Culturally relevant mental health treatment

Countering the stigma of mental illness, especially in certain communities, has been an ongoing mission of the Services Department of The Scarborough Hospital.

One of those communities – a large located around the Birchmount campus of TSH – is well served by the hospital’s seven Chinese psychiatrists and a strong contingent of Chinese nurses and support staff. Each of the psychiatrists covers a special component: inpatient, forensic, day clinic, concurrent diagnosis/shared care, child and dual diagnosis and assertive community treatment, while they all participate in outpatient psychiatry.

“We have a good working relationship with the local Chinese community, and we try to have a good representation of psychiatrists who can relate to the Chinese population – understanding the culture and language,” explains Psychiatrist Dr. Thomas Choy, a native of Hong Kong. “Our psychiatrists each come from different backgrounds, and that reflects the Chinese population, which is very diverse.

“We try to be culturally relevant and, as far as I know, we are the best known provider of mental health services among the local Chinese community.”

TSH Mental Health Services also offers literature in Chinese on a variety of mental health issues, such as suicide prevention, bipolar, depression and schizophrenia. And over the years, TSH has nurtured an excellent relationship with Hong Fook Mental Health Association, which provides a wide range of mental health services to the East and Southeast Asian communities.

“Many Chinese new to Canada face language barriers, or a lack of education about what resources are available and how to access them,” explains Psychiatrist Dr. Regina Liu. “They often experience social isolation, major cultural adjustments to Canadian customs, climate and transportation. And there’s the stigma around mental health issues.”

Depending on where they originated in China, the stigma of mental illness is one of the most difficult barriers to treatment. Dr. Choy explains those Chinese who come from urban areas, such as Beijing or Shanghai, face fewer problems since those centres are very sophisticated.

“But if they come from the inland or rural areas of China, mental illness is regarded as shameful to the family or violent behaviour is associated with mental illness,” explains Dr. Choy. “There are many myths surrounding mental illness. The traditional Chinese family constellation is quite unique, with the one-child syndrome.

“New Chinese residents are often not well-counselled before arriving in Canada. But when they access our services, they feel less alienated. Many deliberately ask for a transfer from another service to our services, or from another psychiatrist to one of ours at the Birchmount campus.”

Psychiatrist Dr. Jacqueline Sze agrees that new Canadians from China face unique challenges.

“I think TSH’s Mental Health Services play an important role in servicing our Chinese community,” Dr. Sze adds. “There are many individuals in the Chinese community who suffer from mental illness and do not seek help because of stigma or they hope their symptoms will just go away on their own.”

And that is why TSH continues to seek new ways to reach out to its Chinese community in an effort to provide effective treatment options that are culturally relevant.

“Dr. Karen Shin is a specialist on Cognitive Behaviour Therapy, and does one-on-one therapy with patients as well as running a Cognitive Behaviour Therapy group for patients primarily with depression,” explains TSH’s Chief of Psychiatry, Dr. Stephen Barsky. “Dr. Sze is working with family physicians and residents in a Shared Care Clinic for their patients with mental health issues. She is also working on a Concurrent Disorders Clinic. Our Child Psychiatrist, Dr. David Ng, speaks fluent Cantonese.

“In addition to our psychiatrists who serve Chinese clients, our Occupational Therapist in the inpatient side speaks Cantonese, and our outreach worker in nursing homes speaks Cantonese. We have several nurses who also speak Chinese.”