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Accessibility of Disability Services from Within the Border

In April of 2018, the Government of Canada made an amendment to the Refugee and Immigration Protection Act to redefine the terms of medical inadmissibility (Government of Canada, 2018; Wright, 2018). Prior to this change, under the medical inadmissibility policy immigrants to Canada were often denied residency on the basis of medical inadmissibility claiming that these newcomers and/or their families would become a burden to Canada’s healthcare system due to their disability (DCCI, 2018; Wright, 2018). The original structure of the policy actually violated the United Nations Convention on the Rights of Person with Disabilities (DCCI, 2018). All that said, the amendment to the Canadian Medical Inadmissibility policy has still garnered critic from both sides, with some suggesting that becoming more inclusive and making the terms of medical inadmissibility lighter will take a toll on the health infrastructure of provinces and territories (Wright, 2018). While others highlight that this change was only minor and there is still much work to be done to make Canada the inclusive nation it claims to be (DCCI, 2018). Although the policy itself makes it easier for immigrants with disabilities to enter Canada, they still face challenges related to accessing healthcare and disability services once in Canada. The challenges experienced by immigrants with disabilities vary depending on a number of factors, such as: cultural/ethnic background, immigration status, English proficiency, settlement location, socioeconomic status, age, and gender (Khanlou, Haque, et al., 2017). For the purposes of this post, this discussion will focus on the experiences and challenges faced by female immigrants living with disabilities.


Female immigrants experience disability in two ways, either they themselves have a disability, or they experience the challenges associated with accessing disability services through their children with disability (El-Lahib, 2018). For the most part, female immigrants with disabilities experience challenges in accessing disability services due to their dependency (O’Mahony & Donnelly, 2013). Due to cultural expectations, many female immigrants are expected to take on the role of caretaker or housekeeper once they arrive in Canada, therefore they enter the country as dependents of a spouse or family member rather than as economic immigrants (O’Mahony & Donnelly, 2013). As a result, these women become financially vulnerable and privy to emotional, physical, and economic exploitation (O’Mahony & Donnelly, 2013). In order to access disability services, immigrant women must seek out these services, however, if they are dependent on an individual that prohibits them from accessing such services these women have little to no means of benefiting from these resources. Additionally, in some cases some disability services are not offered through provincial or territorial insurance plans, therefore making it difficult for these women to afford these services (Khanlou, Haque, et al., 2017). Even if the spouse or relative of a female immigrant is an economic immigrant, if these individuals hold unstable and/or low-paying jobs this introduces additional financial stress on these women and their families (Khanlou, Haque, et al., 2017).


The second way in which female immigrants may try to access disability services is for their children. Once again, due to cultural values, females are often expected to take on primary parental responsibility (El-Lahib, 2018; Khanlou, Haque, et al., 2017; Khanlou, Haque, Sheehan, & Jones, 2014; Khanlou, Mustafa, Vazquez, Davidson, & Yoshida, 2017). This includes navigating the Canadian health care system in order to find the appropriate services for their children (Khanlou, Mustafa, et al., 2017). In many cases, due to language barriers and poor intergovernmental health system integration, navigating health services can be difficult (Khanlou, Mustafa, et al., 2017). Women in Arfa, Solvang, Berg, & Jahnsen (2020) and Bogenschutz's (2014) study noted that they obtained some disability service information from support groups or through social networks, however, Bogenschutz (2014) notes that finding disability-specific information through these informal means becomes difficult. Nonetheless, such social networks are better than none. Some immigrant mothers reported feeling isolated because they were discriminated against (being blamed for their child’s disability), or simply did not have the time to form social relationships since taking care of their child consumed most of their time (Khanlou, Haque, et al., 2017; Khanlou, Mustafa, et al., 2017).


All in all, many immigrant women and mothers were grateful for the services available to them, stating that compared to their country of origin the services available were far more helpful (Arfa, Solvang, Berg, & Jahnsen, 2020). That said, as stated at the beginning of this discussion, there is still room to improve the accessibility of disability services for immigrants. Khanlou, Haque, Sheehan & Jones (2014), concluded that having a central person to help immigrants navigate disability services would improve their ability to access these services. A study in Norway supported this conclusion, the study reported that social workers helped immigrant mothers navigate the healthcare and disability service system, thus improving the accessibility experience of these mothers (Arfa et al., 2020). Such navigators would also be able to support and protect the well-being of immigrant women with disabilities who migrate to Canada as dependents. Additionally, increased funding and educational training for childcare facilities would both equip these facilities to care for children with disabilities and provide immigrant mothers with time to care for themselves, ensuring they do not burnout (Khanlou, Haque, et al., 2017; Khanlou, Mustafa, et al., 2017).



References


Arfa, S., Solvang, K., Berg, B., & Jahnsen, R. (2020). Disabled and immigrant, a double minority challenge: a qualitative study about the experiences of immigrant parents of children with disabilities navigating health and rehabilitation services in Norway. BMC Health Services Research, 20(134). https://doi.org/10.1186/s12913-020-5004-2


Bogenschutz, M. (2014). “We Find a Way”: Challenges and Facilitators for Health Care Access Among Immigrants and Refugees With Intellectual and Developmental Disabilities. Wolters Kluwer Health, 52(10), 64–70.


DCCI. (2018, April 16). New immigration law for people with disabilities. Retrieved March 23, 2021, from https://disabilitycreditcanada.com/new-immigration-law-for-people-with-disabilities/


El-Lahib, Y. (2018). Social Work at the Intersection of Disability and Displacement: Rethinking Our Role. Journal of Progressive Human Services, 31(1), 1–20. https://doi.org/10.1080/10428232.2018.1531744


Government of Canada. (2018, April 16). Government of Canada brings medical inadmissibility policy in line with inclusivity for persons with disabilities - Canada.ca. Retrieved March 23, 2021, from https://www.canada.ca/en/immigration-refugees-citizenship/news/2018/04/government-of-canada-brings-medical-inadmissibility-policyin-line-with-inclusivity-for-persons-with-disabilities.html


Khanlou, N., Haque, N., Mustafa, N., Vazquez, L. M., Mantini, A., & Weiss, J. (2017). Access Barriers to Services by Immigrant Mothers of Children with Autism in Canada. International Journal of Mental Health and Addiction, 15(2), 239–259. https://doi.org/10.1007/s11469-017-9732-4


Khanlou, N., Haque, N., Sheehan, S., & Jones, G. (2014). “It is an Issue of not Knowing Where to Go”: Service Providers’ Perspectives on Challenges in Accessing Social Support and Services by Immigrant Mothers of Children with Disabilities. Journal of Immigrant and Minority Health, 17(6), 1840–1847. https://doi.org/10.1007/s10903-014-0122-8


Khanlou, N., Mustafa, N., Vazquez, L. M., Davidson, D., & Yoshida, K. (2017). Mothering children with developmental disabilities: A critical perspective on health promotion. Health Care for Women International, 38(6), 613–634. https://doi.org/10.1080/07399332.2017.1296841


O’Mahony, J. M., & Donnelly, T. T. (2013). How does gender influence immigrant and refugee women’s postpartum depression help-seeking experiences? Journal of Psychiatric and Mental Health Nursing, 20(8), 714–725. https://doi.org/10.1111/jpm.12005


Wright, T. (2018, April 16). After 40 years, federal government ending barriers to disabled immigrants | CTV News. Retrieved from https://www.ctvnews.ca/canada/after-40-years-federal-government-ending-barriers-to-disabled-immigrants-1.3887123

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