The mental health of immigrants has been an abiding concern for policy-makers, health practitioners, as well as a small community of psychiatric researchers including myself.
Indeed, activists pushed to ensure that the recently-released 'Mental Health Strategy for Canada' included a section specifically devoted to immigrant mental health. This section states that immigrants "face significant barriers to their seeking or obtaining help...health organizations need to be attuned to differences...and take into account cultural diversity"
To better understand underlying issues, I recently led a number of studies comparing the mental health of immigrants to non-immigrants. These have just been concluded and published in the Canadian Journal of Psychiatry. Results are somewhat surprising.
Firstly, we found that (in general) immigrants had better mental health than non-immigrants. Immigrants had less psychological distress, less depression and less alcohol problems, in comparison to people born in Canada. Immigrants also had higher rates of well-being, as well as more satisfaction with daily life and personal relationships.
Secondly, immigrants had lower rates of health service use in comparison to people born in Canada. Immigrants who do use mental health services had higher rates of satisfaction than the Canadian-born. This was especially so for immigrants born in Asia or Africa.
Thirdly, a key concern for immigrants and non-immigrants alike was stigma associated with mental illness. People with mental illness in our studies, regardless of background, reported that stigma was the biggest barrier towards recovery, infecting every area of life including family, employment and social relationships.
In other words, the studies indicate that immigrants tend to have have better mental health than non-immigrants. Why could this be? There are many reasons.
Strengths and Resiliency
To start, it takes strength of character to move from one country to another. People who do this may be especially resilient, and thus less vulnerable to mental health issues. Similarly, immigrants have to pass a strict medical exam to gain permanent residence; those with a mental illness may have their file rejected.
Additionally, studies indicate that immigrants are more likely to belong to close-knit families, tight ethnic communities and religious congregations. All this can provide valuable social support and a sense of belonging, both of which are known to protect mental health.
Immigrants have often been portrayed through a pathological lens in studies of mental health. However our studies indicate the strengths and resiliency of immigrants and immigrant communities. This side of the coin is rarely highlighted.
Stigma and Service Improvement
That said, our studies indicated that people with mental illness from immigrant communities still experience high levels of stigma from people inside and outside their own ethnic community. This suggests that educational, anti-stigma strategies might be useful within immigrant communities.
Likewise, lower rates of service use imply that formal mental health services may not be appealing to immigrants. More could be done to make them more engaging in this regard.
The Mental Health Strategy for Canada states that immigrants face significant barriers. But immigrants also have significant strengths. Both should be considered when discussing immigrant mental health.
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