Promoting mental health in racialised youth
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Promoting mental health in racialised youth. Kwame McKenzie MD. outline. Mental health Importance of time and context Arguing for preservation of mental capital. Mental health.

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Promoting mental health in racialised youth

Promoting mental health in racialised youth

Kwame McKenzie MD


Outline

outline

  • Mental health

  • Importance of time and context

  • Arguing for preservation of mental capital


Mental health

Mental health

  • “a state of wellbeing in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community”

    • World Health Organization.


Rates of mental health of racialised youth

Some black and minority ethnic youth in Canada have lower rates of mental health problems others have higher rates

Substance misuse and suicidal ideation on increase

Refugee rates of illness are elevated

Hansson et al feb 2012

Rates of mental health of racialised youth


4 dimensions of causation

Individual

Ecological

Interaction between ecological and individual

Time

4 dimensions of causation


Time and context for youth

Time and Context for youth


Immigrant population by electoral ward in toronto

% immigrant population by electoral wardIn Toronto


The problem is not just bay street

The problem is not just Bay Street


City1 city2 city3

Most children in Toronto live in City 3

1/3 of people in City 3 live under low income cut off

50% of the housing for families in City 3 is high rise

Poverty is color coded

City1 City2 City3


Ratio of earnings of recent immigrants to canadian people is decreasing over time

Ratio of earnings of recent immigrants to Canadian people is decreasing over time


Canadian born population and immigrants reporting fair or poor health

Canadian-Born Population and Immigrants Reporting "Fair" or "Poor" Health,

Source: Newbold KB. Self-rated health within the Canadian immigrant population: Risk and the healthy immigrant effect. Social Science and Medicine, 2005.16


More likely to develop poor health if you are non european

More likely to develop poor health if you are non-European

* Significantly different from estimate for Canadian-born (p <0.01).Note: All explanatory variables are based on the situation in 1994/95. Because of rounding, some confidence intervals with 1.0 as upper/lower limit are significant.Data source: 1994/95 to 2002/03 National Population Health Survey, longitudinal file.


Time and context for providers

Time and context for providers


World financial crash has widespread impacts

World financial crash has widespread impacts


Austerity at least for some

Austerity – at least for some…


Health increasingly seen as a commodity not a right

Health increasingly seen as a commodity not a right


Despite record government bail outs there has been political shifts to the right

Despite record government bail outs there has been political shifts to the right


Public service reform in the hands of bankers

Public service reform in the hands of bankers


Drummond on the problems with health systems

Drummond on the problems with health systems


Drummond solutions to health care problems

Drummond solutions to health care problems


Drummond challenges for immigration

Drummond challenges for immigration


Drummond solutions for immigration

Drummond Solutions for immigration


What is missing

What is missing?


How do we deal with time and context changes in policy realm

How do we deal with time and context changes in policy realm?


Motivational interviewing

Motivational interviewing


Pathways to change

Pathways to change


Promoting mental health in racialised youth

Are there messages that speak to the economic imperative but offer a win-win scenario for racialised youth mental health?


Mental capital

Mental capital?

  • If we are to prosper in a competitive world our mental and material resources are vital

  • Build environments that enable everyone to realise their potential

  • crucial for our future prosperity and wellbeing.


Mental capital iq eq mental health

Mental capital = IQ + EQ + mental health


Eq social skills

EQ = social skills

  • Emotional intelligence (EQ) is not a new concept;

  • Socrates: Know Thyself.

  • Studies show that EQ is the best predictor of a child's future achievement; better than any other single factor.

  • EQ is a better predictor of success than IQ and technical skills combined


Mental capital and health promotion

Mental capital and health promotion

The challenge to government is to invest in our future

They need to build IQ

To get schools to build EQ

But also to produce environments that protect mental health


Why are rates lower in uk despite ecological risk factors

Why are rates lower in UK despite ecological risk factors?

  • In the UK rates of mental health problems are lower in BME groups

  • Lower rates of mental illness and mental health problems associated with

  • Having friends from another culture

    • Bhui et al

  • ? Because of social capital


What is social capital

What is social capital?

Social capital is a way of describing social processes that shape communities or groups of people.

35


Social capital

Social capital

“By social capital I mean features of social life – networks, norms and trust – that enable participants to act together more effectively to pursue shared objectives”

Putnam

Social capital describes the forces that shape the quantity and quality of social interactions and institutions “the glue that holds society together”

Kawachi.

36


Social capital sub definitions

Social capital: Sub-definitions

Bonding

Between individuals in families

Bridging

Between different groups in a society

Horizontal

Between individuals and groups at similar levels in a society

Vertical

Between different strata in society and ability to control government etc.

37


Specific impacts on mental health from literature

Specific impacts on mental health from literature

Social capital’s relation to mental health is complex

Different types of social capital impact on health in different ways

Bridging social capital may produce more access to information, supports and safety nets which buffer the effects of life events on mental health

38


Toronto s multi culturalism

Toronto’s multi-culturalism


Toronto multi culturalism

Toronto multi-culturalism


Mosaic without the glue

Mosaic without the glue…


Shepherd s bush high street

Shepherd’s bush high street


Promoting mental health in racialised youth1

Promoting mental health in racialised youth

  • Developing a social system links City 3 - City 1

  • Decreasing gulf between rich and poor

  • Increasing opportunity to build social capital

  • Increasing opportunities to link culturally

  • Developing a culture of preserving mental capital


Mental health promotion is not a mystery

Mental health promotion is not a mystery

  • Evidence based, cost-effective strategies documented

  • Ontario legislature - every $1 spent on mental health promotion you get $7 return

  • PHAC youth tell us what they want..

  • But we do not do this very well.


Thanks

Thanks


Simplicity instead of complexity

Simplicity instead of complexity?


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