| Some risk factors for mental health in
migrants include: |
| •
|
Decrease in socioeconomic status |
| • |
Lack of recognition of overseas qualifications, including
educational and employment experiences |
| • |
Low levels of language learning and proficiency |
| • |
Separation from social, religious and cultural networks,
particularly family and friends |
| • |
Social isolation and lack of support |
| • |
Prejudice and discrimination by the host population |
| • |
Traumatic experiences or prolonged stress prior to
or during migration |
| • |
Acculturative stress |
| • |
Language and cultural barriers to mental health services
access, including stigma about mental illness and lack
of knowledge regarding available services |
| • |
Breakdown of traditional and family support structures,
particularly family and relatives, with intercultural
conflict being a major contributor |
Migration is the process of
social change whereby an individual moves from
one cultural setting to another for the purposes
of settling down either permanently or for a prolonged
period…The process is inevitably stressful
and stress can lead to mental illness.
|
Bhugra
and Jones |
|
| There are a number of classifications
of migrants: |
| • |
Settlers — those who plan to
stay in the locations where they have migrated |
| • |
Political exiles — those who
are forced to leave their homes for political reasons;
i.e. they are exiled from their homes |
| • |
Asylum seekers — those who
travel to another country and ask for political asylum
once in the country |
| • |
Refugees — those who cross
international borders fleeing war or persecution for
reasons of race, religion, nationality, or membership
in particular social and political groups |
| • |
Displaced persons — those who,
through natural disasters or man-made circumstances,
are forced to leave their homes |
| Culture can profoundly
influence the way people experience mental illness.
For example, in many cultures…people experience
depression in bodily terms which can often lead
to misdiagnosis. Language issues can further complicate
diagno¬sis. To describe sadness, a Chinese
person may use a term that is often translated
as “congested.” A doctor who does
not understand the subtleties of the expression
might offer treatment for allergies or the flu,
rather than depression. |
| Arthur
Kleinman |
|
There are no easy answers for the management
of mental health issues in the migrant population.
In working with the migrant population, there are many
considerations to take into account. While it is extremely
difficult to generalize about these considerations,
the following may serve as a preliminary guide for increased
understanding of the challenges involved. |
| Considerations |
| • |
Mental health problems may be presented as physical
problems — headache, stomach ache, etc. Look beyond
the physical to a holistic model of health, incorporating
the individual’s cultural and religious values. |
| • |
Culture is a resource as well as a barrier; culture
gives a sense of belonging. Culture may not only be
the glue that holds a group together but it can also
be the chief stressor in trying to adapt to new surroundings
without losing their own identity or sense of self worth.
Cultures vary in terms of their view of the roles of
men and women, children and parents. Power within the
family may be quite different than in one’s own
culture. Children generally learn a new language much
more rapidly than their parents and this often causes
a reversal of roles in the family where the children
may have more power. Marriages may be threat¬ened
due to changing roles, especially when women must work
out of the home. |
•
|
Perceptions of time may be very different in different
cultures: people from individualistic cultures are goal-oriented
and concentrate on the future. People in other cultures
place more emphasis on the past, honouring those who
came before them. There are others who focus on the
present as they don’t know if they will have a
future or not.
Many cultures do not easily trust members of other cultures.
It is important to build trust before moving ahead with
specific mental health questions.
It is important to talk in the same terminology; ensuring
that each person understands the other. |
| • |
Traditional healers from the migrant’s home
culture may assist the individual in getting access
to health care in a culturally acceptable and meaningful
way. Western trained mental health providers and traditional
healers can bridge the gap between cultures and make
the transition smoother |
