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Immigrant and Refugee Mental Health ProjectSyllabus: Special Populations Course: Yazidi Refugees in Canada

Settlement and Social Service Providers

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Acknowledgments

The project is managed by the Office of Health Equity at the Centre for Addiction and Mental Health (CAMH), with funding from Immigration, Refugees, Citizenship Canada (IRCC).

Thank you

The Immigrant and Refugee Mental Health Project team would like to thank all course participants for taking part in this initiative. Your engagement with the course material and with other service providers across Canada will make this an exceptional learning environment and will ultimately lead to better support and care for Yazidi refugees. 

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Course description

This course provides information about the mental health needs of Yazidi refugees in Canada. It is a special-populations course that supplements the current Immigrant and Refugee Mental Health Project (IRMHP) at the Centre for Addiction and Mental Health (CAMH). The IRMHP is a capacity-building project funded by Immigration, Refugees and Citizenship Canada. It provides online training, tools and resources to settlement, social and health service professionals across Canada to support their work with newly arrived immigrants and refugees.   It is recommended, but not mandatory, that you first complete the Immigrant and Refugee Mental Health Project online course. This course provides comprehensive background information on supporting the mental health needs of immigrants and refugees in Canada.   As a course participant, you will learn about the history and background of the Yazidis, promising practices, and resources to help you facilitate the successful integration of Yazidi refugees in Canada. The course’s interactive learning environment will allow you to engage with experts in the field along with thousands of service providers from across Canada. 

Course logistics

Type of course: Self-directed For whom: Settlement and social service providers working with Yazidi refugees in Canada* Location: Online Time commitment: 4 weeks, Self-pacedCost: Free

*This course is only offered to Canadian service providers outside of Quebec, as Quebec is responsible for its own settlement services, resettlement services and administration. Immigration, Diversité et Inclusion is the Quebec provincial government ministry that is dedicated to supporting immigrants, refugees, and the settlement sector and can better meet the unique needs of Quebec service providers. We encourage you to visit their website for more information: www.immigration-quebec.gouv.qc.ca. We also have a number of online resources that are free and available to everyone. You can visit our website at: irmhp-psmir.camhx.ca

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Meet the team

The project is managed from the Centre for Addiction and Mental Health (CAMH) in Toronto. Our dedicated team members are:

Project leads: • Dr. Kwame McKenzie, director, Office of Health Equity, CAMH • Aamna Ashraf, manager, Office of Health Equity, CAMH

Project team:• Leonard Edwards – assistant manager, Office of Health Equity, CAMH• Jewel Bailey – project coordinator • Chantel Spade – communications coordinator• Erin Lee – communications associate• Arda Baykal – former bilingual communications specialist

Subject matter experts:

We acknowledge and thank the following subject matter experts (SMEs) who contributed significant time and expertise in the preparation and development of the course content.

Dr. Annalee Coakley Medical Director, Calgary’s Mosaic

Refugee Health Clinic

Dr. Lisa AndermannCross-cultural Psychiatrist, Mount Sinai Hospital and Associate Professor, University of Toronto

Dr. Ghayda HassanClinical Psychologist

and Professor of Clinical Psychology at

Université du Québec à Montréal

Jennifer SanduMSW/RSW, Community Engagement Specialist,

London Cross Cultural Learner Centre

Contact information

For any inquiries or questions regarding this course, please contact our team at:

Email: irmhproject@camh.ca

We are happy to help!

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National Advisory Committee:

The advisory committee has played a key role in providing recommendations on various aspects of the project and supporting the promotion of project activities. We are grateful for the work of these professionals who represent regions across Canada as well as the settlement, social and health service sectors that support immigrants’ and refugees’ mental health. Below are the current advisory committee members.

• Across Boundaries: An Ethnoracial Mental Health CentreAseefa Sarang, executive director

• Association for New Canadians, Newfoundland and LabradorSuzy Haghighi, director of resettlement and settlement services

• Calgary Catholic Immigration SocietyBožana Šljuka, case manager

• Canadian Centre for Victims of Torture (CCVT)Teresa Dremetsikas, programs manager

• Global Gathering PlaceBelma Podrug, executive director

• COSTI Immigrant ServicesYasmine Dossal, director, social services

• Immigrant Services Association of Nova Scotia (ISANS)Juliana Pelinsom Marques, coordinator, newcomer community wellness program

• Multicultural Council of Windsor and Essex CountyKathleen Thomas, executive director

