Chapter 2: Immigrant Health

Mental Health Considerations for Immigrants

Any form of migration or relocation can trigger stress. The degree of stress depends on the location and whether the move is planned or unplanned. Unplanned migration requiring rigorous adaptation can contribute to stress-related mental health issues. As Gao et al. (2022) noted, “Migration status is a suggestive risk factor for heterogeneous psychiatric conditions” (p. 2).

Immigrants to Canada can be categorized in different groups depending on how they arrived.

Economic and Skilled Immigrants

Economic and skilled immigrants are highly educated individuals who have migrated to Canada by choice. Their education and skills do not automatically provide them with a job upon arriving. They have to meet Canadian standards and licensure requirements. They also sometimes have to undergo language proficiency tests. During this frustrating phase, these individuals may face mental health challenges.

Students

Most international students leave their native homes to seek higher education and greener pastures. These students have unique challenges. They need to meet the requirements of their studies and learn new academic content and standards of academic integrity that are not used in their native countries. At the same time, they need to try to navigate financial barriers if their scholarships are inadequate. These challenges can lead to struggles with mental health.

Crisis Immigrants and Refugees

Refugees: Merriam-Webster defines a refugee as “person who flees to a foreign country or power to escape danger or persecution” (n.d.). By this definition, it is clear that refugees often flee their home countries without preparing or having a destination in mind. This could lead to refugees having tremendous mental health issues from the time they flee to their unplanned destination to when they settle and call a place home. Sometimes refugees flee as an entire family. Other times, they leave other family members at home. They may worry about their loved ones left behind and have difficulty acclimatizing to the climate, language, or culture in their new locations. These and many other experiences can contribute to depression and anxiety about the unknown. Even their adjustments to the new places they call home can be temporary or permanent, as they may be expected to relocate.

Crisis Immigrants: These are individuals who embark on treacherous journeys using unsafe means to migrate.

Refugees and crisis immigrants can develop physical illnesses during the ordeal of flight from danger or persecution. Their physical health is important and needs attention. However, a holistic approach to all aspects of their lives, including their mental health and trauma responses, should be factored in when delivering care.

Culturally Responsive Practice Points for Health Care Providers

• The more precarious the migration, the more attention must be paid to the mental health and trauma responses of the individuals involved.
• Health care team members need to understand the different aspects of migration and the effects on individuals that negatively impact their mental health.
• Mental health can be perceived as a taboo by some immigrants, and the topic can be very daunting for many cultures. Many cultures attribute mental health disorders to some form of spiritual attack. Subu et al. (2022) noted that “[w]orldwide, studies have shown that many people believe mental health illnesses are ‘spiritual illnesses’ caused by demonic or spirit possessions, witchcraft, or the effect of evil eyes” (p.1). Based on this belief, it is not uncommon for patients and their loved ones to seek interventions from shamans and religious experts to treat their mental health challenges. According to Subu et al. (2022), “[i]n Africa, about half of people affected by mental health illness seek therapy from shamans and religious practitioners in the first instance of their illness” (p. 2).

References

Gao, X., Zhao, Y., Wang, N., & Yang, L. (2022). Migration modulates the prevalence of ASD and ADHD: a systematic review and meta-analysis. BMC Psychiatry, 22(1), 1–16. https://doi.org/10.1186/s12888-022-04037-4

Merriam-Webster (n.d.). Refugee. In Merriam-Webster.com dictionary. Retrieved September 5, 2024, from https://www.merriam-webster.com/dictionary/refugee

Subu, M. A., Holmes, D., Arumugam, A., Al-Yateem, N., Maria Dias, J., Rahman, S. A., . . . & Abraham, M. S. (2022). Traditional, religious, and cultural perspectives on mental illness: a qualitative study on causal beliefs and treatment use. International Journal of Qualitative Studies on Health and Well-being, 17(1), 2123090. https://doi.org/10.1080/17482631.2022.2123090