International migration flows and patterns shaped by the determinants, processes and outcomes of social, political, and economic conditions have led to important transformation of society and human geographies. As Canada continues to effectively manage its immigration system and uphold its commitment to international refugee protection and resettlement, it is critical for Canada to do so with an understanding of the changing context of immigration, which are reinforced by shifting policies and their impact, in our contemporary society. In this thesis, the migration trajectory of three groups of newcomers to Canada; international students, Syrian refugees, and refugee youth, are explored by examining policies and conditions that can create group risks and vulnerabilities in immigration, settlement, and integration as groups transition to life in Canada after arrival. As suggested by Castle (2010) migration researchers can advance the field by embedding their work in broader theories of social change to facilitate understanding of the complexity, interconnectedness, variability, contextuality, and multi-mediation of migratory process in the context of rapid change. This thesis employs a geographical lens of place to deepen understanding of processes and outcomes in our contemporary society, while responding to these evolving contexts in one mid-size, post-industrial Canadian city. In three separate research, this thesis examines: 1) economic immigration flow under Express Entry in 2015 and 2016; 2) the role of the voluntary sector during the Syrian Refugee Resettlement Initiative in Hamilton, Ontario in 2016; and 3) the place of school-based settlement in bridging and brokering school-based mental health for newcomer youth. / Thesis / Doctor of Science (PhD) / As Canada continues to effectively manage its immigration system and uphold its commitment to international refugee protection and resettlement, it is critical for Canada to do so with an understanding of the changing context of immigration in our contemporary society. In this thesis, I examine the migration trajectory of three groups of newcomers to Canada; international students, Syrian refugees, and refugee youth, by asking two overarching research questions that explores policies and conditions that can create group risks and vulnerabilities in immigration, settlement, and integration. This thesis seeks to understand how policies could be addressed to improve successful outcome for newcomers. This thesis employs a geographical lens of place to deepen understanding of processes and outcomes in our contemporary society, while responding to these evolving contexts in one mid-size, post-industrial Canadian city.

Studies have shown a concerning and disproportionate amount of treatment failure and premature termination in youth populations. Routine measurement feedback has been proposed as a means to prevent treatment failure and premature termination for adults and may also improve youth mental health services. However, studies examining helpfulness of measurement feedback systems in youth populations have demonstrated a lack of effects more likely due to poor measurement implementation than to the measurement feedback system itself. Because contexts within the service settings are such crucial factors in whether an innovation is successfully implemented, examining barriers and facilitators in said contexts is a necessary step towards improving implementation for the ultimate purpose of improving youth mental health services. The present study explored barriers and facilitators to the implementation of the Youth Outcome Questionnaire (Y-OQ) and Treatment Support Measure (TSM) in youth routine clinical care. Thirteen staff of varying job titles, experiences, education and opinions towards measures were interviewed using consensual qualitative research (CQR) methods. Results were similar to previous studies, indicating multilevel barriers and facilitators to measurement implementation such as at the organization, staff, client and measure level. Using CQR data analysis, domains, categories and subcategories along with level of frequency are displayed and discussed in further detail. In addition to barriers and facilitators, interviewees provided recommendations for how to improve implementation of measures within their organization. Researchers provide recommendations of continued communication, re-assessment of barriers and facilitators over time and shared responsibility between stakeholders and professionals invested in improving youth mental health services.