• New Brunswick Multicultural CouncilMadeleine Whalen, member engagement manager

• Ontario Council of Agencies Serving Immigrants (OCASI)Eta Woldeab, associate executive director

• Ottawa Local Immigration PartnershipHindia Mohamoud, director

• Prince Edward Island Association for Newcomers to Canada Jacinta Showmaker, family counsellor

• Polycultural Immigrant and Community ServicesNadia Sokhan, director, monitoring, reporting and partnerships

• Vancouver Association for Survivors of Torture (VAST)Mariana Martinez Vieyra, coordinator, Provincial Refugee Mental Health

• YMCA of Greater TorontoNicoleta Monoreanu, manager, national programs

• YWCA HamiltonDenise Christopherson, chief executive officer

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Course background

In 2016, the Government of Canada resettled more than 1,000 Yazidi refugees in London, Toronto, Winnipeg, and Calgary, as well as other communities in Canada. The resettlement was in response to the 2014 massacre conducted by the Islamic State of Iraq and Syria to systematically eradicate the Yazidi population in Northern Iraq.

In November 2018, the House of Commons Standing Committee on Citizenship and Immigration recommended that Immigration, Refugees and Citizenship Canada build the capacity of service providers to support the mental health needs of Yazidi women and children. The experience of persecution and genocide in their homeland has left many Yazidis with mental and physical trauma. Those working with Yazidi refugees in Canada need to understand the culture and traditions of the Yazidis to manage their mental health challenges and improve settlement conditions. The Committee stated that, “…in general, refugee populations are more likely than the general population to be exposed to and/or encounter social factors that can affect someone’s risk of developing a mental health problem or illness. The resettled Yazidi women and children have faced a specific set of factors that make them vulnerable to mental health problems or illnesses.”

We developed this course in response to the House of Commons recommendations and the needs expressed by service providers working with the Yazidi refugee population. It is designed to build the capacity of the settlement and health service sectors in providing culturally responsive and trauma-informed services that focus on the unique mental health needs of Yazidis.

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Course outline

The course consists of five online modules (detailed course syllabus below):

Module 1: Understanding the context  Learn about the history, culture, and geography of the Yazidi people and some of the challenges this special population has faced.

Module 2: Mental health needs of Yazidi refugees Learn about the mental health needs of the Yazidis and their unique traits, culture, and experiences.

Module 3: Yazidi women and children  Learn about the unique mental health needs and supports for Yazidi women and children.

Module 4: Supporting the mental health needs of Yazidi refugeesLearn how to adapt existing services and supports to deliver better integration when supporting the mental health of Yazidi families and communities.

Module 5: Self-care: Supporting the service provider  Learn how to help yourself, develop self-awareness and apply self-care strategies that you may need when working with survivors of trauma and the Yazidi population.

Overall learning goals

This course aims to increase settlement, social and health service providers’ knowledge base and skill level to support the mental health of Yazidi refugees in Canada.

Learning goals include:

• Increased knowledge of the unique mental health needs of Yazidi refugees• Increased knowledge of the risk and protective factors and determinants of Yazidis’ mental health while

settling in Canada• Increased capacity of providers to adapt interactions and services to deliver culturally appropriate,

trauma-informed and gender-sensitive care to Yazidi service users.• Increased knowledge and use of self-care strategies among service providers working with highly

traumatized populations such as Yazidis.

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Self-directedStudents have four weeks to complete the course at their

own pace

Evidence-basedBased on current research

and informed by subject matter experts

Expert videos 15 videos on various topics from experts on immigrant and refugee mental health

NetworksOpportunities to develop a national network of service provision through the community of practice discussion board

Essential information Background information, promising practices, tools

and resources

InteractiveInteractive quizzes and activities that explain complex topics

EvaluationOngoing evaluation to

continuously improve and update the course

Course format

This course is an accredited, self-directed, self-paced online training. The five modules must be completed in order. As a self-directed course, you can access the modules at any time during the four week period when the course is in progress. There are no scheduled aspects of the course. Since completion times can widely vary, we advise that you begin the course content as soon as you can, assess the time you need to complete a module and pace yourself accordingly.

The course consists of text, subject matter expert videos, case studies with interactive learning activities and ongoing evaluation components.

Please note that the course is deigned for online e-learning and therefore course materials are not available after the course ends. However, you will have access to a repository of course resources that is housed on the project’s website.

This course will be delivered through Moodle, an online learning management system. To access this online course, you will need a stable internet connection.

