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The report chronicles a 44-year career in cultural psychiatry spent at Duke, Cornell, Harvard, the University of British Columbia, the University of Toronto, and Ryerson Universities. It describes my studies in a rural community in Nova Scotia, in traditional villages in Senegal, West Africa, on Canadian First Nations reserves and American Indian reservations, in refugee camps in Southeast Asia, among immigrant and refugee communities in Canada, in Ethiopia, and in Israel. The report summarizes major findings resulting from these research efforts, and discusses contributions to theory as well as potential implications for practice as well as policy. The article concludes with reflections about the present state of cultural psychiatry, raises concerns about where the field seems to be in danger of going wrong, and offers suggestions about what needs to be done next.

The Ryerson University Refugee Resettlement Project (RRP), a decade-long study of 1348 Southeast Asian refugees who came to Canada between 1979 and 1981, is one of the largest, most comprehensive and longest-lived investigations of refugee resettlement ever carried out. Knowledge gleaned from the RRP about research methodology, about the resettlement experience, about the social costs of resettling refugees, about factors that promote or hinder integration, about risk and protective factors for refugee mental health, and about the refugees' consumption of mental health and social services is summarized in the form of 18 "Lessons." The lessons are offered in order to encourage and stimulate further research, as well to suggest policy and practice innovations that could help make resettlement easier, less costly, more effective, and more humane.

Canada's relative generosity in admitting refugees and fairness in considering refugee claims has earned this country an enviable reputation. However, having opened its doors to those selected, Canada's resettlement policies and programs fail to provide for their needs, and to promote their optimal adaptation. Based on a decade-long investigation of the resettlement of more than 1300 Southeast Asian refugee – 'Boat People' – the current report examines how research concerning (a) the impact of pre-migration trauma; (b) the mental health impact of social resources such as the like-ethnic community, refugee sponsorship programs, and language training; and (c) individual coping strategies such as suppressing the past, can contribute both to theory and to improving policy and practice. The presentation acknowledges the contributions of Dr. Alexander H. Leighton by demonstrating the importance of his insistence on the need for a longitudinal perspective both for conducting research and for planning programs and services.

Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.

ABSTRACTThe University of Toronto Refugee Resettlement Project (RRP) investigated language acquisition over a ten‐year period among a sample of 608 South‐East Asian Refugees in Canada. Two years after arrival, 17 per cent spoke English well, 67 per cent had moderate command of the language, and 16 per cent spoke no English. Ten years later, 32 per cent had good language skills, 60 per cent moderate skills, and 8 per cent still spoke no English. The most rapid improvement occurred during the early years of resettlement. Although demographic characteristics and pre‐immigration achievement were the major factors determining English‐language proficiency during the early years of resettlement, post‐migration opportunities and incentives became increasingly important over time. The results highlight the responsibility receiving countries have to provide opportunities and incentives to facilitate language acquisition by newcomers.