DO IMMIGRANTS AND REFUGEES NEED ETHNO SPECIFIC PSYCHIATRIC SERVICES ? By S.Freeman,M.O.,C.Barwick,J.Durbin & T.Lo,M.D. Clarke Institute & Hong Kong, Toronto,Canada (notice bibliographique)

Although psychosocial stress is a known concomitant of migration,immigrants underuse mental health services,mostly because of linquistic and cultural barriers.To solve this without creating numerous ethno-specific services,Hong Fook Mental Health Service (HF) was developed as a model. Chinese and Southeast Asian immigrants and refugees would be linked to mainstream psychiatric services in Toronto by providing both patient and agency with consultation,family support,education,and cultural interpretation,but not with direct service,unless unavoidable.Yet, in the first 2 years,41% of service units were direct.To understand this better,69 consecutive patients were followed.22 could be referred out but only 7 to mainstream agencies and the others to ethnospecific agencies or workers.47 patients were not referred ;18 needed onl., a brief contact while 29(42%of the total)required extensive therapy and support from HF.This latter group were more likely to have had severe illness(14/29 were schizophrenic),inadequate English,to be recent immigrants, and to need family therapy.This knowledge can help government’s plan for three needed service modalities.

1)Ethno-specific services for those with the foregoing profile

2)Mainstream services for the well-acculturated

3)Linking services(the original HF model)for a group intermediate between 1 and 2.

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