McKenzie Kwame
Wellesley Institute, Director of Health Equity, CAMH, Professor, Department of Psychiatry, University of Toronto, Toronto, ON.
Healthc Pap. 2019 Sep;18(2):4-9. doi: 10.12927/hcpap.2019.25926.
Mental health problems are common and have a significant impact on people and their families, communities and the economy. Sixty percent of the population risk of illness is linked to the social determinants of health, and immigrant, refugee, ethno-cultural and racialized (IRER) groups have more exposure to these social factors. But one size does not fit all; the actual rates of mental health, mental illness or substance misuse for any IRER group depend on a complex interplay between risks and resilience. Disparities in rates of mental health, rates of illness and service use exist for IRER populations in Canada. Moving toward equity requires action on the social determinants of health to promote mental wellness as well as targeted action to prevent mental illness and increase the rates of recovery. Equitable mental health services require culturally competent staff, with interventions that work effectively for differently cultural groups and a system that allows equitable access.
心理健康问题很常见,对个人及其家庭、社区和经济都有重大影响。60%的患病风险与健康的社会决定因素有关,而移民、难民、族裔文化和种族化群体更多地暴露于这些社会因素之中。但不能一概而论;任何移民、难民、族裔文化和种族化群体的实际心理健康、精神疾病或药物滥用发生率取决于风险与恢复力之间的复杂相互作用。加拿大的移民、难民、族裔文化和种族化人群在心理健康率、发病率和服务使用方面存在差异。要实现公平,就需要针对健康的社会决定因素采取行动,以促进心理健康,同时采取有针对性的行动预防精神疾病并提高康复率。公平的心理健康服务需要具备文化能力的工作人员,采用对不同文化群体有效的干预措施,以及一个能实现公平获取的系统。