Myrna Lashley

Careif is an international mental health charity that works towards protecting and promoting mental health and resilience, to eliminate inequalities and strengthen social justice. Our principles include working creatively with humility and dignity, and with balanced partnerships in order to ensure all cultures and societies play their part in our mission of protecting and promoting mental health and wellbeing. We do this by respecting the traditions of all world societies, whilst believing traditions can evolve, for even greater benefit to individuals and society. Careif believes that knowledge should not only be available to those with wealth or those who live in urban and industrialised parts of the world. It considers knowledge sharing to be a basic human right, particularly where this knowledge can change lives and help realise true human potential. Furthermore, there is substantial knowledge to be found in low and middle income countries and within rural and poorer areas of the...

Cultural competency may be helpful to police in fighting violent extremism. Perceived cultural competency of security officers may directly affect citizens responses, especially individuals from vulnerable communities. Police often need to depend upon citizens’ cooperation to identify those who may be engaging in activities of violent extremism. Therefore, officers must be trained in cultural competency to help reduce feelings of citizen alienation. Participants from three Canadian cities completed an online survey concerning perceptions of police cultural competence in several areas, including national security. Results were discussed with focus groups. With cultural variations, citizens were mostly satisfied with police–citizen interactions. However, some felt they were singled out because of race and religion. Participants stated better police training in cultural competence would lead to greater police–citizen cooperation. All would contact police if the security of Canada were ...

The value of understanding patients' illness experience and social contexts for advancing medicine and clinical care is widely acknowledged. However, methodologies for rigorous and inclusive data gathering and integrative analysis of biomedical, cultural, and social factors are limited. In this paper, we propose a digital strategy for large-scale qualitative health research, using play (as a state of being, a communication mode or context, and a set of imaginative, expressive, and game-like activities) as a research method for recursive learning and action planning. Our proposal builds on Gregory Bateson's cybernetic approach to knowledge production. Using chronic pain as an example, we show how pragmatic, structural and cultural constraints that define the relationship of patients to the healthcare system can give rise to conflicted messaging that impedes inclusive health research. We then review existing literature to illustrate how different types of play including games,...

Careif is an international mental health charity that works towards protecting and promoting mental health, wellbeing, resilience and resourcefulness with a special focus towards eliminating inequalities and strengthening social justice. Our principles include working creatively with humility, dignity and balanced partnerships in order to ensure that all cultures and societies play their part in our mission of protecting and promoting mental health and wellbeing. We do this by respecting the traditions of all world societies, whilst believing that culture and traditions can evolve for even greater benefit to individuals and society. Globalisation has created culturally rich and diverse societies. During the past several decades, there has been a steadily increasing recognition of the importance of societal and cultural influences on life and health. Societies are becoming multi-ethnic and poly-cultural in nature worldwide, where different groups enrich each other's lives with th...

Careif is an international mental health charity that works towards protecting and promoting mental health and resilience, to eliminate inequalities and strengthen social justice. Our principles include working creatively with humility and dignity, and with balanced partnerships in order to ensure all cultures and societies play their part in our mission of protecting and promoting mental health and wellbeing. We do this by respecting the traditions of all world societies, whilst believing traditions can evolve, for even greater benefit to individuals and society. Careif believes that knowledge should not only be available to those with wealth or those who live in urban and industrialised parts of the world. It considers knowledge sharing to be a basic human right, particularly where this knowledge can change lives and help realise true human potential. Furthermore, there is substantial knowledge to be found in low and middle income countries and within rural and poorer areas of the...

Black Caribbean parents often immigrate in order to increase their fortune and improve opportunities for themselves and their families. Frequently, they leave their children in their country of origin, to be raised by family members. Reunification with their children often occurs at the time of adolescence and, for a multitude of reasons, is often fraught with conflict which sometimes necessitates the involvement of social services and other agencies. Some reasons for these difficulties are presented and are illustrated through the use of case histories. Mental health professionals are advised to take societal and cultural factors into consideration when creating treatment plans for this population.

Canadian immigrant adolescents have a lower suicide rate than their nonimmigrant peers. We conducted a hypothesis-generating analysis to determine whether this lower rate correlated with level of drug use and (or) with diagnostic and demographic characteristics of Canadian immigrant adolescents presenting to an emergency room for crisis assessment. Known risk factors for suicide were compared among immigrant youth, North American youth, and a culturally mixed group of youth at baseline and at 6-month follow-up. The immigrant group was only differentiated by a lower rate of reported drug use. The lower rate of reported drug use at the time of crisis may contribute to the lower suicide rate among immigrants.

