Dr. Shivajan Sivapalan: Culturally appropriate mental health services for racialized immigrant families

As a tutor and music teacher for underprivileged youth in Scarborough, in the final year of his undergraduate studies in Toronto, Dr. Shivajan Sivapalan met many families— and was shocked to learn they were often misguided or ill-informed about mental health. Dr. Sivapalan met a child on the Autism spectrum, who was of Indian background. “The family wasn’t sure what Autism was or meant . . . The mother had never heard the word before. And the worst part was that she felt it was her fault that her child was on the spectrum.” This was a life-changing encounter for Dr. Sivapalan, sparking a determination in him to pursue his MD and work towards helping the South Asian community to receive better supports for mental health care and Autism.

A first-generation Canadian, born to Sri Lankan parents who immigrated to Canada from Nigeria when he was four, Dr. Sivapalan’s high school years were marked by other’s preconceived ideas of South Asian culture. He saw his social adversity as motivation to succeed, and in his final year of undergraduate studies at the University of Toronto, he decided to pursue medicine at St. George’s University in Grenada.

Dr. Sivapalan felt revitalized about leaving Canada to experience life away from his family’s shepherding. He notes how children growing up in a “typical South Asian household” usually experience sheltered growth: “There’s a lot of dependency on our parents, in terms of even making decisions on what career path we want to take. So, it was the first time I had some independence when I went abroad.”

Importantly, he says that his four years of international study at St. George’s University was a catalyst for profound personal development and a source of newfound respect for his parents’ journey in Canada.

Much of Dr. Sivapalan’s current work pertains to mental healthcare and Autism support for South Asians and newcomer families to Canada as well as with international post-secondary students, particularly in Toronto. But what makes their needs unique?

He recalls a time earlier in his career when as a family doctor, he would receive questions about mental health from his patients and their families. After six years of family medicine, Dr. Sivapalan decided to focus his career on mental health projects.

Lack of access to culturally appropriate care is “one of the greatest challenges that South Asian families face in the Canadian mental healthcare system,” says Dr. Sivapalan. “It’s easier for families to speak to those from the community that they trust, whether it be elders, immediate family, or even religious members, than it is to speak to a healthcare professional,” he says, noting this is a common characteristic of collectivistic cultures. This is why connecting newcomers to proper resources and support and combating mental health-related taboos are necessary first steps in providing culturally-responsive, quality healthcare.

His own journey at the South Asian Autism Awareness Centre began as a volunteer in 2009. Dr. Sivapalan then served as Vice President on the organization’s board. He has been the Director of Clinical Operations since 2018. Dr. Sivapalan says that his work at SAAAC is about identifying discrepancies in current Autism support systems in Ontario and finding solutions to fill these gaps.

“I try to provide solutions that take into account cultural differences, which is significantly important in today’s landscape in healthcare,” Dr. Sivapalan says. One of Dr. Sivapalan’s innovative solutions is the CARES Program, a peer-counselling initiative that addresses the chronic stress, burnout and mental health of caregivers in a culturally sensitive manner.

Trust between families and care providers is pivotal to improve the mental health outcomes of South Asian communities, Dr. Sivapalan says. “Deepening these family and care provider partnerships will gradually remove the cultural barriers and encourage open communication.”

Dr. Sivapalan is also a successful researcher. When he initially struggled to find research collaborators focused on the international student population, CIRCLE became paramount in recruiting community partners and securing funding. Dr. Sivapalan is inspired by the opportunities that a hub like CIRCLE provides for South Asia and India-related research.

“Connections that I have made through CIRCLE have really provided me the opportunity to disseminate my research, not just here in Canada, but also internationally,” he says.

Dr. Sivapalan sees enormous potential for students to learn and contribute, and welcomes students to volunteer, intern or research with SAAAC.

Emmerson Jull is a student writer for CIRCLE. She is in the third year of her undergraduate degree in International Development Studies at the University of Guelph.