Improving Mental Health Care for Migrant and Minority Patients for English-Speaking Communities in Québec

Quebec’s English-speaking communities include people from migrant and minority backgrounds who differ in their cultural background and first language (while preferring English as first official language). Access to mental health care for these communities benefits from training and retaining clinicians from a wide range of cultural and linguistic backgrounds. Unfortunately, these clinicians often leave Québec due to limited French-language support and lack of training in multicultural practice. The loss has direct implications for quality of care: psychological interventions are most effective when delivered in a culturally-sensitive way, in the patient’s first language. We propose a bilingual mini-conference and training workshop to help tackle this challenge.

The event will bring together clinicians, students, educators, and policy stakeholders from those disciplines granting the right to (a) practice psychotherapy in Quebec, or (b) pursue a psychotherapy license: clinical psychology, psychiatry, nursing, social work, and occupational therapy. Through interactive workshops, applied training sessions (e.g., the Cultural Formulation Interview), and collaborative discussions, participants will explore how we can better support the training and retention of multilingual and multicultural mental health professionals. Speakers will also present findings from recent studies, including those funded by Dialogue McGill, investigating clinician retention and language-related barriers to care. The goal is to share knowledge, co-develop solutions, and foster a province-wide dialogue on inclusive training.

The event will be hybrid and fully bilingual: speakers will have the option to present in French or English. Concordia University will host the event, supported by research assistants, a keynote speaker, and trained facilitators. The results will be translated where necessary and shared widely across Québec’s mental health networks. By focusing on both language and culture, this initiative aims to help build a more sustainable, accessible, and culturally safe mental health care system for English-speaking Quebecers, especially those from migrant and minority backgrounds.

Outputs:

March 2026 - Hosted a conference on Language, Culture, and Mental Health.

Integrating French second-language experiences into clinical psychology training to enhance retention of English-speaking trainees

This project addresses the need for culturally and linguistically sensitive mental health services, with a focus on supporting English-speaking clinical psychology trainees in Québec. Many trainees leave the province after graduation due to challenges related to French-language requirements and the difficulty of building a sustainable practice that includes Francophone clients, which contributes to a shortage of English-speaking mental health professionals.

The study examines a new initiative at Concordia University that integrates French-language training into clinical psychology education for English-speaking trainees. It aims to understand how this approach may improve training experiences and support long-term retention in the province.

The project combines a systematic review of international best practices in second-language training for mental health professionals with qualitative interviews. We will speak with 30 clinical psychology trainees, clinical supervisors, and community-based clinicians to better understand their experiences using French in clinical settings.

The findings will be used to produce a report outlining best practices for French-language training and assessment in clinical psychology, with implications for improving trainee retention and strengthening access to bilingual mental health services in Québec.

Outputs:

• Evidence synthesis: Following interviews with trainees and supervisors, the team conducted a global systematic review to identify best practices for second-language training of mental health clinicians, aligned with the study’s qualitative analysis.

• Final report (forthcoming): Will present theory- and evidence-based guidelines for integrating French second-language training into clinical psychology programs.

• Expected impact: Improved retention of English-speaking trainees in Québec and enhanced access to mental health services for English-speaking communities.

• Knowledge sharing: The final report will be disseminated to higher education institutions and Centres intégrés universitaires de santé et de services sociaux to support collaboration and strengthen health and social services for English-speaking populations.

Linguistically- and Culturally-Sensitive Psychotherapy: Evaluating an Approach to Assessment and Treatment

The Centre for Clinical Research in Health (CCRH) successfully established a university- funded state-of-the-art research clinic at Concordia University (of which the principal investigator is co-founding member). The clinic is launching an evidence-based, culturally-sensitive psychotherapy program for migrants with anxiety and/or depression. This larger project provides investigators with a valuable opportunity to evaluate the effectiveness of language-sensitive mental health interventions in a real-life clinical setting.

It is therefore proposed to: (1) Integrate research tools (developed with previous Dialogue McGill funding) into the assessment battery completed by all clients completing the treatment protocol used with migrant clients at CCRH. (2) Use qualitative techniques to study video-recordings and transcripts of actual clinical sessions to study the consequences of language discordance on effective communication and treatment. (3) Use quantitative analysis techniques to test whether potential problems identified by the assessment battery are linked to problematic features of actual clinical interactions. Hypotheses are: H1: Indices related to better functioning in a given language will predict fewer in-session communication difficulties when the treatment is conducted in that language. H2: Fewer in-session communication difficulties will predict more rapid symptom improvement.

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Outputs:

1. Unknown. (2020, May). Cultural scripts for normalcy and deviancy: A mixed-methods approach to understanding mental illness in new contexts [Presentation]. Interacting Minds Center, Aarhus, Denmark

2. Unknown. (2019, November). Linguistically- and Culturally-Sensitive Psychotherapy: A Proposal [Presentation]. Centre for Clinical Research in Health, Montreal, Quebec.

Communication Networks of Linguistic Minorities: Who Talks to Whom About Health?

There is a considerable literature documenting the help-seeking pathways of patients. The early stages usually involve considerable negotiation within a person’s existing social network before outside help is sought. The team has previously developed a social network measure designed to assess linguistic characteristics of social networks (Ryder & Segalowitz, funded by Dialogue McGill) as well as a measure of second language health communication anxiety (Segalowitz & Ryder, funded by Dialogue McGill). The overarching goal of this project is to finalize the adaptation of these measures to Multilanguage settings, establish their psychometric properties, and explore the interrelations of these instruments in Francophone and Anglophone community samples. To this end the project has proposes the following objectives: (1) Adapt the acculturation battery for use in multilingual settings. (2) Translate the adapted acculturation battery into French (the other measures have already been translated). (3) Implement an online system to deliver the entire set of measures in either language. (4) Evaluate the overall set of measures in Francophone and Anglophone community samples.

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Outputs:

1. Zhao, Y., Segalowitz, N., Voloshyn, A., Chamoux, E., & Ryder, A. G. (2021). Language Barriers to Healthcare for Linguistic Minorities: The Case of Second Language-specific Health Communication Anxiety. Health communication, 36(3), 334–346. https://doi.org/10.1080/10410236.2019.1692488

2. Ryder, A. G., Doucerain, M. M., Dere, J., Jurick, T., Zhou, B., & Zhou, X. (in press). From acculturation and psychopathology to cultural-clinical psychology. For M. Gelfand, C.-Y. Chiu, & Y.-Y. Hong (Eds), Advances in culture and psychology (vol. 8). Oxford, U.K.: Oxford University Press.

3. Chang, J., Pak, S., Doucerain, M. M., & Ryder, A. G. (2019, January). Validation of the AIM as a well-being and acculturation measurement tool [Poster presentation]. Sixth Annual Conference of the Centre for Clinical Research in Health, Montreal, QC, Canada

4. Tao, D., Doucerain, M. M., Segalowitz N., & Ryder, A. G. (2018, October). Social network and mental health help-seeking attitudes: The case of Chinese migrants in Montreal [Poster presentation]. 5th International Convention of the World Association of Cultural Psychiatry, New York, NY, USA

5. Tao, D., Doucerain, M. M., Segalowtiz N., & Ryder, A.G. (2018, July). What’s the relationship between one’s social network and mental health help-seeking attitudes? The case of Chinese migrants in Montreal. Paper presented at the 24th International Congress of International Association of Cross-Cultural Psychology, Guelph, ON, Canada