An Intersectionality-Informed Scoping Review of the Literature on Resilience, Mental Health, and the Social Determinants of Health of Migrant Youth in Canada 18th National Metropolis Conference The Westin Harbour Castle March 5th, 2016 Presenters: Attia Khan 1 & Nazilla Khanlou 2 1 MBBS, MSPH, PhD candidate, 2 RN, PhD Faculty of Health, York University

Overview of mental health of immigrant and refugee youth in Canada  Immigrant youth (ages 12-19) make up 11% of youth population in Canada  The Healthy immigrant effect  Resilience  Mental health is a positive state of being and not merely absence of illness  Enhancing resilience and promoting mental health can contribute significantly to healthier individuals and better social well-being Statistics Canada, (2006); Public Health Agency of Canada,(2011); Khanlou and Wray, (2014)  The 14 Social Determinants of Health  Freedom from discrimination and violence  Social inclusion  Access to economic resources Mikkonen and Raphael (2010); Keleher and Armstrong (2006); CAMH (n.d)

Methods Arksey, & O'Malley’s (2005) six-stage methodological framework for scoping review  Stage 1: Framing the question “What does the literature on migrant youth in Canada inform us about the effects of intersecting social identities, specifically gender, race/ethnicity, culture, age, migrant status and social class on migrant youth mental health at personal, and family level and the society at large?”  Stage 2: Identifying relevant studies from electronic databases  Stage 3: Study selection-14 studies selected  Stage 4: Charting the data  Stage 5;:Collating, summarising and reporting the results  Stage 6: Consultation with stakeholders

Flow chart of scoping review Studies identified through electronic search: 1209 PubMED: 219 Sociological Abstracts: 290 Social Science Abstracts: 105 CINHAL: 23 PsychINFO: 382 Studies meeting inclusion, exclusion criteria: 14 Studies assessed for eligibility: 87 PubMED: 32 Sociological abstracts: 29 Social Science Abstarcts: 8 CINHAL: 0 PsychINFO: 14 Other sources: 4 Studies identified through other sources: 10 Studies screened and excluded including duplicates: 942

ThemesCategoriesSubcategories  Determinants of Mental Health  School adjustment Marginalization Lack of fluency in the English Feeling ‘different’ and ‘not fitting’  Parent-child relationship Communication difficulties Intergenerational conflict Cultural differences  Intra-personal conflict Ethnic Identity Acculturative stress Self-esteem  Coping and Adaptation  Resilience Practicing their faith Attending school: Confidence & self-esteem  Ethnic identity and national identity Treasured ethnic identity Higher academic achievements Sense of agency/self-determination  Perceived racism & discrimination  Neighbourhood  Schools; teachers, peers Affected sense of belonging Affected mental health

Intersection of Multiple axis of Social Identities & Resilience A System’s Approach (Khanlou &Wray, 2014) Socio-economic and political School level Family Individual youth Labelling Self-confidence Relationships of trust Feelings of insecurity Poor academic performance Decline in mental health Racism Classism Discrimination Influence oppression and domination Our contribution

Gender based differences  Gender was a powerful influence on how girls felt  Female youth’s self concept consisted of dynamic self, silenced self, cultural/ethnic identity, female role models and future aspirations (Khanlou et al, 2002)  Discriminatory and racist attitudes: Barriers to integration into mainstream culture  Academic success important influence on sense of self-esteem  Coping strategy  Anglicizing of names  Silencing their self  Rationalizing negative experiences as jokes

Limitation & Conclusion  Limitations  Conclusion  Importance of family, school and cultural connectedness in reducing acculturation stress and protecting mental health  Strong sense of ethnic/cultural identity contributed to improving mental health, but the effect was reversed in circumstances where racism and discrimination was experienced  Experiences of discrimination and racism also contributed to resilience building in migrant youth

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