Browser requirements

Moodle is compatible with any standards compliant web browser. We regularly test Moodle with the following browsers:

Desktop:• Chrome• Firefox• Safari• Edge• Internet Explorer

Mobile:• MobileSafari• Google Chrome

For the best experience and optimum security, we recommend that you keep your browser up to date. https://whatbrowser.org

Note: Legacy browsers with known compatibility issues withMoodle 3.5:• Internet Explorer 10 and below• Safari 7 and below

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Accreditation, Course requirements and Letter of completion

This continuing education training is held under the auspices of Continuing Professional Development, Temerty Faculty of Medicine, University of Toronto and the Centre for Addiction and Mental Health.

Accreditation

• College of Family Physicians of Canada – Mainpro+ - 8.0 credits• Royal College of Physicians and Surgeons of Canada – Section 1 – 8.0 credits

Course requirements and Letter of completion

In order to be eligible to receive a letter of completion, participants are required to complete:

• the course pre-test and the course post-test

Please note that there is no passing grade that needs to be achieved in order to be eligible for the letter of completion. The grades are for course evaluation purposes only; they assist in understanding the degree of learning that participants gain from this course.

Fee: There is a $20.00 fee to obtain the letter of completion. This fee covers accreditation costs. If you are eligible to receive the letter of completion, you will automatically receive an email one week after the course sessions ends that includes a link for making a secure online payment. Letters of completion will be sent by email to participants who have made the payment within two months after the course finishes.

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National Community of Practice

As a course participant, you have access to the national Community of Practice (CoP). The CoP is a password-protected discussion board for settlement, social and health service providers across Canada who work with immigrants and refugees. This forum includes current course participants, course alumni (from the IRMHP core course) and other CoP members. The CoP allows you to engage in professional development, enhance your referral network and to stay up to date in the field.

Through the CoP, you will be able to:

• Establish connections: Develop meaningful professional connections and potential partnerships with service providers across Canada, who are addressing immigrant and refugee mental health.

• Discuss service provision: Communicate with other service providers about practical experiences and work together to produce better outcomes for immigrant and refugee mental health.

• Exchange resources and events: Share and access resources and events that are relevant for building capacity to address immigrant and refugee mental health.

• Pose questions to experts: Draw on the knowledge and expertise of leaders from the settlement and health care sector by posing questions about scenarios you may encounter in your work.

New forum

• Supporting Yazidi refugees: There will be a specific thread in the CoP that will be a designated space for discussing, sharing, and posing questions related to better support and care for Yazidi refugees. As a participant in this course, this thread will be the primary thread that you should visit; however, you are welcome to explore the other threads as well to learn about supporting the mental health of immigrants and refugees in general.

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Course syllabus

Module 1: Understanding the context  

This module will provide you with foundational knowledge about the persecution, genocide and forced migration experienced by the Yazidi population, along with their resulting need for mental health supports. This module will also outline Canada’s response to the genocide and the resettlement of Yazidi refugees in this country. The last component of the module will walk you through the unique characteristics of the Yazidi population that you need to understand to provide appropriate mental health support and services. Understanding Yazidi history and culture, including the importance they place on tradition, the land, family and community, will help you better understand their needs.  This module has four sections:  1. The need 2. Mental health and barriers to care 3. Canada’s response and Yazidi refugees in Canada 4. The Yazidi population 

Learning objectives

After completing this module, you will be able to: • Explain the need for a unique Yazidi refugee resettlement program in Canada.  • Explain the barriers to accessing mental health care for Yazidi refugees.  • Describe the current situation of Yazidi refugees in Canada, including settlement locations and

population demographics. • Explain how the design and delivery of mental health and social support services can be responsive to: 

• Yazidi refugees as survivors of historical persecution, forced migration and multiple genocides • Yazidi religious beliefs and practices as well as cultural rituals and celebrations • the language and interpretation needs of Yazidi refugees • the Yazidi social caste system  • the Yazidi concept of “shame culture.” 

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Module 2: Mental health needs of Yazidi refugees

The goal of this module is to increase your awareness of the mental health needs of Yazidi refugees. We will discuss the unique needs of Yazidi refugees, the risk and protective factors that have been identified through research and key informant interviews, as well the types and levels of trauma experienced by this population.

Recognizing that trauma is complex and of major consequence within the Yazidi population, this module is not a comprehensive review of these topics, but an introduction to raise awareness. Research of the long-term effects and the successful interventions is limited due to this being a new area researched and published on.

