Mental health services for newcomers spread thin in Scarborough

News Sep 24, 2015 by Mike Adler Scarborough Mirror

Mental health services are spread thin in Scarborough, and too many people, particularly newcomers to Canada, fall through the cracks.

A provincial panel studying health care in Scarborough and West Durham Region got that message at meetings last month, from people hoping it can help.

Health care providers, meanwhile, keep trying new programs aimed at reaching Scarborough residents struggling with mental illness despite barriers of culture, language or distance.

Acknowledging people who need cognitive behavioural therapy “typically face challenges like long wait lists, a shortage of therapists, and a lack of access to a therapist outside of regular business hours,” The Scarborough Hospital (TSH) has started putting therapy sessions for outpatients online.

This month, the hospital also announced patients can also use its library of mental health applications for devices, suggesting patients “could use a relaxation app while taking transit to a mental health appointment.”

For now, the apps or online sessions are only available in English.

Dr. David Gratzer, a TSH staff psychiatrist, said they’re a great help anyway to many people with anxiety or depression.

Some patients have physical ailments or busy schedules, and online tools mean the hospital can deliver treatment “on their terms and on their schedule,” said Gratzer, adding the English used is simple and free of jargon.

But in Scarborough, where 58 per cent of residents are immigrants, there are more calls for what are called culturally competent or adaptive mental health services.

Immigrants and visible minorities tend to underutilize mental health services, and in Scarborough many of their needs are still not met, Bonnie Wong, executive director of the Hong Fook Mental Health Association said last month at the agency’s head office on Midland Avenue.

Hong Fook started more than 30 years ago to help people of East Asian backgrounds navigate the health-care system. Today, Raymond Chung, one of its founders, is a member of the provincial panel, but last month panel members were told Scarborough providers don’t offer enough services adapted for people of different cultural backgrounds.

Nor is there any dialogue between local providers such as Hong Fook and the Central East Local Health Integration Network (LHIN), the province’s health authority, on how to fill in these gaps, said Wong.

In last five years, Wong argued, there’s been no real spending increase through the LHIN for mental health programs in Scarborough, “but in Durham it’s double-digit, more than that. That’s a huge discrepancy in terms of investment.”

At one meeting last month, Hong Fook staff and volunteers told the panel culturally competent care means more dignity and respect for patients.

Wong said hiring staff members who speak other languages isn’t enough unless a provider offers culturally adaptive programs and can demonstrate cultural training that extends throughout the organization.

When struggling with mental health, many Scarborough residents of East Asian backgrounds approach settlement services, but avoid mental health services because of language barriers and stigma, Wong said.

“Then they end up in the hospital. We want to do a lot more preventative work.”

Dr. Ian Dawe, mental health and addictions physician lead for the LHIN, which covers an area from Scarborough to Peterborough, said he’s not involved in budgeting, but the issue of service access “is huge” and waits for some mental health services across Ontario “are unconscionably long.”

During his 18 months as lead, Dawe said, the LHIN has launched six significant projects related to Scarborough. The most successful is ACTT, the Assertive Community Treatment Team, “like a hospital without walls” for people with severe and recurring mental illness.

Dawe said people languished on wait lists or hospital beds waiting for ACTT, but the LHIN recently created an “after ACTT,” a step-down program, to expand the service.

“Is there still need out there? Absolutely,” he said.

Mental health challenges affect people from each culturally background differently, said Dawe, adding the University of Toronto, where he teaches, is focused on cultural competency.

“Culturally competent practitioners will be practicing within our boundaries,” Dawe said. “They don’t have to speak the actual language specifically,” but having “good, nuanced understanding” of a culture helps.

Last month, agency representatives told the panel some patients, when discharged from hospital in Scarborough, are not going back to a healthy home.

Gladys Cheung, resident access and support manager for Toronto Community Housing, has a team that tries to connect TCH tenants with infestation or clutter issues to mental health services.

Often in Scarborough, there’s not a whole lot to connect to, she said.

The “best window” to deal with a problem could be when a troubled tenant is in a hospital, but sometimes, Cheung said, her team isn’t “looped in.” If the tenant returns to an unhealthy environment, it can become a revolving door situation, she added.

Services for mental health and addiction are lacking across Toronto, and when tenants are asked to go as far as Ajax for treatment, it’s discouraging, Cheung said. “When you don’t have a car, that’s way too far.”

Claire Fainer, executive director of East Metro Youth Services (EMYS), said it’s hard for the service system to develop the expertise and perhaps cultural competence and sensitivity required by every new population coming to Scarborough.

Scarborough is unique in Toronto because of its transportation challenge for people without cars. If you or your children must see a specialist once or twice every week, as some programs require, “you can’t manage,” Fainer said.

EMYS, named lead agency for Toronto in transforming mental health services for children and youth, wants to make access as easy and equitable as possible across the city, said Fainer, adding EMYS opened a mental health walk-in clinic, now operating six days a week, where youth can be seen within 25 minutes.

“You don’t have to overthink things,” just walk in the door, she said.

Panel members send their recommendations to Health Minister Dr. Eric Hoskins on Oct. 10.

