Sanctuary: A focus on refugees' mental health

As Kitchener-Waterloo welcomes more refugees to the region, many citizens and specialists have stepped up to support their settlement and well-being. Among those supporters are faculty and a graduate student from UWaterloo’s department of Psychology.

Considering the extraordinarily stressful lives most refugees have led, many arrive in Canada suffering from severe anxiety, mood problems and post-traumatic stress disorder (PTSD). Additionally, some refugees, similar to people in Canada’s general population, may experience other mental health difficulties that affect their critical thinking skills.

In response to specific needs of the local refugee population, clinical psychology PhD candidate Brenda Chiang provided psychological consultations and assessments to refugees under the supervision of adjunct faculty member Dr. Nicole Ethier.

To learn first-hand about refugees’ lives and experiences, to observe their resilience in the face of the hardships and difficulties they experience, is both powerful and moving. It inspires compassion and understanding in a whole new way.

Chiang’s work was part of a pilot program initiated in winter 2017 by the UWaterloo’s Centre for Mental Health Research in collaboration with staff, volunteers and translators at the Sanctuary Refugee Health Centre (SRHC) in Kitchener.

Lives under stress need specialized support

Mental health struggles can create or exacerbate an exceptionally distressing situation for refugees, whose lives are in limbo while decisions are made about their future  in Canada.

The refugee claim process would be daunting for anyone. Often working through a translator, claimants must make their case in a hearing before the Immigration and Refugee Board of Canada. Hearings often rely on the refugee’s personal account of their experiences; and, if they forget details and confuse dates, as people with mental health disorders often do, examiners may incorrectly conclude that they are fraudulent and send them back to the same country they risked their lives to escape.

Meanwhile, even with the uncertainty about their eligibility to stay in Canada, refugees must try to rebuild their lives here. With only one year of government employment or disability benefits available to them upon arrival, it is a crucial time for new refugees to receive the support that will help them to become independent. But, only one type of financial support is available at a time, meaning refugees who get help finding work do not get help addressing their mental health.

In the long term, failure to promptly identify and address refugees’ mental health disorders contributes towards significant healthcare, welfare, social and human costs.

Building a CMHR-SRHC refugee mental health program

Formally assessing refugees’ mental health means their claims process will be supported with documented evidence, and equally important, the assessment report will help ensure they access the right social services. With the government requirement that only qualified psychologists conduct these assessments, there is significant scope for partnerships between the CMHR and community organizations such as SRHC.  

During her practicum, Brenda Chiang trained under Dr. Ethier to work with refugees and interpreters, and to understand the range of mental health and legal challenges faced by refugee claimants in Canada.

“To learn first-hand about refugees’ lives and experiences," says Chiang, "to observe their resilience in the face of the hardships and difficulties they experience, is both powerful and moving. It inspires compassion and understanding in a whole new way – one that can’t be learned through books and classes alone.”

Waterloo’s Clinical Psychology PhD program is ideally positioned to play a part in responding to the growing need for refugee psychological assessments. Through the CMHR, the program provides students with comprehensive training in psychological assessment of children, adolescents and adults, as well as opportunities to participate in clinical practices under close supervision.

With additional funding to build on the success of the first pilot phase, the CMHR-SRHC refugee mental health program will provide essential training to the next generation of psychologists and help to meet the psychological needs of Canada’s changing demographic.

To learn how you can help support this program, contact Kim Bardwell, Arts Advancement Director at 519-888-4567, ext. 37310 or

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