Addressing refugee men’s health in the EAL classroom

What is needed in the increasingly diverse and complex learning environment of language instruction for immigrants?

I am grateful and excited to do the work I do, opening doors to look beyond current systems, structures and practices, asking questions such as these, and listening. Throughout the past year, through conversations with refugee men and the settlement and language professionals that work with them, this is what I know about addressing refugee men’s health and well-being:

Experienced settlement and language professionals say refugee men are adapting less well than women, less equipped and inclined to learn English, and reluctant to attend programs. This impacts their ability to access health services and information, and takes a toll on their mental well-being. A sense of isolation persists. Their frustration at a system they don’t understand and loss of agency fuel fear and anger.

Refugee men themselves say that there is a mis-match between the roles and behaviours expected of them as males, husbands and fathers in Canada and those of their home countries. Many refugee men are used to being the sole breadwinner, some having held down 3 jobs; in Canada, their wives are getting jobs more easily than they are. Along with the necessity of shared responsibility in earning income, there is also an expectation of shared decision-making. “Everything needs to be discussed”, against a backdrop of seeing conversations about relationships and conflict as a poor use of their masculinity.

Over-riding these challenges there is willingness to engage in conversations around learning and trying new ways of doing things, both on the part of settlement and language professionals and refugee participants. For me, I am continually encouraged by the shimmer of resilience and hope that others shine on this path of inquiry and collaboration into better ways forward.

I strongly believe that the EAL (English as an Additional Language) classroom is a hopeful place to address these complex needs and challenges. There, we can build upon the familiarity and trust that typically exist in an EAL class, experiment with how language instruction takes place to create safe spaces for conversations, and support instructors with the freedom to choose topics and the resources to respond to needs and dynamics of their class. We can recognize, for example, that providing accurate information around topics such as men’s sexual health and smoking are extremely important, and so too are spaces for honest conversations to explore gender roles in family planning, and how men can re-connect with the sense of community that has always been part of their lives.

Introducing ‘Refugee Men’s Health and Well-being: Strategies for Language Instructors’

Diana Jeffries, Mohammed Alsaleh, Taslim Damiji and I received the 2018 BCTEAL Health Education grant and over the past 6 months have been working to create this resource: Refugee Men’s Health and Well-being: Strategies for Language Instructors (which can also be found in the Resources section of this website). It is intended to help EAL instructors and male students engage in topics around men’s physical, mental and sexual health in a safe and supported way, and addresses the much larger picture of refugee men and their barriers to physical and mental wellness.

In its early stages, the resource team conducted primary qualitative research in order to more clearly understand the barriers facing refugee men and how they could be supported in an EAL class. We led an advisory group made up of language and settlement professionals with knowledge and experience working with refugee men. Mohammed and his co-facilitators then led two male-only focus groups in Arabic for refugee men Surrey, one hosted by Options Community Services, and one hosted by DIVERSEcity Community Resources Society. Our research surfaced the following themes: refugee men’s lack of understanding around accessing health services and information; the stigma around mental health inherent in most cultures, but particularly those cultures which refugees often represent; and refugee men’s challenges in socio-cultural adaptation both within their families and in the community.

In responding to this research and our own experiences and background in developing EAL curricula and programs, the resource provides information, lessons and resources to help refugee men build language skills around developing healthy lifestyles in Canada, accessing health services, connecting with their new communities and building healthy relationships. Through suggestions, considerations and guided discussion, it deals implicitly with the stigma around mental health and the challenges many refugee men face as partners and fathers in Canada, and encourages instructors to adopt cultural humility into their practice. It highlights the importance of familiarity and trust between instructor and students in choosing and broaching topics.

Addressing socio-cultural adaptation –  a lesson on ‘Feelings and Male Roles’

With socio-cultural adaptation arising as one of the most prevalent themes in both the advisory and the two focus groups, Diana, content writer for the resource, developed a lesson on Feelings and Male Roles, under the theme of Building Relationships. The lesson begins with stretching and breathing exercises learned in previous lessons, and leads into an activity on identifying feelings and talking with a partner by responding to questions such as: What makes you feel happy at home? What makes you feel angry at home? Who do you talk to when you feel scared? Where do you go when you are tired? The next activity has students sharing in a group who does what household responsibility within their culture. Students become more comfortable sharing differences when the instructor emphasizes that families and cultures are unique, and that no answers are right or wrong. This kind of framework allows for moving into more difficult territory such as a guided discussion on setting boundaries and abuse. This lesson, as with most in this resource, requires a high level of trust and sensitivity between instructor and students, as well as amongst students, and it is important that instructors employ cultural humility.

What is cultural humility?

‘Cultural humility in teachers can be seen as a life-long process that involves self-reflection and self-critique, learning from and actively listening to diverse students, building partnerships with student and communities, and showing a willingness to negotiate mutually acceptable alternatives to communication, engagement, and education.” (Chang, Simon & Dong, 2012)

While recognizing it is the role of the teacher to make sure that students understand laws such as those around abuse and violence, for example, they can at the same time adopt and model a genuine approach to recognize the challenges of negotiating relationships and meaning when the rules and expectations are very different, to learn through sharing ideas and strategies, and to identify appropriate solutions in a Canadian legal and social context.

Moving the work forward

The initial responses to Refugee Men’s Health and Well-being: Strategies for Language Instructors have been very encouraging, both in terms of the continued need to address refugee men’s health and well-being, as well as how EAL instructors can be better supported. In recognizing the complexities around addressing health and mental wellness, and the challenges of outreach and delivery of a language-based men’s health group, Diana and I are hoping to move this work forward by piloting the ideas in different learning contexts (i.e. male-only LINC students outside of class time versus an informal/community English program for refugee men). If you are interested in trying any of these activities and approaches (even as a one-off lesson within a health unit) and would like to provide some feedback, I would be very happy to hear from you!

Please contact me by replying to this post or sending me a note through my Contact page. Please also feel free to repost.