By Sean O’Malley

A Centre for Addiction and Mental Health (CAMH) team has been given just over a million dollars from Health Canada to develop a culturally adapted form of Cognitive Behavioural Therapy (CBT) for Canadians of South Asian origin.

Canada is home to 1.6 million people of South Asian origin, the largest racialized group in the country.  Previous research has shown higher rates of anxiety and mood disorders for this population compared to immigrants from other parts of the world, primarily due to cultural and socio-economic factors. People of South Asian origin also have the highest perceived barriers to mental health treatment, and are 85 per cent less likely to seek treatment for mental illness than those who identify as white.

This is the first major project to develop and test culturally adapted CBT for South Asians in North America and Europe.

“The evidence shows that CBT is as good as medications to treat depression and anxiety, as well as to prevent relapse,” says grant recipient CAMH psychiatrist Dr. Farooq Naeem. “But we also have a lot of data that shows that CBT does not work as well with people from non-western cultural backgrounds.  When we adapt it for other cultural contexts – as we’ve done for other racialized communities – it becomes far more effective.”

“CAMH’s project is a welcomed approach in improving the mental health interventions for Canadians of South Asian origin,” says the Honourable Ginette Petitpas Taylor, Minister of Health. “The investment announced today is a further step in the Government helping Canadians access mental health supports and resources that meet their specific needs and help them lead healthier lives.”

Shreya Kumar, 26, who was born in India and came to Canada when she was 18, knows from personal experience the stigma that people of South Asian origin feel about seeking treatment for mental illness.

Despite experiencing major depression beginning when she was 17, she did not seek treatment until almost 5 years later.

“Among South Asians, if you’re faced with a challenge, you should be able to cope with it and if you’re not, you’re doing something wrong,” says Shreya.

She is now working as a freelance graphic designer for The Roshni Project, an awareness initiative supported by the CAMH Foundation that has helped to create culturally grounded mental health supports and resources to enhance the mental health of young South Asian women.

“It was such a profound experience for me to be with so many other young South Asian women who were going through what I was going through,” says Shreya. “It helped me realize how powerfully my culture is associated with my mental health.”

The culturally adapted CBT initiative for Canadians of South Asian heritage will include:

• The creation of guidelines informed by consultations with patients, caregivers, mental health professionals and community leaders.
• Pilot Feasibility Testing of culturally-adapted CBT to be conducted in Vancouver, Ottawa and the Greater Toronto Area in order to assess its acceptability and effectiveness.
• Training for 20-30 therapists on the use of the new guidelines.

The goal is to produce a culturally adapted CBT manual as well as a training package for therapists working with people of South Asian origin with depression or anxiety.  Longer term, the team hopes they can serve as a model for other types of culturally adapted CBT programs across Canada for other racialized groups.

“CAMH has had a great experience in adapting CBT for people of African and Caribbean origin,” says principal co-investigator Dr. Kwame McKenzie, Director of Health Equity at CAMH and CEO of the Wellesley Institute. “When culturally adapted CBT was used at Women’s Health In Women’s Hands Community Health Centre it significantly improved equity in care and decreased the number of their patients coming to the CAMH Emergency Department in crisis.  We hope to have the same impact for the South Asian population.”

Sean O’Malley is the Senior Media Relations Specialist at CAMH.