Immigration & Trauma Part 3: Mental Health Care for Immigrants

As discussed in Part 2 of the Immigration & Trauma series, immigrants often face many challenges and trauma that impact their mental health as they adjust to new environments.

Despite such a high level of need for support, they face significant hurdles in accessing mental health services. In this part of the blog series, we will recognize and address the many barriers immigrants face regarding mental health care. We will also discuss practical ways they can care for themselves and access needed services. 

Barriers Immigrants Face in Accessing Mental Health Services

There are several challenges that can make it difficult for immigrants to seek the mental health care they need. These barriers are complex and can often lead to mental health struggles going unaddressed.

1. Language Barrier: Some studies show that limitations in English can discourage individuals from seeking medical treatments or check-ups. Additionally, there’s a harmful misconception that people with limited English proficiency are less intelligent, which can have serious implications for healthcare access and the quality of care they receive.

2. Cultural Barrier: The field of psychology and counselling is still predominantly white-dominant. Even though a large proportion of immigrants are either BIPOC or from a culture different than that of the White, often individualistic culture of Canada, they are not well represented in the mental health field, seen by a lack of BIPOC therapists or culturally informed/ sensitive treatment approaches. This lack of diversity can create a disconnect where the unique needs of immigrants are not met, and they may feel unsafe or misunderstood.

3. Distrust of the Medical System: Historically, the medical system, especially the field of psychology, has not been kind or accessible to those who aren’t part of the mainstream culture. Immigrants may have had negative or traumatic experiences with healthcare (e.g. dismissal, operations without explanations or consent, abuse, etc.), and combined with the unfamiliarity of the healthcare system in their host country, trying to access care can be even more discouraging. This can lead to anxiety and reluctance to seek out mental health services.

4. Financial Barriers: Immigrants who are not yet permanent residents or citizens may not have access to government-funded healthcare, which can prevent them from receiving needed mental health services. Additionally, many immigrants may still be trying to establish employment and financial stability and have no or limited insurance, which can further limit their access to care.

5. Surviving Everyday Life: Many immigrants, particularly those who are first-generation, may be focused on surviving and adapting to their new life, whether that’s finding a job, securing housing, or caring for family members. This struggle for basic survival often leaves little time or energy to prioritize mental health.

6. Legal Issues: Some immigrants may fear that seeking mental health services could lead to legal complications, including potential deportation, if they are undocumented, yet to be documented, or are in a complex legal situation. There is also a significant amount of misunderstanding around the confidentiality of therapy records, which may discourage some from seeking help.

7. Cultural Stigma and Pressure: Many cultural elements can hinder people from seeking mental health help. In cultures where “hard work” is valued and showing emotions may be seen as a sign of weakness, there can be a stigma around mental health. Immigrants may feel ashamed to ask for help, fearing judgment from their family or community. For children of immigrants, the pressure to succeed can make it difficult to express distress without the fear of letting their family down. There may also be a cultural norm that taking care of oneself is selfish, especially if they are from a collectivistic culture, which can cause feelings of guilt and shame in wanting to reach out for help. Further, there may be a cultural relativity in the perception of pain. That is, what may be considered a distressing amount of pain in the host country may be considered as something to simply be tolerated in their home culture, leading to not recognizing that one can benefit from mental health support. Lastly, immigrants who experience something in their community may fear repercussions and ostracization from others in the community, and thus may not report or underreport. 

8. Lack of Awareness or Knowledge: Many immigrants may simply not be aware of the mental health services available to them. If they come from a culture where mental health is not prioritized, they may not consider the potential benefits that can come from such support. Furthermore, even when immigrants know mental health care exists, they may not know how to navigate the system. In addition, standard trauma/mental health assessment may not consider immigrants’ unique experiences, which means even if they do access services, much of their needs and struggles can go unnoticed and missed, or worse, dismissed or wrongfully treated. 

What Immigrants Can Do to Protect Their Mental Health

It should be kept in mind that even though individual efforts are important, we must also recognize the responsibilities that the Canadian society and government have in protecting immigrants’ mental well-being. That is, the matter of immigrants’ mental health is not simply an individual issue but a systemic one, and the dominant society needs to be held accountable in promoting policies and actions to improve access and delivery of care. This is not to say that immigrants are helpless. Yet, we need to distribute the onus and responsibilities to proper places to not burden people with a sense of guilt or pressure over situations they have little control over. This is especially so when so much immigration trauma and a sense of safety stems from policies and societal sentiments of the host country and its government.

