Advancements and challenges in providing access to mental health services for diverse patients in Canada – Good Practices Lola Bendana

Prepared for: Scottish Universities Insight Institute Heriot-Watt University University of Strathclyde Psychiatry Unit, St John’s Hospital Mental Welfare Commission for Scotland April 10, Edinburgh

Immigration in Canada New patterns of immigration poses new challenges for the delivery of mental health services. For the first 100 years of Canada being formed as a country, immigration came from Europe. 3Multi-Languages Corporation

4 Since the 1960’s there has been a shift in immigration sources. In Canada, the proportion of the population that requires an interpreter for health care is at least 1 in 50, and possibly much higher. Over 100 languages are spoken in main cities Toronto, Montreal, Vancouver

5 Very diverse situation from province to province. Issues are accentuated in smaller communities. Some communities are not well prepared for diverse immigrants. Since 1990 Canada has accepted approximately 230,000 immigrants per year, mostly from countries where English is not the first language.

6 Ontario is the most ethnically diverse province in Canada - its residents speak more than 200 languages and dialects. Over one quarter of the population has a mother tongue other than English or French (Statistics Canada, 2007). Immigrants make up 41% of the population in the Toronto Central Local Health Integration Network.

7 Provision of Services: Canadian Universal healthcare o o Equal access to mental health services to all Mental Health Programs offered at: o o Family medicine clinics o o Hospital Psychiatric departments o o Community health centres, etc.

Advancements Professionalization process o o Development of the Canadian National Standards for Community Interpreting Services NSGCIS o o Development of a standardized post- secondary training for interpreters in Ontario which is now available to other provinces online 8Multi-Languages Corporation

Advancements Canadian Coalition and provincial coalitions such as the Nova Scotia Coalition and the Ontario Coalition for interpreting services Recent creation of a multi tier-accreditation system for community interpreters in Ontario 9Multi-Languages Corporation

10Multi-Languages Corporation National Standard Guide for Community Interpreting Services

11Multi-Languages Corporation What does the NSGCIS cover? Definitions of interpreting terminology Definitions of interpreting terminology Human Resources requirements Human Resources requirements Settings Settings Responsibilities of interpreting parties Responsibilities of interpreting parties Clients Clients Interpreting Service Providers Interpreting Service Providers Interpreters Interpreters

12Multi-Languages Corporation What does the NSGCIS cover? Annexes Professional Standards of Practice and Core Ethical Principles Professional Standards of Practice and Core Ethical Principles Language Classification Language Classification Professional Associations Professional Associations Healthcare Interpreting Healthcare Interpreting Legal Interpreting Legal Interpreting

13Multi-Languages Corporation Impact of the NSGCIS Standardized Code of Ethics at the National level Common understanding on expectations Educational tool New criteria for purchasers of services Shared responsibility

14 Claims involving rights of language access in health care in Canada are principally based on interpretations of: o o The Canadian Charter of Rights and Freedoms o o The Canadian Human Rights Act o o Provincial and territorial Human Rights Codes o o The Canada Health Act o o Provincial Health Acts o o The Criminal Code of Canada o o The Canadian Multiculturalism Act of 1988