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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 Kwame McKenzie MD
outline • Mental health • Importance of time and context • Arguing for preservation of mental capital
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.
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
Individual Ecological Interaction between ecological and individual Time 4 dimensions of causation
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
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 * 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.
Despite record government bail outs there has been political shifts to the right
How do we deal with time and context changes in policy realm?
Are there messages that speak to the economic imperative but offer a win-win scenario for racialised youth mental health?
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.
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 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? • 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? Social capital is a way of describing social processes that shape communities or groups of people. 35
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 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 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
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 • 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.
