Cultural Safety in Working with Refugees and Immigrants: The Case of Farsi-speaking Newcomers in Quebec

Objectives: This study aimed to: 1) examine how current access to mental health care services for Farsi-speaking newcomers is affected by cultural issues; and 2) apply the findings to the refining of cultural safety in the context of underutilization of mental health care by Farsi-speaking newcomers in Quebec.

Methodology: A qualitative study of the perceived barriers to accessing mental health care. We conducted 10 semi-structured individual interviews with Farsi-speaking health professionals working in Quebec, and 8 focus group interviews with members of Farsi-speaking community organizations, with 8-10 participants per group. Content analysis was used to identify core themes related to cultural barriers to care.

Results: The barriers to seeking mental health care that participants identified included: 1) language barriers and concerns about confidentiality with the use of interpreters; 2) issues related to cultural competency and safety; 3) lack of information about the Quebec mental health care system; and 4) concerns about stigma.

Discussion: Inequity in accessing and using mental health services by immigrants and refugees cannot be addressed without recognizing the core issues of cultural safety which reflect social, historical, political and economic circumstances that create power differences and mistrust in clinical settings.

Learning Objectives: 1) Understand how cultural barriers prevent access resulting in underutilization of mental health services by cultural minorities; 2) Highlight similarities and differences between cultural competency and cultural safety in clinical work with newcomer immigrants and refugees.