In Canada, immigrants on average arrive with advantageous mental health when compared to the Canadian-born population. However, as the length of stay in Canada increases their mental well-being and general mental health declines. This is known as the "healthy immigrant effect". The healthy immigrant effect is explained by unique stressors that immigrants experience and the inadequate resources available to them that can lead to a decline in their mental health and well-being.
The mental health of immigrant populations is a neglected issue that is in need of immediate attention. Few mental health services are specific to the need of diverse cultures, are economically accessible and address the barriers that immigrants face. Furthermore, many refugees arrive with existing mental health problems that are not recognized in a timely manner. This calls for better and efficient resources for migrants. A study by Salami, Salma & Hegadoren (2018), identifies barriers and strategies recognized by immigrant service providers (ISP) that have the potential to enhance prevention and treatment of mental health in immigrants and refugees.
If you are an immigrant then you know that the immigrant service providers are the first and most influential contact upon arrival. Immigrant service providers take the role of helping immigrants resettle, overcome cultural barriers, find jobs and everything else that aid in the resettlement process. Thus it would make sense that they are often the first people to recognize someone is suffering from a mental health concern and needs care. 49 ISPs from Alberta participated in this study and identified three major barriers to accessing mental health services in immigrants and refugees. These barriers are listed below:
- Language and Cultural Barriers: In many cultures, mental health issues are not recognized as an illness that needs treatment. These cultures may perceive mental illness as an individual being weak or a test of their faith. Additionally, they may not recognize the symptoms of mental illness and have stereotypical views of what mental health concerns may entail. Lastly, due to language barriers, they may need the help of interpreters which make the treatment process even more difficult.
- Persistence of Stigma: Stigma in regards to mental illness is both internalized and externalized in ethnic populations. The individual may feel a sense of shame or failure. They feel responsible to resolve the issue by themselves and not seek help. The people around them will also try to hide the issue that a family member or a close relative is suffering. Recognition of a problem may lead to discrimination and social exclusions from the rest of the community. Mental health concerns are often not recognized as a legitimate issue and result in individuals suffering alone and not seeking the help they need.
- Fear of Negative Repercussions: The ISPs identified that many immigrants and refugees fear that admitting that they are suffering from mental illness would result in negative repercussions from the Canadian government. They feared that they might lose custody of their child, be deported or even terminated from their jobs.
- Presence of Systematic Access Barriers: Lastly, other identified barriers were the high financial cost and none flexible hours to meet the needs of immigrants and refugees. Immigrants and refugees already face an economic barrier compared to the rest of the population, and find it difficult to pay for therapy and treatment sessions. Additionally, free services are limited and the referrals take from weeks to even months for them to get the services they need.
Improving Mental Health Services
In light of these findings, community-based mental health services would suit the needs of migrants. They will provide easily accessible and flexible resources that provide information about mental health and familiarize it in ethnic communities. Additionally, mental health services need to be enhanced to use holistic approaches that combine the various needs of immigrants while overcoming the cultural and stigmatization barriers. A proper language to address mental health in migrant populations that appeals to them and takes away the stigma should be established. Furthermore, ISPs need additional and more competent training. ISPs hold a significant role in identifying migrants with mental health issues and guide them throughout the support process. However, many of these ISPs feel that they lack the proper training to address such issues.
Immigrants and refugees experience barriers to accessing mental health services. These barriers were mentioned as language and cultural barriers, stigma in communities and fear of negative repercussions, that are a result of unfamiliarity to the Canadian system. Services need to be enhanced to overcome the barriers and also be economically accessible to migrant populations. Although many mental health services exist this does not mean that they are the proper services. Mental health services should be easily accessible to all cultures and backgrounds.
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