published_or_final_version / Social Work / Master / Master of Social Work

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-06-14T19:40:40Z No. of bitstreams: 1 DissJFS.pdf: 1537912 bytes, checksum: 5c0bc9f181d07163e84cc47cb09da0fb (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-06-28T07:54:58Z (GMT) No. of bitstreams: 1 DissJFS.pdf: 1537912 bytes, checksum: 5c0bc9f181d07163e84cc47cb09da0fb (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-06-28T07:55:11Z (GMT) No. of bitstreams: 1 DissJFS.pdf: 1537912 bytes, checksum: 5c0bc9f181d07163e84cc47cb09da0fb (MD5) / Made available in DSpace on 2017-06-28T08:01:35Z (GMT). No. of bitstreams: 1 DissJFS.pdf: 1537912 bytes, checksum: 5c0bc9f181d07163e84cc47cb09da0fb (MD5) Previous issue date: 2016-12-19 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / The historical path of the attention to the mental health of children and adolescents accompanied, in a particular and late way, the paths taken in the care of the adult population with psychic suffering, so that from the beginning of the nineteenth century there is recognition of the needs of care to the child and adolescent population, being, at first, the historical care delegated to the educational and social assistance sectors. However, from a few milestones, such as the Brazilian psychiatric reform and the declaration of human rights, it became possible to develop a new conception for childhood and adolescence, as well as the recognition of child and adolescent psychosocial care in the public policy arena. However, literature in the area has pointed to the scarcity of research that focuses on the assistance to Mental Health of adolescents, since they have presented significant indexes of psychic suffering, and indicate the need for more research that can subsidize the actions and policies aimed at this population. Thus, the present study aimed to identify how psychosocial attention has been given to the adolescent from the perspective of professionals linked to a service of Strategic Psychosocial Care (CAPS) and to Basic Health Care services (UBS and USF). In order to respond to the proposed objectives, a qualitative, descriptive and exploratory research was developed. The study was attended by 19 professionals from the Strategic Psychosocial Attention Service (CAPSij) and Basic Health Care (UBS and USF) and located in a medium-sized municipality in the interior of the State of São Paulo. Four data collection instruments were developed, two forms for characterization of professionals and services, and two semi-structured interviews for professionals. The data coming from the forms were analyzed in a descriptive way and those of the interviews were investigated by the Thematic Analysis, one of the techniques foreseen in the Content Analysis Method. The main results of the interviews with CAPSij professionals indicated that it acts as a gateway to the mental health demand of adolescents in the municipality, which is perceived as a challenge, considering the role of the service in the definition of eligible cases or not for the CAPSij. In addition, the participants also reported on the difficulties that the team faces with regard to the adherence of the adolescents users to the service, indicating the need for more strategies that facilitate the linkage of the same and the effectiveness of the work, as well as in relation to the users' families. The difficulty in enabling RAPS in the municipality was also a challenge pointed out by professionals. On the other hand, the data show the commitment of the participants in care actions focused on the premises of policies and the search for network articulation, especially with the Basic Health Care. The results of the interviews with the professionals of Basic Health Care Pointed out the challenges in the care and follow-up of the adolescent population in general, especially those who experience the psychological suffering that, according to the statements, hardly reach the service and, when they arrive, are referred to CAPSij. It was also observed that the activities carried out in adolescent ABS services are fundamentally curative, and health promotion and prevention actions are rare, as well as those of a network of care that, when they occur, are triggered by the CAPSij. Therefore, it was possible to verify with the present study that the psychosocial attention of adolescents in the investigated context is a field under construction and, currently, it occurs in CAPSij. It is hoped that the findings obtained may provide more subsidies for reflection and planning of policies and more effective interventions directed at the population of adolescents in psychological distress. / O percurso histórico da atenção à saúde mental de crianças e adolescentes acompanhou, de maneira particular e tardiamente, os caminhos trilhados no cuidado com a população adulta com sofrimento psíquico, de modo que, a partir do início do século XIX, há o reconhecimento das necessidades de cuidado à população infantojuvenil, sendo, a priori, o histórico assistencial delegado aos setores educacionais e de assistência social. Entretanto, a partir de alguns marcos, como a reforma psiquiátrica brasileira e a declaração dos direitos humanos, tornou-se possível o desenvolvimento de uma nova concepção para a infância e a adolescência, bem como o reconhecimento da atenção psicossocial infantojuvenil no cenário das políticas públicas. No entanto, a literatura da área tem apontado sobre a escassez de pesquisas que focalizem a assistência à Saúde Mental de adolescentes, visto que estes têm apresentado índices significativos de sofrimento psíquico, e indicam a necessidade de mais investigações que possam subsidiar as ações e políticas voltadas a essa população. Assim, o presente estudo objetivou identificar como tem ocorrido a atenção psicossocial ao adolescente sob a ótica de Profissionais vinculados a um serviço de Atenção Psicossocial Estratégica, no caso o Centro de Atenção Psicossocial Estratégica Infantojuvenil (CAPSij), e a serviços da Atenção Básica em Saúde referentes à Unidade Básica de Saúde (UBS) e à Unidade de Saúde da Família (USF). Para responder aos objetivos propostos, foi desenvolvida uma pesquisa qualitativa, de caráter descritivo e exploratório. O estudo contou com a participação de 19 profissionais de serviços de Atenção Psicossocial Estratégica (CAPSij) e Atenção Básica em Saúde (UBS e USF) localizados em um município de médio porte do interior do Estado de São Paulo. Foram desenvolvidos quatro instrumentos de coleta de dados, sendo dois formulários para caracterização dos profissionais e dos serviços, e dois roteiros de entrevistas semiestruturados destinados aos profissionais. Os dados advindos dos formulários foram analisados de forma descritiva e os das entrevistas foram tratados por meio da Análise Temática, uma das técnicas previstas no Método da Análise do Conteúdo. Os principais resultados das entrevistas com os profissionais do CAPSij indicaram que o órgão atua como porta de entrada da demanda de saúde mental de adolescentes no município, o que é percebido como um desafio, considerando o papel solitário do serviço na definição dos casos elegíveis ou não para o CAPSij. Além disso, os participantes relataram, também, sobre as dificuldades que a equipe enfrenta no que se refere à adesão dos adolescentes usuários ao serviço, indicando a necessidade de mais estratégias que facilitem a vinculação deles e a efetivação do trabalho, assim como em relação às famílias dos usuários. A dificuldade em viabilizar a RAPS no município também foi um desafio apontado pelos profissionais. Por outro lado, os dados mostram o empenho dos participantes nas ações de cuidado voltadas às premissas das políticas e a busca de articulação em rede, em especial com a Atenção Básica em Saúde. Os resultados advindos das entrevistas com os profissionais da Atenção Básica em Saúde apontaram os desafios no cuidado e acompanhamento da população adolescente de forma geral, especialmente aquela que vivencia o sofrimento psíquico que, segundo as falas, dificilmente chegam ao serviço e, quando chegam, são encaminhadas para o CAPSij. Observou-se, ainda, que as atividades realizadas nos serviços de ABS junto aos adolescentes são fundamentalmente curativas, sendo raras as ações de promoção e prevenção em saúde, bem como aquelas de articulação de rede de atenção que, quando ocorrem, são disparadas pelo CAPSij. Portanto, foi possível verificar, com o presente estudo, que a atenção psicossocial de adolescentes no contexto investigado é um campo em construção e, atualmente, dá-se no CAPSij. Espera-se que os achados obtidos possam fornecer mais subsídios para reflexão e planejamento de políticas e intervenções mais efetivas direcionadas à população de adolescentes em sofrimento psíquico.

published_or_final_version / Social Work / Master / Master of Social Sciences