This module has six sections:1. Understanding the unique needs of Yazidi refugees2. Trauma and the concept of agency3. Mental health disorders4. Somatic complaints, survivor guilt and triggers5. Risk and protective factors6. Social determinants of mental health for Yazidi refugees in Canada

Learning objectives

After completing this module, you will be able to: • Define the four core properties of agency and explain how service providers can help Yazidis recover

agency in Canada.• Distinguish among the four specific levels of trauma experienced by Yazidi refugees—intact/ongoing

trauma, individual trauma, collective trauma and historical trauma.• Recognize the somatic manifestations of trauma in Yazidi refugees and culturally specific descriptors of

distress.• Recognize the common triggers experienced by Yazidi refugees.• Identify the risk factors that put Yazidi refugees at risk of distress.• Identify protective factors contributing to resiliency among Yazidi refugees.• Identify the social determinants of mental health for Yazidi refugees in Canada.

Note: This module aims to provide a brief overview and should not be a substitute for professional clinical diagnoses.

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Module 3: Yazidi women and children  

Module 3 will provide information about the context surrounding the trauma specifically experienced by Yazidi women and children. Yazidi women and children are particularly marginalized and vulnerable because of the violence they have been subjected to. As a result, they have unique needs. By understanding these needs, you may consider adapting care and support to enable better mental health outcomes.  This module has four sections: 1. The need: Yazidi refugee women and children 2. Gender-based violence 3. Yazidi children 4. Child soldiers

Learning objectives

After completing this module, you will be able to: • Explain how the trauma experienced by Yazidi women affects their mental health needs as survivors of

gender-based violence. • Describe the effects of stigma from within the Yazidi community toward women with children born out

of rape. • Recognize the signs and symptoms of trauma in Yazidi children, such as physical symptoms,

psychological symptoms, and behavioural issues. • Describe the difficulties that former child soldiers have in adapting to life in Canada and identify

possible interventions.

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Module 4: Supporting the mental health needs of Yazidi refugees

This module will help you increase your awareness of the social interventions that have been successful in supporting the mental health needs of Yazidi refugees. We will discuss the importance of culturally adaptive interventions and the social supports that need to be in place to make interventions even more successful. The social supports (e.g., housing, employment, poverty, integration) that go hand in hand with resettlement can often be crucial to success in the journey toward recovery from trauma.

As mentioned in earlier modules, the mental health needs of Yazidis and their experiences are complex and of major consequence. This module does not provide a comprehensive review of these topics, but rather is an introduction to raise awareness. This module does not address the issues faced by Yazidi refugees in detail since limited research is available. Although the content in this module is important, you should also recognize its limitations.

This module has two sections: 1. Promising practices2. Key considerations

Learning objectives

After completing this module, you will be able to: • Compare examples of promising practices currently being used by service providers working with Yazidi

refugees, and identify common strategies.• Apply key strategies for adapting mental health interventions for Yazidi refugees, including strategies for

building trust and for empowerment. • Explain the need for service provider partnerships when supporting Yazidi refugees and their mental

health.

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Module 5: Self-care: Supporting the service provider 

To manage their mental health and well-being, service providers should be aware of risk factors and strategies for mitigating the effects of working with highly traumatized clients, such as Yazidi refugees. This module provides an overview of burnout, compassion fatigue and secondary traumatic stress/vicarious trauma. It outlines individual-level and organizational-level risk factors, and offers insights about various self-care strategies and methods, with a focus on the importance of vicarious resiliency.  This module has seven sections: 1. Understanding stress 2. Burnout, compassion fatigue and secondary traumatic stress/vicarious trauma  3. Risk factors 4. Self-care: Strategies and methods 5. Vicarious resilience 6. Self-assessment tools 7. Self-reflection activities  Learning objectives

After completing this module, you will be able to: • Explain the need for self-care interventions for mental health service providers who work with a

traumatized population such as Yazidi refugees. • Recognize the signs and symptoms of vicarious trauma/secondary traumatic stress, burnout and

compassion fatigue. • Identify individual and organizational/workplace risk factors that put providers at higher risk of

developing vicarious trauma/secondary traumatic stress, burnout and compassion fatigue. • Identify individual and organizational/workplace interventions and prevention strategies for managing

vicarious trauma/secondary traumatic stress, burnout and compassion fatigue. • Define “vicarious resilience” and reflect on how mental health service providers may be positively

affected by working with clients who are survivors of trauma. • List appropriate self-assessment tools for secondary traumatic stress, burnout and compassion fatigue.