While immigrants face numerous challenges, they have ways to safeguard and prioritize mental health during and after immigration. 

• Acknowledge the Challenges: Understand that hardship is a part of the immigration experience, but that doesn’t mean you are weak or “crazy.” Your struggles are valid and a natural part of the process. Just like how there is no trophy in suffering alone, there is also no shame in reaching out for help.

• Stay Connected: Keeping in touch with your family, as well as pre-existing social supports, community, and cultural roots, can help prevent feelings of isolation and offer a sense of stability. Maintaining contact with your culture can be as simple as engaging in your home country’s music or media, or practicing its specific traditions or rituals.  

• Maintain consistent access to heritage culture as well as host culture. The heritage culture offers access to support and resources, while the host culture gives access to institutions that can help immigrants adjust. For second-generation immigrants and children, familiarity with one’s heritage, culture, and native language can ease familial conflict and build a strong sense of identity. 

• Practice Self-Care: Take care of your mental and physical health. Prioritize sleep, exercise, and proper nutrition. It’s important and can be empowering to be engaged with current events, but you are allowed to disconnect from triggering interactions, situations, or news that could cause stress responses. Recognize difficult emotions that come up - anger, anxiety, grief - and explore ways to release them. This can look like deep breathing, talking with others, and light exercise, or something a bit more unconventional, such as dances, movements, or art/ music to express your feelings.

  
  

• Find Support Groups: Seek out other immigrants or individuals with similar experiences. There is power in shared understanding and connection.

• Engage in Social Justice Causes: Channelling your energy into social causes can be an empowering way to process difficult emotions while helping others, such as engaging in or assisting with community events, advocating for a cause, engaging in social justice movements online, or gathering a community. Helping others can bring fulfillment and allow you to process your difficult emotions while easing isolation meaningfully.

• Ask for Help: It’s okay to reach out for professional help when needed. Therapy and similar support can help you heal and process your emotions.

How Immigrants Can Access Mental Health Services

If you’re an immigrant looking for mental health services, there are several ways to get started:

1. Local Agencies and Community Resources: Seek out services within your local community. Often, community centers, centres for newcomers, family centres, municipal/ provincial government websites, immigration services, schools, or religious organizations provide helpful information and access to mental health resources, even if they do not necessarily list “mental health” as a part of their services. If you are at the intersection of multiple identities (for example, immigrant and queer), you may want to seek services tailored to those specific needs.

2. Family Physicians and General Healthcare Providers: You can often get a referral to a mental health professional through your family doctor or primary care provider. Many doctors are aware of resources available in the community and can direct you to trusted therapists or mental health care.

3. Language Support: If you face language barriers, you are entitled to request an interpreter when accessing healthcare or mental health services. This ensures that you can communicate effectively and receive the care you need.

4. Telepsychology Services: If you’re having trouble finding a therapist in your area, consider telepsychology or online therapy options. This can widen your search and give you more flexibility to find the right fit.

What Immigrants Should Look for in a Therapist

When seeking 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, but also be responsible in doing their own research, not to put the burden of education on you.

• Understanding of Systemic Issues: A good therapist should recognize that some struggles, particularly related to discrimination and trauma, are not just individual problems - they are often systemic issues.

• Advocacy and Support: Does the therapist advocate for you in areas of your life beyond therapy, such as navigating the healthcare systems or providing resources in other areas? 

• Experience with Immigrant Issues: It’s okay to ask your therapist if they have experience working with immigrants or individuals from non-dominant groups. If they do, they will likely understand the complexities you face.

Finally, remember that finding the right therapist may take time. 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 for it to take a few tries to find someone who understands you, whether you share the same culture/ language or not.

By recognizing and addressing these challenges, we can create a more inclusive, supportive environment for immigrants seeking mental health services. Together, we can break down the barriers that prevent so many from accessing the care they deserve.

Next week, in the final part of the series, we will look at Immigration & Trauma Part 4 for therapists working with immigrant clients.

Jiwon You is a psychologist specializing in working with adults in trauma therapy and self-esteem therapy. She is passionate about helping people heal from immigration and racial trauma and self-criticism so they can feel better and live more fulfilling lives. Jiwon provides affirming online therapy in Calgary and across Alberta for all folks 18+ and can provide services in Korean and English.