No. 9, Winter 2000 BC’s Mental Health Journal Cross Cultural Mental Health poster (original in full-colour) c/o CMHA, Novia Scotia Division’s Cross Cultural (original in full-colour) c/o CMHA,poster Mental Health Initiative Novia Scotia Attitudes Approaches Accessibility Acceptance editor’s message he story underlying Dr. Terry ground? If not, where are the due to migration from countries TTafoya’s editorial [opposite gaps? And what can we learn from outside of Canada, 76% of whom page] is a powerful illustration of the people who deal with mental were people from an Asian the simple truth laid out in its fi- illness — i.e., consumers and fam- country. nal sentence: “There are different ily members — who come from dif- BC’s methods of healing because ferent backgrounds? What can we This edition reflects changes in Mental there are different needs of peo- learn from the traditions of knowl- the CMHA Editorial Staff. Eric Health ple.” And while the lesson applies edge and wisdom that people Macnaughton takes over the du- Journal to what the biomedical model bring with them? ties as Editor from Dena Ellery, might think of as “treatment,” it who has returned to school full- obviously relates to the other is- Considering this issue of cross cul- time. Sarah Hamid continues in Visions sues of cross cultural mental tural mental health is crucial, a Design and Production Editor health that this edition of Visions because there is still a long way capacity. Vinay Mushiana, the Co- is a quarterly publication pro- will address: access to services, to go, and much to learn in rela- ordinator of the Cross Cultural duced by the Canadian Mental appropriate methods of ass- tion to all of these questions. Let Mental Health project, has acted Health Association, BC Division. It is essment, and “healing” in all it be said, too, that discovering an- as Co-Editor of this special issue. based on and reflects the guiding philos- its manifestations (treatment, swers to these questions is not just ophy of the CMHA, the “Framework for Sup- rehabilitation, and community a narrow endeavour, done for the With these changes, we remain port.” This philosophy holds that a mental support). benefit of certain citizens. Expand- committed to ensuring that health consumer (someone who has used ing the wealth and scope of our Visions addresses topical issues mental health services) is at the centre of People have different needs be- approaches to mental illness for people with mental illness and any supportive mental health system. It also cause they come from different brings increased hope to all indi- all those — family members, advocates and values the involvement and backgrounds and have different viduals. As with the legend (see Dr. friends, and professionals — who perspectives of friends, family members, experiences. As the articles in this Tafoya’s article), this process will play a significant role in their service providers, and community. In this issue will explore, they under- transform our understanding of lives. We recognize that some of journal, we hope to create a place where the stand “mental health” in different mental illness into “not something these issues may be controver- many perspectives on mental health issues ways; they view “mental illness” that will disappear, but something sial, and that this edition is per- can be heard. and the stigma so often attached that can be dealt with,” and a trou- haps no different, as it deals with to it, differently. As we will also ble from which people can heal, sensitive issues related to ethnic- The Canadian Mental Health Association explore, being an immigrant, a regardless of who they are and ity, culture, and race. While some invites readers’ comments and concerns refugee, or a visible minority from where they come. disagreements are inevitable, we regarding articles and opinions expressed brings another layer of experi- feel strongly about ensuring that in this journal. Please e-mail us at ence that must be understood if This edition of Visions carries for- the journal remains a forum for [email protected] or send your letter with we are to respond with equal care ward the work of the CMHA BC dialogue between people of dif- your contact information to: to all those who come through Division’s Cross Cultural Mental fering or opposing viewpoints. We the doors of the mental health Health Project, which has promot- hope you enjoy and benefit from Visions Editor system. ed organizational change aimed this edition of Visions on Cross CMHA BC Division at making BC Division reflective Cultural Mental Health and look 1200 - 1111 Melville Street Are the concepts and approach- and inclusive of the ever-changing forward to your responses. Vancouver, BC es we use to foster recovery face of this province. The latest V6E 3V6 meeting the challenge for all our census figures show BC to be the citizens, regardless of their fastest growing province in the