Mental health care | Ukrainian refugees come up against a wall

Post-traumatic shock support and interpreter services: Ukrainian newcomers have access to health care in Canada, but it remains limited, finds an analysis published Monday by the Canadian Medical Association.

Lila Dussault
The Press

Mental health care is not covered for Ukrainians fleeing war and arriving in Canada through the three-year temporary visa program called the Canada-Ukraine Emergency Travel Authorization (AVUCU). Eventually, Canada could accommodate up to 112,000 Ukrainians in this way.

While they have access to coverage from the Régie de l’assurance maladie du Québec, they do not benefit from all the services associated with the usual reception programs for refugees, such as psychological support for traumas.

“This visa program could leave some Ukrainian migrants vulnerable due to limited settlement and medical support services,” notes an abstract from the Lady Davis Institute for Medical Research study titled “War in Ukraine and Refugee Health “, published Monday.

Having lived through the war, however, leaves marks: “We see cases where [nouveaux arrivants ukrainiens] are afraid to go out with the planes flying above them, after all they have been through”, cites the D^D Lya Roudaia, hematologist-oncologist at Lakeshore General Hospital in Pointe-Claire, who has met Ukrainians in her practice.

An observation shared by D^D Christina Greenaway, study co-author and migrant health expert. “One of the major problems is stress and mental health, for people who had to flee quickly, she says. It’s really important to offer additional services in that regard, and with the temporary visa program, people don’t have access to that. »

Even before arriving in Canada, 33% of Ukrainians had mental health problems due to the instability in the country since 2014, the study said.

A lack of interpreters

The research also highlights the lack of interpreters in health facilities across Canada. “However, interpreter services are the key to being able to communicate with patients, to prescribe them appropriate treatments and to ensure that they understand them,” says Dr.^D Greenaway, also a professor of medicine at McGill University.

This communication barrier does not only affect Ukrainians, notes the researcher. With the exception of clinics for refugees, these services are absent from the majority of health establishments in the country and, by the same token, block access to care.

“We want to talk about it, because it is a major barrier to our ability to provide adequate care,” adds Dr.^D Greenaway.

Migrant patients, unable to navigate the health system, risk falling “into the cracks”, she believes.

A system undermined by COVID-19

The objective of the study is also to equip doctors across the country about the services to which Ukrainian migrants have access, or not, as well as to draw up a portrait of their main health needs.

For example, this population has a high prevalence of chronic diseases (cardiovascular or diabetes) and high tobacco consumption.

The study also notes that health systems in Canada have been undermined by the pandemic and offers food for thought specifically relating to the health of migrants.

“While Canada has a long history of welcoming and integrating groups of refugees and other migrants in crisis, the simultaneous arrival of war-displaced Ukrainians and refugees from Afghanistan into strained by COVID-19 requires a review of current refugee health practices and programs and demands creative solutions,” the authors write.