator or art therapist as a guide. The artwork should never be judged or compared, rather it should be celebrated as the self-expression of the person that created it.

Textile art was chosen as the creative medium for this group as it has been used traditionally in Syria for expression of identity, social status, secrets, and stories. Many women were taught embroidery at a young age and would embroider both clothing and household items such as bed covers, wall hangings, and pillowcases. It seemed to be a suitable outlet to support the women in the group to tell their stories. Furthermore, creating art with fiber has demonstrated psychological benefits, including the promotion of coping skills as well as the development of skills and mastery of the medium.

There were several aims of the Arabic women’s embroidery group including: helping participants build a sense of community and connection to one another; to foster a sense of connection to “home” through their embroidered artwork; encourage self-expression through textile making by telling visual stories about their lives and offering the chance for the participants to use embroidery to share their stories with people living in Canada.

The program is trauma informed, meaning that facilitators understand, recognize and respond to trauma in the group. Because we are working with refugees, we recognize that anyone in the group may have experienced trauma. We recognize participant disclosures may require the support of a social worker/mental health professional. We also ensure that the program is culturally informed. Meaning facilitators need to understand where the client is from, their culture and how that impacts their thought, behavior preferred type of art.

The mental health of the clients is supported through bringing the group together for social connection, and through self-expression. Through bringing in a settlement worker, we are able to address the causes of stress related to system navigation and access to services.

Combining expressive arts and settlement can be an incredibly helpful to support the mental health and well-being on newcomers to Canada. It is important to incorporate the skills of Settlement, Mental Health and Creative professionals in order to maximize the support for clients. Developing partnerships and working in a collaborative and interdisciplinary way is essential. Ensuring the program is accessible and free of barriers is necessary to ensure participation. This means providing interpretation, transportation, childcare and culturally relevant programming.

Newcomer Initiative for Arabic-Speaking Youth 

Location:  National

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrants and refugees, Arabic-speaking youth
• The Need:  There is a lack of in-language mental health services available for the high number of Arabic-speaking young people in Canada.
• What's Promising:  Kids Help Phone recently launched a pilot service through which they are offering telephone counselling service, in Arabic, facilitated by an interpreter service, for a trial period of six months. This service also works to ensure that the professional counsellors are well-trained in aspects of cultural humility and multicultural counselling.
• Key Takeaway:  This has involved comprehensive research, the collection of feedback from Arabic-speaking youth populations and speaking with multiple stakeholders working in the newcomer space to effectively plan and implement a service that is sensitive to the needs of immigrants and refugees with a lens on the Arabic-speaking community.

Ravina Anthony, Project Manager, Newcomer and Diversity Initiatives, Kids Help Phone writes:

Our initial research indicated that there was a lack of in-language mental health services available for the high number of Arabic-speaking young people who have entered Canada in recent years as refugees and immigrants. Moreover, the English or French proficiency levels of this particular population, that is Arabic-speaking communities, was generally lower than newcomers from other countries (Houle, 2019). This pilot service was developed to test the feasibility of offering over-the-phone, professional counselling, facilitated by interpreters in a newcomer-specific language.

With generous funding from Immigration, Refugees and Citizenship Canada (IRCC), we have recently launched a pilot service through which we are offering our telephone counselling service, in Arabic, facilitated by an interpreter service, for a trial period of six months (May – October 2020). We are thrilled to be offering this new service that allows Kids Help Phone to become more culturally and linguistically inclusive in our service delivery and innovation.

This service is available to all Arabic-speaking youth in Canada (regardless of legal status). They can call 1-800-668-6868 and select 3 for services in Arabic. This includes Syrian refugees, newcomers and other kids, teens and young adults across Canada who prefer to receive support in Arabic.

Kids Help Phone addresses the mental health of immigrants and refugees by ensuring that our professional counsellors are well-trained in aspects of cultural humility and multicultural counselling.

We recognize that refugees and newcomers to Canada may experience unique challenges and struggles. Over the past year, we have conducted comprehensive research, collected feedback from Arabic-speaking youth populations and talked with multiple stakeholders working in the newcomer space to effectively plan and implement a service that is sensitive to the needs of immigrants and refugees with a lens on the Arabic-speaking community.

Through this service, we’re empowering Arabic-speaking youth in Canada to reach out for support. We’re offering them a safe, trusted, non-judgmental space to talk and receive e-mental health support from a professional in a language they’re more comfortable speaking.

