Part 3 of a 3-Part Series on Ethno- Specific Services at CAMH
Today our third and final installment of a series on ethno-specific services at CAMH features a Spanish speaking group for families of young people who have schizophrenia.
It is difficult enough to come to a new country to live, but consider the stress of having to deal with an unfamiliar health care system to get help for a family member newly diagnosed with schizophrenia.
Vivian Del Valle, social worker with CAMH’s LEARN, a social, educational and vocational program for young people experiencing psychosis, began seeing Spanish speaking family members who were facing these challenges. Few spoke English and they were not able to access services in their own language.
So Vivian organized the first Spanish speaking group for family members of clients attending LEARN. “Latin American families are focused on community, and connections are very important. I felt that having a group instead of individual sessions would help clients feel that they are not alone," she says.
Family member receives recognition for her dedication to the group.
Lisa Robyn Palmer, Occupational Therapist with CAMH’s First Episode Psychosis Clinic, who also speaks Spanish, co-facilitated the group with Vivian. She says, "Vivian's dedication to helping family members is apparent in many ways. She is an advocate for these families and made this group happen.”
The group ran from May to September 2012 and included people from Mexico, Venezuela, Ecuador, Nicaragua and Chile. Participants ranged from a grandmother to a mother attending with her baby. A few of the family members spoke English, but they still wanted to attend the group. “There's a huge difference when you are sharing your deepest fears and stories in your own language," Vivian says.
Beyond providing support, the group addressed such practical issues as navigating the system, mental health law, communication, responding to crises, and general education about psychosis, medications and stigma. Guest speakers spoke in Spanish and Vivian and Lisa translated the English manuals and handouts and also revised them to be culturally appropriate.
“We wanted to respect the nuances of this culturally distinct group. We developed the materials to fit different educational levels and focused on what they needed, using educational methods that were in line with how they learn,” Lisa says. That meant a lot of visual learning including a collage that the group assembled together showing the cultural barriers and understandings of mental illness. They also incorporated music and social time.
Collage with poem* created by the Spanish speaking family group
“Allowing time for socializing is a very important part of establishing trust among people in Latin America,” Lisa says.
For many in the group it was their first experience with mental illness. Even if they had an uncle, aunt or other family member back home with the illness, they rarely talked about it.
Vivian says in Latin America, as in many countries around the world, stigma surrounding mental illness is significant and can sometimes have religious connotations. One woman told Vivian, “Before my daughter was diagnosed with schizophrenia, I thought schizophrenia was from the devil,” which made it difficult for the mother and the family to come to terms with the diagnosis.
Being in the group and hearing how others dealt with situations that arose from their child or other relative's psychosis helped and was a great source of support.
Vivian adds, "What made the group so impactful was that they formed a small micro-community from the first day.” Some members still see each other frequently and have developed deep friendships.
Vivian believes that to facilitate a group of this nature, it is important to have a deep understanding of the culture. “I cannot be 100 per cent culturally competent in all Latin American countries, but I speak the language and I understand the culture, the values and beliefs,” she says.
She could also empathize with the family members. “As a Mexican woman I faced lots of barriers in Canada. Being an older woman, single, not speaking English, and not understanding how the Canadian systems work, there were lots of barriers, but with the knowledge I gained at university and the support of people who cared about me, I was able to overcome them.”
Lisa who was born in Canada but has spent time in many parts of South America, says, “Vivian and I had such an effective dynamic between us as co-facilitators. It was great to have the perspective of someone born and raised in Latin America and someone with experience with Canadian culture and the health care system.”
Lisa Robyn Palmer and Vivian Del Valle
The group received very positive feedback from the participants. “In Latin America a lot of people are very passionate and very hands-on,” Vivian says, describing a mother who stood up at one meeting, and stretching her hands out as if feeling her way in the darkness, said, “It was like I was in the dark. I didn't know where to go, what psychosis or schizophrenia is.” This same woman later went on a community radio program called Latin Voices with Vivian and a nurse from LEARN. When Vivian said that she could remain anonymous if she chose to, the woman responded, “I'm going to say my name because now that I understand, I can see again and I want to help other people to see.”
If you would like more information about the Spanish speaking family group, please contact Vivian Del Valle (416-535-8501 ext. 77311) or Lisa Robyn Palmer (ext. 6105).
*Translation of the collective poem written by the family members:
The stigma of schizophrenia is painful
It isolates, hurts and oppresses,
frightens and makes us feel alone.
Let’s unite our steps with their steps,
As their steps are ours as well.
If we don’t name it we can’t get help.
Learning about psychosis and schizophrenia
gives us understanding, peace, strength