Global Position Statement: Stigma, Mental Illness and Diversity

Careif is an international mental health charity that works towards protecting and promoting mental health, wellbeing, resilience and resourcefulness with a special focus towards eliminating inequalities and strengthening social justice. Our principles include working creatively with humility, dignity and balanced partnerships in order to ensure that all cultures and societies play their part in our mission of protecting and promoting mental health and wellbeing. We do this by respecting the traditions of all world societies, whilst believing that culture and traditions can evolve for even greater benefit to individuals and society. Globalisation has created culturally rich and diverse societies. During the past several decades, there has been a steadily increasing recognition of the importance of societal and cultural influences on life and health. Societies are becoming multi-ethnic and poly-cultural in nature worldwide, where different groups enrich each other's lives with their unique culture/s. Cultural transition and acculturation is often discussed as relevant to migrants and mentions the need to integrate, when in fact it is of relevance to all cultures in an ever interconnecting world. It is indeed necessary to be equipped with knowledge about cultures and their influence on mental health and illness. Culturally informed mental health care is rapidly moving from an attitudinal orientation to an evidence-based approach, therefore understanding culture and mental health care becomes greater than a health care issue

Conceptualization, Measurement, and Association of Underemployment to Mental Health Inequities between Immigrant and Canadian-born Labour Force Participants

This thesis aims to increase understanding of the association of underemployment (unemployment or overqualification) to mental health inequities between immigrant and Canadian-born labour force participants. The first paper provides a theoretical framework to guide design, analyses and interpretation of findings for this thesis, and future research on social determinants of mental health inequities. The second paper uses the Canadian Community Health Survey (CCHS) Cycle 1.2 to assess the construct validity of self-rated mental health (SRMH) for the overall population, and sub-groups by immigrant status and sex. Positive associations between SRMH and a comprehensive array of mental morbidity measures were large and consistent, but a sizeable percentage of respondents with mental morbidity did not rate their mental health as fair/poor. SRMH is useful for assessing social determinants of inequities in general mental health, but not specific mental health morbidities. The third paper uses CCHS Cycle 2.1 (2003) to examine the association of underemployment to fair/poor self-rated mental health (SRMH) in: 1. labour force participants (18-64yrs) in Canada, and 2. between a. immigrants vs. Canadian-born labour force participants, and b. recent immigrant (Ph.D

Opportunity costs: Underemployment and mental health inequities between immigrant and Canadian-born labour force participants, a cross-sectional study

Objectives To examine the association of underemployment (operationalized as unemployment or overqualification) to fair/poor self-rated mental health (SRMH) in: 1. labour force participants, 2. between a. immigrant vs. Canadian-born and b. recent (< 10 years in Canada; arrived 1993-2003) vs. long-term immigrant (³ 10 years in Canada) labour force participants. Methods Data from the Canadian Community Health Survey (CCHS) 2.1 (2003) was used to explore associations within the context of a 1993 national immigration policy shift prioritizing admission of skilled immigrants. Logistic regression analyses were performed to estimate odds ratios associating underemployment with fair/poor SRMH for the full study sample, then stratified by a. immigrant status, and b. length of time in Canada. Data was weighted to reflect the CCHS 2.1 sample design, adjustments for nonresponse, and post-stratification. The study sample included 57 308 labour force participants aged 18–64. Following a listwise deletion of participants with missing values for independent variables, dependent variable, and/or covariates, the resulting sample was 54 064 (94% of the eligible sample). Results Underemployment was positively associated to fair/poor SRMH for labour force participants. Overqualification was positively associated to fair/poor SRMH for immigrant (AOR 1.63; 95% CI 1.16 to 2.27), but not for Canadian-born labour force participants (AOR 1.03; 95% CI 0.90 to 1.20). Unemployment (AOR 3.41; 95% CI 1.79 to 6.48) and overqualification (AOR 1.52; 95% CI 1.04 to 2.21) only had significant positive associations with fair/poor SRMH for long-term immigrants. The magnitude of association of overqualification was greater for recent (AOR 2.04) than long-term immigrants and this may have practical importance. Conclusions The findings suggest the need for tailored interventions to prevent underemployment and fair/poor SRMH for immigrant vs. Canadian-born labour force participants. A whole of government approach is needed to reduce underemployment of immigrants and its mental health impact.Dr. Farah N. Mawani: Current funding: - Canadian Institutes of Health Research (CIHR) Health System Impact Fellowship. While designing and conducting this study: - CIHR Institute of Gender and Health Canada Graduate Scholarship Doctoral Research Award - CIHR Research in Addictions and Mental Health Policy & Services (RAMHPS) Fellowship - Statistics Canada Tom Symons Research Fellowship - Graduate Ontario Student Opportunity Trust Funds (OSOTF) Institute for Work and Health Graduate Fellowship - CP Shah Ontario Graduate Scholarship in Science and Technology - University of Toronto Open Fellowship