Eric Macnaughton Subscriptions are $25 a year for four issues. ethnic, cultural, or racial back- country. Of this growth, 43% was and Vinay Mushiana For more information, call us at 688-3234 or if you are calling from outside the Lower Editorial Board Nancy Dickie, Jane Duval, Dr. Raymond Lam, Dr. Rajpal Singh Mainland, dial our toll-free number: Executive Director Bev Gutray 1-800-555-82221-800-555-8222. Editor Eric Macnaughton, Vinay Mushiana (co-editor this issue) Staff Contributors Vinay Mushiana, Eric Macnaughton, Terry Morris, The opinions expressed in this journal are Sarah Hamid, Marie-Claude Lacombe, Catharine Hume those of the writers and do not necessarily Design / Production Editor Sarah Hamid reflect the views of the Canadian Mental Printing Advantage Graphix Health Association, BC Division, or its branch offices. The Canadian Mental Health Association is grateful to the BC Ministry of Health which has assisted in underwriting the production of this journal. 2 Guest Editorial ..................................................... 3 Social Issues .................................................. 24 Glossary of Key Terms ........................................ 4 Ethnocultural Consumers & Families ........ 29 ooNTENTSNTENTS Perspectives on Mental Health and Illness .... 5 Provincial Updates and Reflections ........... 34 CC Cultural Competence for Providers .................. 14 Resources ...................................................... 39 Programs and Approaches ................................ 18 Visions: BC’s Mental Health Journal Cross Cultural Mental Health No. 9, Winter 2000 guest editorial Befriending Demons: Healing Across Cultures magine a Native Am- was done through a hospi- Dr. Terry erican anthropologist Trained as a traditional Native tal interpreter. Tafoya Iworking on his PhD by American Storyteller, Dr. Tafoya documenting the healing is a Taos Pueblo and Warm I began by telling her a tra- ceremonies of a major North Springs Indian who has used ditional story from the Pacif- American hospital. He comes American Indian ritual and ic Northwest. The story tells in at his convenience and ceremony in his work as a Fam- of a cannibal woman who observes a man in white, ily Therapist while serving as steals young children, decorated with colourful Clinical Faculty and Senior Staff whisking them away in an writing utensils in a pocket for the University of Washing- enormous basket she carri- and a shiny medallion hang- ton’s School of Medicine. He ers on her back. Eventually ing from a narrow rubber has worked extensively in Can- the young hero of the story tube that he will periodical- ada, Mexico and Europe, train- outsmarts her and mobiliz- ly place on the chest of his ing mental health professionals es the other kidnapped chil- patients to make them well. and educators in the areas of dren to push her into a fire, He draws strange designs on transcultural concerns and where her ashes fly up and a small square of white pa- bilingual education. He is presently a Visiting Professor in the De- become mosquitoes. (Which, per that he will give patients partment of Applied Human Science at Concordia University in of course, is why mosquitoes to take with them. Because Montreal. He also acts as an Adjunct Professor of Educational Policy bite even today.) the anthropologist does not Studies at the University of Alberta. fully understand the bio- The story is one I frequently medical culture, and is not use with suicidal patients, spending twenty-four hours whether they worked on traditional healer, or Twati since their problems paral- of every day in contact with other North American Indi- can adjust actions to meet lel the structure of the leg- the man in the white coat, an people, or on non-Indi- the needs of his or her pa- end: their problems are he will make a number of ans, they would not treat all tient. Some people seeking devouring them alive, and errors in understanding the people the same, even if the healing come as a last resort the story provides the frame structure of healing. symptoms were the same. In- to a Twati or a surgeon, some for understanding that with deed, some of the prelimi- will come with complete appropriate action, trouble A serious mistake would be nary activities, like cleaning confidence that this is what won’t disappear, but will to assume that anyone who and purification, would be has to be done, while others transform into something comes in with a similar the same, but the actual will come in terror, uncer- that can be dealt with. Be- symptom would obtain a healing actions are different. tain of what might happen fore the story was half-told, similar treatment. But in re- A comparison would be to a during the healing process she had calmed down, and ality, the treatments are medical doctor who will or if the healing is success- was quietly listening. not the same — not all pa- “scrub up” in the same man- ful.