Kids Help Phone is Canada’s only 24/7, national mental health support service. For the last 31 years, we have been there for youth in English and French and now, we are looking to you to help us reduce the stigma attached to help-seeking behaviour in newcomer communities. If you are aware of or work closely with Arabic-Speaking young people who might benefit from availing our new service, we encourage you to share information about our service. Our promotional materials can be downloaded through our webpage: Supporting Arabic-Speaking Youth at kidshelpphone.ca.

Simcoe County Local Immigration Partnership public education campaign encourages collective action against racism and discrimination 

Location:  Toronto, ON

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee populations
• The Need:  There was a lack of ethno-specific and culturally competent services specific to aid African, Caribbean and Black people living with HIV or affected by HIV/AIDS.
• What's Promising:  Black-CAP responded to the need for adequate and appropriate services, including Support and Harm Reduction teams that address mental health, for African, Caribbean and Black communities who were diagnosed or affected by HIV/AIDS.
• Key Takeaway:  Take some time to research, talk with others in the community and gain knowledge to strengthen the relationship and trust that the client forms with you. Also, alongside having strong alliances with other AIDS Service organizations, Black CAP has remained a source of strength and advocacy in the ACB community.

Tineke Harrison-Hansraj, Interim Mental Health Coordinator, Black Coalition For AIDS Prevention, writes:

In the 1980s, there was a rise in the number of African, Caribbean and Black (ACB) individuals who were being diagnosed with HIV (Human Immunodeficiency Virus) in Toronto. However, at that time, there were no ethno-specific and culturally competent services to aid them. In response, the Toronto AIDS Committee started the Black AIDS Project and from this a steering committee entitled Black Coalition for AIDS Prevention (Black-CAP) emerged. Over the past 30 years, Black-CAP has grown to become the largest Black AIDS Service Organization in Canada.

Black-CAP is a volunteer-driven, charitable, not-for-profit, community-based organization. We provide HIV/AIDS education, prevention, settlement, mental health and other supports to the culturally diverse ACB communities in Toronto, including LGBTQ+ identified people. Our mission is to reduce the transmission of HIV within Black communities and to enhance the quality of life for ACB people living with HIV or affected by HIV/AIDS. There have been significant changes over the years – from the initial 3 staff to now over 25, and countless volunteers – Black CAP has grown to include further services such as Refugee and Settlement, Support Workers, Harm Reduction, Healthy Sexuality Educators, Clinical Youth Outreach and Mental Health.

Our organization addresses the mental health needs of immigrants and refugees through our Support and Harm Reduction teams. Within the Support team, there is a Refugee Settlement Worker and a Settlement Coordinator who start and follow the journey of clients from arrival in Canada, to their hearing, and beyond. Their role is predominantly to help clients with their basis of claims forms, understanding the process and connecting them with other supports. In addition, the Support, Women Support and Women Peer Support Coordinators work alongside clients as advocates, community workers and outreach workers to support their integration. We also have a Clinical Youth Outreach Worker who provides support to immigrant and refugee youth aged 12-25 who are LGBTQ+ or living with HIV or both. Counseling is provided through various clinical and holistic strategies.

Within the Harm Reduction team, we have MSM (Men who have sex with men), Trans outreach, Prevention and Education coordinators who are tasked with providing different supports. For example, educators work to aid clients who may be dealing with or affected by substance use. As a team we work together to ensure that each client has well-rounded and dedicated supports.

There are certain components that service providers should keep in mind when working with this vulnerable population. For example, when working with ACB immigrant and refugee clients ensure that you are aware of the stigmas and discrimination that our own government systems have regarding this population. This includes the addition of a Tuberculosis test; which clients must pay for themselves and in many cases results in forced treatment – even if the client has been successfully treated in the past. This is an additional stressor for those in the ACB community when arriving in a new country - beyond the already daunting task of trying to establish themselves. This additional medical testing can further delay the processing of their application and overall be extremely burdensome and traumatizing.

Gaining an understanding of the culture, traditions and history of people from African and Caribbean regions can greatly improve the work you do with clients. The upbringing and life experiences of clients can greatly affect their willingness to engage in traditional clinical practice. Take some time to research, talk with others in the community and gain knowledge to strengthen the relationship and trust that the client forms with you. Also, alongside having strong alliances with other AIDS Service organizations, Black CAP has remained a source of strength and advocacy in the ACB community, and we hope that all clients can experience this at every organization they visit. Immigrants and refugees all have stories to tell and providing the space for them to do so is very powerful in itself.