OBJECTIVE Using a retrospective sample, the authors sought to determine whether Black patients with first-episode psychosis (FEP) in Canada were at a higher risk for coercive referral and coercive intervention than non-Black patients with FEP. METHODS Retrospective data from patients referred to an FEP program in 2008-2018 were collected via chart review (N=208). The authors used chi-square and logistic regression analyses to explore the relationships among race-ethnicity, diagnosis of psychosis, and coercive referral and intervention. RESULTS Results showed that Black persons of Caribbean or African descent with FEP were significantly more likely to be coercively referred (χ2=9.24, df=2, p=0.010) and coercively treated (χ2=9.21, df=2, p=0.010) than were non-Black individuals with FEP. Age and violent or threatening behavior were predictors of coercive referral. Ethnoracial status, age, and violent or threatening behavior were predictors of coercive intervention. CONCLUSIONS This study contributes to the dearth of research on Black Canadians and offers insight into factors that may place patients with FEP at risk for coercive treatment. More research is needed to explore the role that ethnoracial status may play in hospital admissions and to uncover the role of racial prejudices in the assessment of danger.

... The Unrecognized Social Stressors of Migration and Reunification in Caribbean Families ... Most black Caribbeans live in countries in which they not only make up the majority of the citizenry, but where they are liberally represented in all institutions, including the government. ...

... The Unrecognized Social Stressors of Migration and Reunification in Caribbean Families ... Most black Caribbeans live in countries in which they not only make up the majority of the citizenry, but where they are liberally represented in all institutions, including the government. ...

Members of a multicultural society must all be subject to the same equitable system of justice. However, culture exerts profound influences on human behavior, and cultural considerations have a place in determinations of capacity and in appropriate sentencing. Cultural psychiatry can contribute to forensic psychiatry by helping to contextualize individuals' actions and experiences. This contextualizing can be done through cultural consultations that employ interpreters and culture brokers to identify the role of culture in individuals' psychopathology. Clarifying how cultural background has affected individuals' capacity to form a criminal intent or control their behavior may allow a better determination of level of culpability and guide appropriate sentencing. However, framing behavior as culturally influenced may also stereotype and stigmatize specific groups. To avoid this, culture must be understood in terms of power relationships between minority groups and the domi...

While many studies of the mental health of immigrants and refugees continue to focus on pre-migration psychopathology and risk factors, the importance of the post-migration environment as a key determinant of mental health in these populations, traditionally considered to be at risk, is becoming increasingly clear (Porter and Haslam, 2005). Globalization is reshaping migratory phenomena and international relations. Fast-paced change in host environments demands paradigm shifts not only in the understanding of issues in immigrant mental health but also in the planning of intersectoral programs and services. This article surveys recent Quebec studies of adult and minor immigrants and refugees in the greater Montréal area, conducted by the Transcultural Research and Intervention Team (TRIT), examining the dialectic between local and international contexts. It describes studies of 1) families from the Philippines and English-speaking Caribbean countries; 2) the Maghrebi/Middle Eastern a...

This study investigates the prevalence and subtypes of conduct disorder (CD) and behavioral problems among youth in two communities characterized by prolonged parent-child separation upon immigration. CD and problem behaviors were assessed in 252 Caribbean-Canadian and Filipino-Canadian adolescents (12-19-year-old) using the DISC-C, the YSR and the CBCL cross-informant construct. Adolescents reported less problem behaviors than their host country peers, despite immigrant background or parent-child separation. The high adolescent-onset CD rate supports the hypothesis that psychosocial stressors play a role in the emergence of the disorder. Specifically, high levels of perceived racism and low collective self-esteem predicted problem behaviors in these youngsters.

Informed consent for surgical procedures requires that the procedures are explained and that the patient understands the procedures and risks and agrees to undergo them. Proxy consent occurs when an individual is provided with the legal right to make decisions on behalf of another. This study was conducted to determine how surgeons communicate information to obtain an informed proxy consent, and to investigate how that information is received and processed by surrogates responsible for providing such consent. Twenty English-speaking parents or legal guardians and 5 surgeons in an urban pediatric hospital were interviewed before, and 2 to 4 weeks after, the surgical procedure. In addition, the interview between the surgeon and surrogate, when consent was obtained, was audiotaped and subsequently analyzed. Semistructured interviews were used to elicit the motivations and influences on the surrogates to consent to the procedure. The same methodology was used to elicit the corresponding impressions of the surgeons. The data were analyzed using descriptive statistics and crosstabulations. Demographic data did not influence the results. Although there was concordance between the surrogate's understanding of the procedure and the surgeon's impression of this understanding, only 3 of 17 surrogates could recall any specifics of the explained procedure. Contrary to the stated belief of surgeons, surrogates consulted with a variety of others, including medical and paramedical professionals, family members, and spiritual leaders. Communication plays an important role within the surrogate-surgeon dyad. Psychologic variables such as expectations, and the perception of both the surrogates and the surgeons, influence the amount of information that is proffered and the manner in which it is received. Improved communication may be achieved by use of visual aids, discussion of anesthesia and the postoperative course, recognition of the circumstances around the discussion, such as timing and location of the discussion, and personalization of the discussion.