An Analysis of Canadian Psychiatric Mental Health Nursing through the Junctures of History, Gender, Nursing Education, and Quality of Work Life in Ontario, Manitoba, Alberta, and Saskatchewan

A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN). This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner.</jats:p

Digital exclusion of racialized women at risk of Gender-Based Violence during the COVID-19 pandemic

Racialized women at risk of gender-based violence are a priority group to focus on for upstream mental health support during the COVID-19 pandemic. Data collection is a strategic tool to address the specific risks of women experiencing GBV. We will present findings from our knowledge synthesis project to analyze guiding principles for data collection

A Whole Community Approach toward Child and Youth Resilience Promotion: A Review of Resilience Literature

A literature review of child and youth resilience with a focus on: definitions and factors of resilience; relationships between resilience, mental health and social outcomes; evidence for resilience promoting interventions; and implications for reducing health inequities. To conduct the review, the first two following steps were conducted iteratively and informed the third step: 1) Review of published peer-review literature since 2000; and 2) Review of grey literature; and 3) Quasi-realist synthesis of evidence. Evidence from three perspectives were examined: i) whether interventions can improve ‘resilience’ for vulnerable children and youth; ii) whether there is a differential effect among different populations; and, iii) whether there is evidence that resilience interventions ‘close the gap’ on health and social outcome measures. Definitions of resilience vary as do perspectives on it. We argue for a hybrid approach that recognizes the value of combining multiple theoretical perspectives, epistemologies (positivistic and constructivist/interpretive/critical) in studying resilience. Resilience is: a) a process (rather than a single event), b) a continuum (rather than a binary outcome), and c) likely a global concept with specific dimensions. Individual, family and social environmental factors influence resilience. A social determinants perspective on resilience and mental health is emphasized. Programs and interventions to promoting resilience should be complimentary to public health measures addressing the social determinants of health. A whole community approach to resilience is suggested as a step toward closing the public health policy gap. Local initiatives that stimulate a local transformation process are needed. Recognition of each child’s or youth’s intersections of gender, lifestage, family resources within the context of their identity markers fits with a localized approach to resilience promotion and, at the same time, requires recognition of the broader determinants of population health

Becoming Resilient: Promoting the Mental Health and Well-Being of Immigrant Women in a Canadian Context

This paper reports on grounded theory findings that are relevant to promoting the mental health and well-being of immigrant women in Canada. The findings illustrate how relationships among settlement factors and dynamics of empowerment had implications for “becoming resilient” as immigrant women and how various health promotion approaches enhanced their well-being. Dimensions of empowerment were embedded in the content and process of the feminist health promotion approach used in this study. Four focus groups were completed in Toronto, Ontario, Canada with 35 racialized immigrant women who represented diverse countries of origin: 25 were from Africa; others were equally represented from South Asia (5), Asia (5), and Central or South America and the Caribbean (5). Participants represented diverse languages, family dynamics, and educational backgrounds. One focus group was conducted in Somali; three were conducted in English. Constructivist grounded theory, theoretical sampling, and a critical feminist approach were chosen to be congruent with health promotion research that fostered women's empowerment. Findings foreground women's agency in the study process, the ways that immigrant women name and frame issues relevant to their lives, and the interplay among individual, family, community, and structural dynamics shaping their well-being. Implications for mental health promotion are discussed

Stressors and Barriers to Services for Immigrant Fathers Raising Children with Developmental Disabilities

This narrative review examines research on the experiences of immigrant fathers raising children with developmental disabilities, and considers the findings within the Canadian context. Applying Green, Johnson & Adams’ (Journal of Chiropractic Medicine, 5(3), 101–117, 2006) methodology, a step-by-step process was followed to conduct the review. Four databases (PsychINFO, PubMed, CINAHL and Sociological Abstracts) were used for the search. A total of 39 articles were found to be relevant after applying the inclusion/exclusion criteria. Also 20 articles from published reference lists and peer-reviewed journal articles, located through Google Scholar, complimented the initial search. Along with House’s (1981) four dimensions of social support, an intersectional approach underpinned the analysis of findings. Four themes were identified which included: economic challenges, social influences, cultural influences, and the changing gender roles of fathers. Stressors and barriers to accessing health services in the post-migration setting were examined. Based on the review’s findings, the paper recommends 1) addressing income inequality, 2) improving access to health care, social and developmental services, 3) improving cultural-sensitivity of health care, social and developmental services, and 4) increasing participation of fathers. Overall, a more systemic understanding of immigrant fathers’ experiences is called for, taking into account their multiple social locations