HIV Edmonton

Location:  Edmonton, AB

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee populations
• The Need:  It is recognized that a positive HIV result upon immigration can exacerbate the social isolation often experienced by newcomers which can have lingering mental health effects.
• What's Promising:  HIV Edmonton developed the Newcomer Support Program to provide intensive support to newcomer individuals with HIV to address their underscoring emotional, informational and mental health needs
• Key Takeaway:  To reduce denial, stigma, and discrimination, as service providers it is important to engage in conversations about mental and sexual health while facilitating ongoing treatment, care and support for individuals living with HIV

HIV Edmonton was founded by Michael Phair and a group of close friends in 1984, as Edmonton braced for its own AIDS outbreak. HIV Edmonton adopted harm reduction principles, and was developed to provide support for individuals living with or affected by HIV in the community. The agency was originally called the AIDS Network of Edmonton, but in 1999 it changed its name to HIV Edmonton to better reflect the advancements in the area of HIV and AIDS.

HIV Edmonton is a charitable organization serving people and communities primarily in metropolitan Edmonton. We are dedicated to making life better for people living with, or affected by HIV and AIDS. We do this by focusing on the elimination of HIV transmission and AIDS-related deaths and working to erase the stigma and discrimination faced by people living with, and affected by HIV and AIDS. 

HIV Edmonton supports people living with, and affected by HIV and AIDS by: developing educational resources for community organizations, healthcare professionals and the general public; developing and delivering prevention, health promotion and support programs; and providing a voice for people living with, and affected by HIV and AIDS through our work with local, provincial and national organizations on policy development, health strategy and program design.

We recognized a positive HIV result upon immigration can exacerbate the social isolation often experienced by newcomers which can have lingering mental health effects. Through our Newcomer Support Program funded by IRCC, we provide intensive support to newcomer individuals to address their underscoring emotional, informational and mental health needs, from a strengths-based approach. The program also provides a safe supportive environment for clients to express themselves without fear of judgement or prejudice. The Newcomer Support Program Coordinator offers one-on-one support which includes trauma-informed crisis counselling and referrals to other mental health support across the city. The Coordinator also facilitates group workshops to normalize conversations around sexual health to ensure participants are well-equipped to make informed choices regarding their health and wellness.

It is crucial to create a positive and welcoming environment for all who use our services. To reduce denial, stigma, and discrimination we have to engage in conversations about mental and sexual health while facilitating ongoing treatment, care and support for individuals living with HIV. It is also important to acknowledge the complex relationship between immigration/refugee status and health outcomes. A strengths-based approach can be an effective way to address these complexities.

Trauma Centered Trauma-Sensitive Yoga 

Location:  National

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Immigrant and refugee populations, particularly trauma survivors
• The Need:  Refugees who come to Canada may have experienced trauma. Integrating trauma-informed yoga into a treatment plan may lead to better mental health outcomes for these individuals, as evidence suggests that the body is a crucial tool for helping people process trauma.
• What's Promising:  Trauma-informed yoga can be used as an innovative adjunctive treatment for complex trauma.
• Key Takeaway:  Trauma centered trauma-sensitive yoga can be integrated as a program or service, serving as an alterative method for processing trauma.

Some immigrants and refugees may have experienced trauma. Although different people respond to traumatic experiences in different ways, most people will not require trauma treatment. Nevertheless, trauma is an experience that can overwhelm an individual’s emotional and psychological ability to cope. Evidence suggests that programs and services for refugees should be trauma-informed to ensure that service providers recognize the effect of trauma on survivors and incorporate this knowledge into service delivery (Fallot & Harris, 2001; Blanch, 2008).

Trauma Centered Trauma-Sensitive Yoga (TCTSY) is an empirically validated, adjunctive treatment for complex trauma or chronic, treatment-resistant PTSD and can help people find new possible ways of feeling in their bodies.

The TCTSY methodology is based on central components of the hatha style of yoga, where participants engage in a series of physical forms and movements. Elements of standard hatha yoga are modified to maximize experiences of empowerment and to cultivate a more positive relationship to one's body. Unlike many public yoga classes, TCTSY does not use physical hands-on adjustments to influence a participant's physical form. Rather, TCTSY presents opportunities for participants to be in charge of themselves based on a felt sense of their own body.  We consider physical assist to be a clinical issue and we do not involve any adjustments in TCTSY, nor do we recommend them. Especially in dealing with immigrants or refugees, touching may be culturally inappropriate. This kind of yoga also excludes the use of any sanskrit or mantras (what may often be experienced in public classes) and avoids potentially triggering gestures and postures; making it accessible to all and is especially ideal for immigrants and refugees who might otherwise be uncomfortable with traditional yoga styles.

