Finding one’s way through Canada’s health-care system can be difficult, even for adults who were born and raised here.
For many newcomers, who are still working on getting settled in a new country and its unfamiliar systems, accessing health care can pose even more of a challenge. Research published in the Journal of Immigrant and Minority Health found that language barriers, long wait times, and lack of transportation are among some of the many barriers to care.
As for adolescent newcomers who aren’t yet ready for adult care, but also aren’t young children anymore? That’s a whole other set of needs altogether, said Meriem Ferkli, a cultural navigator at the Montreal Children’s Hospital.
“Transitioning from pediatric to adult health-care services is already challenging, but in the case of some newcomer teens with special health-care needs, the transition becomes even more complex when you add on a new environment, system, and culture,” she said.
Some common needs of newcomers can include needing support navigating complex health-care systems, overcoming language and economic barriers, and managing cultural differences.
The Multicultural Clinic at the Montreal Children’s Hospital hopes to help meet the particular needs of newcomer youth — specifically immigrants, refugees, and asylum seekers — thanks in large part to a recent $500,000 grant through the TD Ready Commitment, the Bank’s corporate citizenship platform.
The money will help fund the “Migrant Teen Navigator” program at the Multicultural Clinic, which is designed to help eligible young newcomers avoid barriers to care, gain access to essential services, and transition into a healthy adulthood. The hospital expects the project to support around 200 to 300 newcomer teenagers and their families over the next two years.
To achieve this, the Migrant Teen Navigator program will pair eligible newly arrived teens with patient navigators. Employed by the clinic, patient navigators guide patients through the health-care system, ensure they receive necessary medical attention, and provide them with tools for self-care and self-advocacy to manage their own care as they transition into adulthood.
Patient navigators will help young newcomers in the program integrate with the health-care resources available in Montreal through interactions that range from a friendly greeting at the Multicultural Clinic, to orienting families to the resources available to them, to collaborating with health-care providers to ensure care plans are implemented.
“The navigator acts as a lighthouse, guiding the teens and their families to the appropriate resources and facilitating their transition to adult care,” Ferkli said.
Patricia Li, a pediatrician at the Montreal Children’s Hospital, researcher with the Research Institute of the McGill University Health Centre, and program lead, said the use of “navigators” in health care has grown in recent years. This increase is to help young newcomers in need of additional support better navigate the health-care system – which is often vital if they arrive in Canada with an urgent need for personalized care.
Li said that there are many barriers and gaps that exist in health care, which can lead to “pretty serious outcomes, especially as the youth transfer from pediatric to adult care.”
Newcomer youth who have a chronic condition, such as diabetes or kidney disease, for example, can run out of medications, Li said.
“They might not get the appropriate preventative care. That ultimately can result in them ending up in the emergency room, where they can suffer potentially lethal complications of their condition.”
In designing the Migrant Teen Navigator program, Li has drawn on the lessons she learned from previous patient navigator pilot projects for migrant children and youth, which she developed at the Multicultural Clinic at the Montreal Children’s Hospital in conjunction with the Compass Clinic at St. Michael’s Hospital in Toronto.
Through that experience, Li said, she and her colleague in Toronto, Dr. Shazeen Suleman, came to recognize “that there were gaps in our patient navigator programs in that we didn’t address the unique needs of teenagers and youth,” especially their need for a managed transition from pediatric to adult care.
Newcomers themselves have also provided their insights.
“We've co-developed the program alongside families, incorporating their voices and their experiences to address these kinds of issues and care gaps that they have,” Li said. “It’s created and inspired based on the stories of these families and their experiences.”
Li said empathy is one of the key traits her team is looking for as it hires navigators.
“They need to have some of what we call ‘cultural humility’ and ‘cultural safety,’ meaning they're good listeners, they recognize their own biases, and they're able to understand the context of people's lives and understand some of their culture and how that relates to their lived experiences,” she said.
Based on the outcomes of the pilot project in Montreal and Toronto, the Migrant Teen Navigator team are anticipating positive impacts including a decreased number of “no-shows” to the clinic, fewer emergency department visits, more interpreters to be available during appointments when required, and a greater proportion of patients completing a doctor’s examinaton and any requested tests on the same day as their clinic visit.
Ultimately, the program hopes to gather data that shows positive outcomes — enough that it could serve as a model for similar programs elsewhere.
Looking to the future
The Bank's donation to the Migrant Teen Navigator initiative is part of a 10-year pledge through the TD Ready Commitment and Canada’s Children’s Hospital Foundation (CCHF) to address critical social challenges, including access to health care for adolescent youth.
“Arriving in a new country comes with its own set of challenges, and I’m proud that TD is supporting the Montreal Children's Hospital to facilitate this transition for newcomers and their families,” said Abe Adham, Chair of the Quebec Market at TD.
“By supporting innovative health care solutions, TD is helping to support organizations that are working to remove barriers to care for adolescents and their families as they settle into their new country.”
Once they’re comfortably settled in Canada and receiving the health care they need, Li said, newcomers often look to the future — and see themselves working in health care.
“A lot of the youth we support are interested in careers and futures in health care," Li said. I'm really excited to help them develop leadership and teamwork skills so that they can actually help shape the future of our health-care system and be the leaders for us. They really want to give back to the system that's helped them establish their lives in Canada.”
To learn more about how TD is contributing to Better Health solutions head to the TD Ready Commitment.