Immigration & Trauma Part 3: Mental Health Care for Immigrants

As we saw in Part 2 of this series, immigrants often face many challenges and traumas that affect their mental health as they adjust to a new environment. Yet even with such a high need for support, they face major hurdles in getting mental health care.

In this part of the series, we'll look at the barriers immigrants face in accessing mental health care, along with practical ways to care for yourself and find the services you need.

Barriers to mental health care for immigrants

Several challenges can make it hard for immigrants to get the mental health care they need.

These barriers are complex, and they often mean mental health struggles go unaddressed.

Language: Research shows that limited English can discourage people from seeking medical care or check-ups. There is also a harmful misconception that people with limited English are less intelligent, which can seriously affect their access to care and the quality of care they receive.

Culture: Psychology and therapy are still predominantly White fields. Many immigrants are BIPOC, or come from cultures very different from Canada's mostly White, often individualistic culture, but they aren't well represented in the mental health field. There are too few BIPOC therapists and too few culturally informed approaches. This gap can leave immigrants' needs unmet, and leave them feeling unsafe or misunderstood.

Distrust of the medical system: Historically, the medical system, and psychology in particular, has not been kind or accessible to people outside the mainstream culture. Immigrants may have had negative or traumatic experiences with health care, like being dismissed, having procedures without explanation or consent, or abuse. Combined with an unfamiliar health care system, this can make seeking care feel even more daunting, and lead to anxiety and reluctance to reach out.

Cost: Depending on their status, some newcomers aren't yet covered by Alberta Health Care. Even with coverage, most therapy outside Alberta Health Services isn't publicly funded. Many immigrants are also still building employment and financial stability, with little or no insurance, which limits their access to care even more.

Surviving everyday life: Many immigrants, especially first-generation immigrants, are focused on surviving and adapting to a new life, like finding work, securing housing, or caring for family. This often leaves little time or energy to focus on mental health.

Legal worries: Some immigrants worry that seeking mental health care could cause legal problems, including deportation, especially if they are undocumented, waiting on their status, or in a complex legal situation. There's also a lot of confusion about how confidential therapy records are, which can keep people from reaching out.

Cultural stigma and pressure: Many cultural factors can make it hard to seek help for mental health. In cultures that value hard work and see showing emotion as weakness, there can be stigma around mental health. Immigrants may feel ashamed to ask for help, or fear being judged by their family or community. For children of immigrants, the pressure to succeed can make it hard to share their distress without fearing they'll let their family down.

In some cultures, especially collectivist ones, taking care of yourself can be seen as selfish, which can bring up guilt and shame about wanting help. People's sense of pain can also be shaped by culture. What might be seen as a distressing amount of pain in Canada might be seen as something to simply endure in someone's home culture, so they may not recognize that support could help.

And immigrants who experience something hurtful within their own community may fear backlash or being shunned, so they may not report it, or may downplay it.

Not knowing what's available: Many immigrants simply don't know what mental health services exist. If they come from a culture where mental health isn't a priority, they may not see how support could help. Even when they know care exists, they may not know how to navigate the system.

Standard trauma and mental health assessments may also miss immigrants' unique experiences. So even when people do get care, many of their needs can go unnoticed, or worse, be dismissed or treated in the wrong way.

What immigrants can do to protect their mental health

Individual efforts matter, but immigrants' mental health is not just an individual issue. It's a systemic one.

Canadian society and governments have a responsibility to protect immigrants' well-being, and need to be held accountable for policies and actions that improve access to care. This is especially true since so much immigration trauma, and so much of the loss of safety, comes from the policies and attitudes of the new country.

This doesn't mean immigrants are helpless. It means the responsibility needs to sit in the right places, so people aren't left carrying guilt or pressure over things they have little control over.

With that in mind, here are some ways to protect your mental health during and after immigration:

Acknowledge the challenges: Hardship is part of the immigration experience, and struggling doesn't mean you are weak or crazy. Your struggles are valid and a natural part of the process. There's no trophy for suffering alone, and there's no shame in reaching out for help.

Stay connected: Staying in touch with family, existing friends and supports, your community, and your cultural roots can ease isolation and offer a sense of stability. Staying connected to your culture can be as simple as listening to music or watching shows from your home country, or practising its traditions and rituals.