“It is an Issue of not Knowing Where to Go”: Service Providers’ Perspectives on Challenges in Accessing Social Support and Services by Immigrant Mothers of Children with Disabilities

In Canada little is known about the challenges immigrant mothers of children with disabilities encounter in accessing formal and informal social support. This paper presents the perspectives of service providers on the mothers’ challenges. Data was collected from 27 service providers in Toronto, Canada in 2012 through in-depth interviews. The interview guide was informed by published literature on families of children with special needs. Level one analyses entailed descriptive analyses; and level two consisted of applying House’s 4 domains of social support to organize the themes. Following House’s domains, challenges to (1) Structural support, (2) Instrumental support, (3) Emotional support, and (4) Perception of support were identified. Among providers who work with families of children with disabilities there is recognition of the mothers’ particular challenges in light of their immigration status. Language and communication are significant barriers for immigrant mothers in accessing social support

2020 syndemic: convergence of covid-19, gender-based violence, and racism pandemics

Objective: To conduct a rapid knowledge synthesis of literature on the social determinants of mental health of racialized women exposed to gender-based violence (GBV) during the COVID-19 pandemic. Methods: We adapted the Cochrane Rapid Reviews method and were guided by an equity lens in conducting rapid reviews on public health issues. Four electronic databases (Cochrane CENTRAL, Medline, ProQuest, and EBSCO), electronic news media, Google Scholar, and policy documents were searched for literature between January 2019 and October 2020 with no limitations for location. Fifty-five articles qualified for the review. Results: Health emergencies heighten gender inequalities in relation to income, employment, job security, and working conditions. Household stress and pandemic-related restrictions (social distancing, closure of services) increase women’s vulnerability to violence. Systemic racism and discrimination intensify health disparities. Conclusion: Racialized women are experiencing a 2020 Syndemic: a convergence of COVID-19, GBV, and racism pandemics, placing their wellbeing at a disproportionate risk. GBV is a public health issue and gender-responsive COVID-19 programming is essential. Anti-racist and equity-promoting policies to GBV service provision and disaggregated data collection are required

A descriptive phenomenology study of newcomers’ experience of maternity care services: Chinese women’s perspectives

BACKGROUND: Maternity health care available in Canada is based on the needs of women born in Canada and often lacks the flexibility to meet the needs of immigrant women. The purpose of this study was to explore immigrant Chinese women’s experiences in accessing maternity care, the utilization of maternity health services, and the obstacles they perceived in Canada. METHODS: This descriptive phenomenology study used in-depth semi-structured interviews to examine immigrant Chinese women’s experiences. Fifteen participants were recruited from the Chinese community in Toronto, Canada by using purposive sampling. The interviews were digitally recorded and transcribed verbatim into written Chinese. The transcripts were analyzed using Colaizzi’s (1978) phenomenological method. RESULTS: Six themes were extracted from the interviews: (1) preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, (2) strategies to deal with the inconvenience of the Canadian healthcare system (3) multiple resources to obtain pregnancy information, (4) the merits of the Canadian healthcare system, (5) the need for culturally sensitive care, and (6) the emergence of alternative supports and the use of private services. CONCLUSIONS: The findings provide new knowledge and understanding of immigrant Chinese women’s experiences in accessing maternity health services within a large metropolitan Canadian city. Participants described two unique experiences within the themes: preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, and the emergence of alternative supports and the use of private services. Few studies of immigrant maternity service access have identified these experiences which may be linked to cultural difference. Further investigation with women from different cultural backgrounds is needed to develop a comprehensive understanding of immigrant women’s experiences with maternity care