It’s been 10 years since Aivana watched her teacher die in front of her. She was sitting in her classroom when a bomb suddenly exploded.

She and the other students ran screaming and crying from the room, fearing for their lives.

KIDS, POVERTY AND MENTAL HEALTH: About this series:
A child who lives in poverty is three times more likely to have a mental health problem. Reporter Denise Davy investigates why this happens and what’s being done. Davy’s research was supported with a journalism
fellowship from the Canadian Institutes of Health Research.

PART ONE - Why kids in poverty are at higher risk to developing mental health problems

PART TWO - How Hamilton schools are helping students in lower income neighbourhoods

PART THREE - Anxiety: Why so many children in poverty struggle with anxiety

PART FOUR - Children of war: Healing immigrant and refugee children

PART FIVE - Hamilton’s poor children could be a better place to raise a child poverty

“I see my teacher die,” says the 17-year-old St. Jean de Brebeuf Secondary School student, in an emotionless tone.

Aivana talks in an almost robotic way when she recounts the violence that surrounded her while growing up in Iraq. She was seven when her family fled, moving first to Syria then to Hamilton.

When Aivana arrived in Canada, she spoke no English and learned slowly by watching TV. She talks about the violence she lived with as a child in a composed and calm tone.

Like many children and youth who grew up in war-torn countries and witnessed ongoing  violence, the trauma lives on inside of her. 

Targeted programs needed

Programs to deal with the mental health challenges of immigrant and refugee children are important since immigrant children under the age of 15 represent 22 per cent of the school-age population in Hamilton.

Hamilton also has a higher than average refugee population than other Canadian cities its size. Twenty per cent of foreign-born children living in Hamilton arrived as refugees compared to the national average of around 11 per cent.

Although they left behind the violence, for many coming to a new country means the beginning of new stressors. Immigrant children are more likely to live in poverty so their families are dealing with the stressors of having to struggle financially, said Lily Lumsden, senior regional manager of Employment, Training and Settlement for the YMCA Hamilton/Burlington/Brantford.

Haunted moments

New immigrants have the highest child poverty rate of any sub-population in Hamilton at 50 per cent and twice as many immigrants are likely to be unemployed as non-immigrants.

“When you think of what they have to handle, new home, new school and new friends and, on top of that, they’re teenagers which means they’re going through all these changes,” said Lumsden.

Live Chat Friday at noon: Join series author Denise Davy and Dr. Jean Clinton, child and adolescent psychiatrist at the Offord Centre for Child Studies for a live chat with CBC Hamilton

The moment that haunts Aivana most is when she was grabbed on the street and almost kidnapped. She prefers not to talk about it as it brings the fear. Her friend Mary, 19, is also from Iraq and, like Aivana, she still vividly remembers the gunfire and explosions and seeing classmates and family killed.

Recalling one day when soldiers stormed into her classroom, she says, “We started to cry and yelling. They just started shooting. When I talk about it sometimes it comes back again and it feels scared.”

Both girls asked that their last names not be used.

Shadow of violence

For Mary, the trauma has eased but she says it’s still sometimes difficult to sleep.

Many immigrant and refugee children, like Aivana and Mary, who grew up in the shadow of violence become stuck in a cycle of reliving the trauma long after they’ve left their homeland.

Some children have such severe post traumatic stress syndrome (PTSD), they are not able to leave their parent’s side. Others become weighted down with a profound sense of isolation which can lead to depression.

Aivana and Mary found support through a program called Let’s Talk Girls which is offered by the YMCA’s Settlement Workers in the Schools (SWIS). It provides a forum for newcomer girls to discuss their feelings, specifically around moving to a new country.

Opening up about trauma

The groups have been held at Glendale Secondary School, Sir John A. MacdonaldBarton Secondary School and St Jean de Brebeuf. Each group typically includes eight to 12 participants.

'They often say, ‘I feel like I’m living two different lives, one at school and the other at home.’- Jenny Martinez,  school settlement worker, SWIS

Jenny Martinez, lead school settlement worker with SWIS, said about 20 per cent of the girls she’s seen have had severe enough mental health problems that they needed individual counselling.

Getting them there isn’t always easy because mental health issues aren’t something that are openly discussed within some cultures. One 16-year-old girl was suicidal but refused to see a counselor for fear her parents would find out. Martiniez had to arrange for a counselor to come to the school so her parents wouldn’t know.

Sometimes the girls themselves have a hard time opening up because they’re not accustomed to sharing their personal feelings with strangers. Once they do, the key issue most want to share isn’t the trauma they left. It’s the struggle they have with their parents because of the cultural divide they experience between their lives at home and  at school.

“They often say, ‘I feel like I’m living two different lives, one at school and the other at home’,” said Martinez.

Some girls have talked about how they feel their parents don’t care about them anymore.

“We try and explain to them that their parents are juggling jobs and trying to pay the rent  and also taking ESL classes,” said Martinez.

When asked if she likes her new life in Canada, Mary pauses then says, “It’s quiet.”

Look at the family

The Child Abuse Council of Hamilton runs a unique program called OASIS (Outreach, Assessment and Specialized Intervention Services Program) for refugee and immigrant children and youth who have experienced trauma.

Child psychotherapist Mary-Jo Land, who runs the program, said the trauma children have experienced often shows in different ways, such as problems sleeping or with food issues such as overeating. Many are related to the traumas they’ve survived.

Where to go for help:

Contact Hamilton - 905-570-8888

COAST (Crisis Outreach and Support Team) — 905-972-8338

Schizophrenia Society of Ontario (family support) — 905-777-9921

Alternatives for Youth (substance abuse issues) — 905-527-4469

Canadian Mental Health Association (Hamilton) — 905-521-0090

Woodview Mental Health and Autism Services - 905-689-4727

Land said they bring in the whole family for counseling as they always find that parents  and other siblings are also suffering from trauma. Their job entails much more than working through the trauma, said Land, adding that it’s common for issues related to poverty to come up.

“We work with families who are trying to get their house sorted out, their finances, their kids and school. Many have bed bugs and cockroaches because they’re in low income apartments. They’re overwhelmed,” said Land.

For many, simply getting to an appointment is a huge challenge. Just taking a bus across town to get to there can take an hour and a half, said Land, adding it’s not uncommon to have missed appointments.

Many families need translators. Says Land, “It can take twice as long.”

The biggest obstacle, however, is simply building trust. Many have lived in countries where the governments and police were completely corrupt. Open up to a complete stranger about their problems and innermost fears can take a long time.

Working with young children takes a special touch and Land uses play therapy or has them draw pictures or use clay to express how they feel or to show her what they’ve experienced.

Some of the paintings are dark while others are filled with colour.

“It all helps them feel a sense of regaining control,” said Land.