Understanding the Impact of Linguistic Barriers and Stigma on English-Speaking Sinosphere Quebec Patients with First Episode Psychosis (FEP) and Their Family Members

We want to understand how negative attitudes and beliefs towards mental illness (known as stigma) affect English-speaking individuals from Sinosphere countries living in Quebec diagnosed with first episode psychosis (FEP), as well as their families. Stigma can make it harder to seek help, follow treatment, and recover. It also adds burden to their families. Therefore, it is important to recognize the challenges faced by this group. 

21.1% of Canada's visible minority population comes from East and Southeast Asian countries, including China, Hong Kong, Taiwan, Japan, Korea, and Vietnam, collectively known as the Sinosphere. Among these individuals residing in Quebec, there is a preference for English over French. Unfortunately, Sinosphere Canadians often experience poorer mental well-being and display lower rates of seeking professional help compared to others. Additionally, there is a lack of research on this specific group, which motivates us to address this knowledge gap and prioritize improving access to mental health and social services for the English-speaking Sinosphere FEP community, thereby enhancing their well-being. 

To tackle this issue, we will gather information on the experience of stigma, explore the linguistic and cultural factors that influence their experience, and find ways to reduce stigma among English-speaking Sinosphere individuals in Quebec who have FEP and their family members. We will conduct interviews with ten FEP patients and ten family members from three hospitals in Quebec. The participants must meet the following criteria: (1) they or their parents immigrated from a Sinosphere country, and (2) they prefer English as their official language. 

Culturally Adapted Psychosis Interventions: A scoping review

First episode psychosis (FEP) typically occurs in late adolescence and early adulthood when identity is in formation and parents play a key role in care. As a result, the experience of psychosis is exceptionally distressing for youth and family who often endure this crisis without support. In FEP services Family Psychoeducation has been widely recommended as one of the key evidence-based psychosocial interventions. Family Psychoeducation consists of seminars in which the FEP caregiving team meet the families of their newly referred patients to provide education about psychosis, to listen to their concerns and to explore strategies to improve family problem-solving skills, communication skills and positive coping mechanisms. There are no FEP studies considering an adapted program specifically for linguistic and cultural minorities to make interventions better suited to the needs of patients and families. This is a glaring gap in clinical knowledge that requires urgent attention. Furthermore, recently arrived immigrant groups have the greatest need for family and community support.

Common experiences of stress, isolation, and burden experienced by families dealing with mental illness are likely to be further intensified for newly settled migrant families because of language and communication difficulties, reduced access to extended family supports, and lack of knowledge of mental health services as well as cultural differences regarding the etiology of mental illness and issues of social stigma. Through the current proposed scoping review, we aim to gather the extant literature on culturally adapted psychoeducation for families; document what gaps currently exist regarding culturally adapted psychoeducation for the families of patients with first episode psychosis (FEP) from English-speaking minority communities; and describe additional positive ingredients in psychoeducation for the families of patients with first-episode psychosis (FEP) from English-speaking minority communities. The findings of the current project will redress the knowledge gap that exists in psychoeducation in Quebec, especially for English-speaking minorities, and will clarify future directions for healthcare professionals within Quebec.