Mental health services for newcomers spread thin in Scarborough

Care providers also have to deal with cultural and language barriers

News Sep 24, 2015 by Mike Adler Scarborough Mirror

Mental health services are spread thin in Scarborough, and too many people, particularly newcomers to Canada, fall through the cracks.

A provincial panel studying health care in Scarborough and West Durham Region got that message at meetings last month, from people hoping it can help.

Health care providers, meanwhile, keep trying new programs aimed at reaching Scarborough residents struggling with mental illness despite barriers of culture, language or distance.

Acknowledging people who need cognitive behavioural therapy “typically face challenges like long wait lists, a shortage of therapists, and a lack of access to a therapist outside of regular business hours,” The Scarborough Hospital (TSH) has started putting therapy sessions for outpatients online.

This month, the hospital also announced patients can also use its library of mental health applications for devices, suggesting patients “could use a relaxation app while taking transit to a mental health appointment.”

For now, the apps or online sessions are only available in English.

Dr. David Gratzer, a TSH staff psychiatrist, said they’re a great help anyway to many people with anxiety or depression.

Some patients have physical ailments or busy schedules, and online tools mean the hospital can deliver treatment “on their terms and on their schedule,” said Gratzer, adding the English used is simple and free of jargon.

But in Scarborough, where 58 per cent of residents are immigrants, there are more calls for what are called culturally competent or adaptive mental health services.

Immigrants and visible minorities tend to underutilize mental health services, and in Scarborough many of their needs are still not met, Bonnie Wong, executive director of the Hong Fook Mental Health Association said last month at the agency’s head office on Midland Avenue.

Hong Fook started more than 30 years ago to help people of East Asian backgrounds navigate the health-care system. Today, Raymond Chung, one of its founders, is a member of the provincial panel, but last month panel members were told Scarborough providers don’t offer enough services adapted for people of different cultural backgrounds.

Nor is there any dialogue between local providers such as Hong Fook and the Central East Local Health Integration Network (LHIN), the province’s health authority, on how to fill in these gaps, said Wong.

In last five years, Wong argued, there’s been no real spending increase through the LHIN for mental health programs in Scarborough, “but in Durham it’s double-digit, more than that. That’s a huge discrepancy in terms of investment.”

At one meeting last month, Hong Fook staff and volunteers told the panel culturally competent care means more dignity and respect for patients.

Wong said hiring staff members who speak other languages isn’t enough unless a provider offers culturally adaptive programs and can demonstrate cultural training that extends throughout the organization.

When struggling with mental health, many Scarborough residents of East Asian backgrounds approach settlement services, but avoid mental health services because of language barriers and stigma, Wong said.

“Then they end up in the hospital. We want to do a lot more preventative work.”

Dr. Ian Dawe, mental health and addictions physician lead for the LHIN, which covers an area from Scarborough to Peterborough, said he’s not involved in budgeting, but the issue of service access “is huge” and waits for some mental health services across Ontario “are unconscionably long.”

During his 18 months as lead, Dawe said, the LHIN has launched six significant projects related to Scarborough. The most successful is ACTT, the Assertive Community Treatment Team, “like a hospital without walls” for people with severe and recurring mental illness.

Dawe said people languished on wait lists or hospital beds waiting for ACTT, but the LHIN recently created an “after ACTT,” a step-down program, to expand the service.

“Is there still need out there? Absolutely,” he said.

Mental health challenges affect people from each culturally background differently, said Dawe, adding the University of Toronto, where he teaches, is focused on cultural competency.

“Culturally competent practitioners will be practicing within our boundaries,” Dawe said. “They don’t have to speak the actual language specifically,” but having “good, nuanced understanding” of a culture helps.

Last month, agency representatives told the panel some patients, when discharged from hospital in Scarborough, are not going back to a healthy home.

Gladys Cheung, resident access and support manager for Toronto Community Housing, has a team that tries to connect TCH tenants with infestation or clutter issues to mental health services.

Often in Scarborough, there’s not a whole lot to connect to, she said.

The “best window” to deal with a problem could be when a troubled tenant is in a hospital, but sometimes, Cheung said, her team isn’t “looped in.” If the tenant returns to an unhealthy environment, it can become a revolving door situation, she added.

Services for mental health and addiction are lacking across Toronto, and when tenants are asked to go as far as Ajax for treatment, it’s discouraging, Cheung said. “When you don’t have a car, that’s way too far.”

Claire Fainer, executive director of East Metro Youth Services (EMYS), said it’s hard for the service system to develop the expertise and perhaps cultural competence and sensitivity required by every new population coming to Scarborough.

Scarborough is unique in Toronto because of its transportation challenge for people without cars. If you or your children must see a specialist once or twice every week, as some programs require, “you can’t manage,” Fainer said.

EMYS, named lead agency for Toronto in transforming mental health services for children and youth, wants to make access as easy and equitable as possible across the city, said Fainer, adding EMYS opened a mental health walk-in clinic, now operating six days a week, where youth can be seen within 25 minutes.

“You don’t have to overthink things,” just walk in the door, she said.

Panel members send their recommendations to Health Minister Dr. Eric Hoskins on Oct. 10.