It helps to stay connected to both your heritage culture and your new one. Your heritage culture offers support and resources, while your new culture gives access to institutions that can help you adjust. For children of immigrants, knowing their heritage, culture, and first language can ease family conflict and build a strong sense of identity.

Take care of yourself: Look after your mental and physical health by prioritizing sleep, movement, and nourishing food. Staying engaged with current events can be important and empowering, but you're allowed to step away from interactions, situations, or news that trigger a stress response.

Notice difficult emotions as they come up, like anger, anxiety, or grief, and explore ways to release them. That might be deep breathing, talking with others, or light exercise, or something more creative, like dance, movement, art, or music.

Find support groups: Look for other immigrants or people with similar experiences. There is power in shared understanding and connection.

Get involved in social justice: Putting your energy into causes you care about can be an empowering way to process difficult emotions while helping others. You might take part in or help with community events, advocate for a cause, join social justice movements online, or bring a community together. Helping others can bring a sense of meaning and ease isolation.

Ask for help: It's okay to reach out for professional help when you need it. Therapy and other support can help you heal and process your emotions.

How immigrants can access mental health care

If you're an immigrant looking for mental health support, here are some ways to get started:

Local agencies and community resources: Community centres, newcomer centres, family centres, settlement and immigration services, schools, religious organizations, and municipal or provincial government websites can often point you to mental health resources, even if mental health isn't listed as one of their services. You can also call or text 211 to find local options. If you hold multiple identities, for example as an immigrant and queer, you may want to look for services that fit those specific needs.

Family doctors and primary care: Your family doctor or primary care provider can often refer you to a mental health professional. Many doctors know what's available in the community and can connect you with trusted therapists or mental health care.

Language support: If language is a barrier, you can ask your provider for an interpreter when using Alberta Health Services, including Health Link and mental health services. Phone interpretation is available in over 200 languages. Private therapists may not offer interpreters, so it's worth asking, or looking for a therapist who speaks your language.

Online therapy: If you're having trouble finding a therapist near you, online therapy can widen your search and give you more flexibility to find the right fit.

Free and affordable options: If cost is a barrier, our guide to free and affordable therapy in Alberta lists options, including services for immigrants and refugees.

If you're worried about privacy, it can help to know that therapy in Alberta is confidential, with limited exceptions such as serious safety concerns, child protection concerns, or a court order. You can ask a therapist to explain these at your first session.

What to look for in a therapist

When looking for a therapist, it's important to find someone who understands your cultural background and experiences.

Here's what to look for:

Cultural sensitivity: Does the therapist respect and understand your cultural background without judgment? They should be curious, open-minded, and willing to learn from you, while also doing their own learning, so the work of educating them doesn't fall on you.

Understanding of systemic issues: Your therapist should recognize that some struggles, especially those related to discrimination and trauma, aren't just individual problems. They are often systemic.

Advocacy and support: Will the therapist advocate for you in areas of your life beyond therapy, like helping you navigate the health care system or finding resources in other areas?

Experience with immigrant issues: It's okay to ask a therapist whether they have experience working with immigrants or people from non-dominant groups. If they do, they're more likely to understand the complexities you face.

Finding the right therapist can take time, so don't hesitate to explore different options until you find a good fit. If you feel comfortable with a therapist who shares your cultural background, great! But it's completely normal to take a few tries to find someone who understands you, whether you share a culture and language or not.

Coming up in this series

By recognizing and addressing these challenges, we can create a more inclusive, supportive environment for immigrants seeking mental health care.

Together, we can break down the barriers that keep so many people from the care they deserve.

In the final part of the series, we'll look at what therapists should keep in mind when working with immigrant clients.

Trauma Therapy in Alberta

If barriers have kept you from getting the mental health care you need, reaching out for support can help.

Trauma therapy offers a space that recognizes your experience and adapts to what you need. A therapist can help you access care in a way that feels safe and respectful.

Support is possible.

This article is for educational purposes only and is not a substitute for therapy, medical advice, diagnosis, or treatment.

If you or someone you care about is in crisis or at risk of harm, please get help now. Call 911 or go to your nearest emergency department. You can also call or text 988 any time for suicide and crisis support. For more options, see our crisis support page.

About the Author

Jiwon You is a Registered Psychologist specializing in trauma therapy and self-esteem therapy with adults. She is passionate about helping people heal from trauma and self-criticism so they can feel better and live more fulfilling lives. Jiwon offers services in Korean and English.