More and more research is coming out that point to the body as a crucial tool for helping people process trauma. Trauma is based on immobilization and trauma-sensitive yoga is an opportunity for the opposite - for a person to be completely in charge of his or her body in the present moment. By becoming aware of our body movement, by noticing our sensations, we can help rewire the brain-body experience —potentially then also allowing for a new autographical narrative. In my experience working with refugee children, watching them create this new understanding and relationship with their personal space and self also becomes a bridge to rebuilding their curiosity. Therefore, two of the most important questions we can ask ourselves in a trauma-informed yoga practice are: what am I feeling in my body and what do I want to do about that?

TCTSY is equally accessible to all people regardless of age, gender identity, race, ethnicity, body type, and physical ability. As a service provider, integrating TCTSY into your treatment plan, referring clients to partake in this practice, or by incorporating a certified facilitator into your organizations’ team, may serve as an alternative to more traditional treatments.

For a list of Canadian certified facilitators, and to learn more about this practice, feel free to visit our website.

Women Sharing Heritage Program, Association for New Canadians

Location:  St. John’s, Newfoundland and Labrador

Quick Facts

• Audience:  Settlement and social workers
• Population of Interest: Immigrant and refugee populations
• The Need:  Evidence shows that refugee women are particularly vulnerable to experiencing sexual and gender-based violence. Safe spaces are needed to facilitate social networks and a sense of community belonging.
• What's Promising:  The Women Sharing Heritage (WiSH) Program demonstrates how a connection to land, sea, sky and others can positively influence the mental health of refugee women.
• Key Takeaway:  Physical and psychological health are positively influenced by engagement with nature and with one another

Suzy Haghighi, Director of Settlement Services, Association for New Canadians, writes:

Association for New Canadians (ANC) is a non-profit, community-based organization that has delivered settlement and integration services to immigrants and refugees in Newfoundland and Labrador for over 40 years. Part of this work includes offering holistic programs and services to Government Assisted Refugees that are rooted in the social determinants of health. We work with individuals and families to secure housing, learn English, enroll in school, develop or enhance skills, and to secure employment. We offer childcare services for language learners at our English school and offer programming to connect with community and one another.  Settlement Social Workers offer short-term counseling and we have a public health clinic located on site. Through our holistic approach, we have developed trusting, empowering relationships with individuals and families.  These collaborative partnerships facilitate positive outcomes for newcomers as they establish lives in Canada and become a vital and enriching part of our community.

Statistics tell us that refugee women are more likely to experience or be vulnerable to sexual and gender-based violence (SGBV) during displacement, flight to safety and in communities where they resettle. Women, particularly those arriving alone or as single parents, may have limited social and family supports and be vulnerable to isolation.

Women Sharing Heritage (WiSH) Program

In response, ANC saw a need to develop a program that connects women to their community and decreases isolation. Drawing on the expertise of Fishing For Success, we established the six-week WiSH program to connect women to the outdoors, traditional Newfoundland and Labradorean crafts and activities and other young women from the province. WiSH is a part of our group programming to support young newcomer women who may have experienced SGBV. It serves as a safe space to socialize and explore, while celebrating one another’s culture and ways of knowing.

We call it an “un-program” as we purposely try to create a loose structure for the group to let the women determine what they want to do; activities have included cod fishing, berry picking, an Eritrean coffee ceremony and dancing.

Research tells us that physical and psychological health are positively influenced by engagement with nature and with one another. There is power connecting to land, sea, sky, and one another. Women, and particularly those arriving as Government Assisted Refugees, face so many stressors as they establish lives in Canada. Nature provides a safe space and time for self-directed healing and is a wonderful setting for cross-cultural knowledge exchange. The program has led to positive outcomes for many of the women we work with, including increased school attendance, fewer crisis interventions, and increased confidence in decision making with peers and family.

WiSH serves as an example of group programming that takes place outside the confines of a traditional settlement or health service setting. Service providers can replicate this promising practice in different ways by using nature as the catalyst for support.  In addition, nature-based activities often serve as good opportunities to provide a client with a space to connect with others and to establish a sense of belonging – all of which can lead to better mental health outcomes.