Mental health services for newcomers spread thin in Scarborough

Care providers also have to deal with cultural and language barriers

News Sep 24, 2015 by Mike Adler Scarborough Mirror

Mental health services are spread thin in Scarborough, and too many people, particularly newcomers to Canada, fall through the cracks.

A provincial panel studying health care in Scarborough and West Durham Region got that message at meetings last month, from people hoping it can help.

Health care providers, meanwhile, keep trying new programs aimed at reaching Scarborough residents struggling with mental illness despite barriers of culture, language or distance.

Acknowledging people who need cognitive behavioural therapy “typically face challenges like long wait lists, a shortage of therapists, and a lack of access to a therapist outside of regular business hours,” The Scarborough Hospital (TSH) has started putting therapy sessions for outpatients online.

This month, the hospital also announced patients can also use its library of mental health applications for devices, suggesting patients “could use a relaxation app while taking transit to a mental health appointment.”

For now, the apps or online sessions are only available in English.

Dr. David Gratzer, a TSH staff psychiatrist, said they’re a great help anyway to many people with anxiety or depression.

Some patients have physical ailments or busy schedules, and online tools mean the hospital can deliver treatment “on their terms and on their schedule,” said Gratzer, adding the English used is simple and free of jargon.

But in Scarborough, where 58 per cent of residents are immigrants, there are more calls for what are called culturally competent or adaptive mental health services.

Immigrants and visible minorities tend to underutilize mental health services, and in Scarborough many of their needs are still not met, Bonnie Wong, executive director of the Hong Fook Mental Health Association said last month at the agency’s head office on Midland Avenue.

Hong Fook started more than 30 years ago to help people of East Asian backgrounds navigate the health-care system. Today, Raymond Chung, one of its founders, is a member of the provincial panel, but last month panel members were told Scarborough providers don’t offer enough services adapted for people of different cultural backgrounds.

Nor is there any dialogue between local providers such as Hong Fook and the Central East Local Health Integration Network (LHIN), the province’s health authority, on how to fill in these gaps, said Wong.

In last five years, Wong argued, there’s been no real spending increase through the LHIN for mental health programs in Scarborough, “but in Durham it’s double-digit, more than that. That’s a huge discrepancy in terms of investment.”

At one meeting last month, Hong Fook staff and volunteers told the panel culturally competent care means more dignity and respect for patients.

Wong said hiring staff members who speak other languages isn’t enough unless a provider offers culturally adaptive programs and can demonstrate cultural training that extends throughout the organization.

When struggling with mental health, many Scarborough residents of East Asian backgrounds approach settlement services, but avoid mental health services because of language barriers and stigma, Wong said.

“Then they end up in the hospital. We want to do a lot more preventative work.”

Dr. Ian Dawe, mental health and addictions physician lead for the LHIN, which covers an area from Scarborough to Peterborough, said he’s not involved in budgeting, but the issue of service access “is huge” and waits for some mental health services across Ontario “are unconscionably long.”

During his 18 months as lead, Dawe said, the LHIN has launched six significant projects related to Scarborough. The most successful is ACTT, the Assertive Community Treatment Team, “like a hospital without walls” for people with severe and recurring mental illness.

Dawe said people languished on wait lists or hospital beds waiting for ACTT, but the LHIN recently created an “after ACTT,” a step-down program, to expand the service.

“Is there still need out there? Absolutely,” he said.

Mental health challenges affect people from each culturally background differently, said Dawe, adding the University of Toronto, where he teaches, is focused on cultural competency.

“Culturally competent practitioners will be practicing within our boundaries,” Dawe said. “They don’t have to speak the actual language specifically,” but having “good, nuanced understanding” of a culture helps.

Last month, agency representatives told the panel some patients, when discharged from hospital in Scarborough, are not going back to a healthy home.

Gladys Cheung, resident access and support manager for Toronto Community Housing, has a team that tries to connect TCH tenants with infestation or clutter issues to mental health services.

Often in Scarborough, there’s not a whole lot to connect to, she said.

The “best window” to deal with a problem could be when a troubled tenant is in a hospital, but sometimes, Cheung said, her team isn’t “looped in.” If the tenant returns to an unhealthy environment, it can become a revolving door situation, she added.

Services for mental health and addiction are lacking across Toronto, and when tenants are asked to go as far as Ajax for treatment, it’s discouraging, Cheung said. “When you don’t have a car, that’s way too far.”

Claire Fainer, executive director of East Metro Youth Services (EMYS), said it’s hard for the service system to develop the expertise and perhaps cultural competence and sensitivity required by every new population coming to Scarborough.

Scarborough is unique in Toronto because of its transportation challenge for people without cars. If you or your children must see a specialist once or twice every week, as some programs require, “you can’t manage,” Fainer said.

EMYS, named lead agency for Toronto in transforming mental health services for children and youth, wants to make access as easy and equitable as possible across the city, said Fainer, adding EMYS opened a mental health walk-in clinic, now operating six days a week, where youth can be seen within 25 minutes.

“You don’t have to overthink things,” just walk in the door, she said.

Panel members send their recommendations to Health Minister Dr. Eric Hoskins on Oct. 10.