Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward

Abstract

The Mental Health Commission of Canada’s (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O’Malley (Int J Soc Res Methodol 8:19–32, 2005). Over two decades of relevant literature on immigrants’ health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed.

Settlement and Integration Needs of Skilled Immigrants in Canada

“…On the other hand, the immigrants are also less likely to experience declining health if they are highly satisfied with their settlement experience. In other words, there is a positive association between the settlement experience and the health and well-being of immigrants (Newbold 2009;George et al 2015).…”

Social determinants of emotional well-being in new refugees in the UK

“…Discrimination has unfailingly been found to be associated with poor mental health outcomes amongst refugees and immigrants in previous studies 35 . While discrimination can take many forms, this study was restricted to measurement of being a victim of verbal or physical attack, and those who reported this suffered from worse emotional well-being.…”

Uncertainty in situations of forced displacement: A critical interpretative synthesis of refugee literature

“…Even though uncertainty is often loosely defined and poorly contextualised, it is deemed to explain experiences of hopelessness, despair, trauma (Afifi et al, 2011;Becker et al, 2000;Brun, 2015), frustration, fear (Crea, 2016), psychological distress (Crea, 2016;Dupont et al, 2005;Samarasinghe, Fridlund, & Arvidsson, 2006;Warfa et al, 2006), powerlessness, boredom, drug problems (Dupont et al, 2005), a deepening mental deterioration, self-harm and suicidal behaviour (Kenny & Procter, 2016), and chronic states of anxiety and depression (Mansouri & Cauchi, 2007). Several other studies likewise relate uncertainty to refugees' state of mental well-being (Afifi et al, 2011;George, Thomson, Chaze, & Guruge, 2015;Hussain & Bhushan, 2009;Laban, 2011;Mansouri & Cauchi, 2007;Roberts, Ocaka, Browne, Oyok, & Sondorp, 2009;Warfa et al, 2006Warfa et al, , 2012. Afifi et al (2011) argue that uncertainty is "one of the hallmarks of refugee status and a known source of anxiety" that should be taken into account in mental health assessments (p. 495).…”