The Influence of Culture on Immigrant Women's Mental Health Care Experiences From the Perspectives of Health Care Providers

Abstract

It is well documented that serious mental health problems such as depression, schizophrenia, and post migration stress disorders exist among immigrant women. Informed by Kleinman's explanatory model, this qualitative exploratory study was conducted with seven health care providers who provided mental health services to immigrant women. Analysis of the data revealed that (a) immigrant women face many difficulties when accessing mental health care services due to cultural differences, social stigma, and unfamiliarity with Western biomedicine, (b) spiritual beliefs and practices that influence immigrant women's mental health care practices, and (c) the health care provider-client relationship, which exerts great influence on how immigrant women seek mental health care. The study also revealed that cultural background exerts both positive and negative influences on how immigrant women seek mental health care. We suggest that although cultural knowledge and practices influence immigrant women's coping choices and strategies, awareness of social and economic differences among diverse groups of immigrant women is necessary to improve the accessibility of mental health care for immigrant women.

If I Was Going to Kill Myself, I Wouldn't Be Calling You. I am Asking for Help: Challenges Influencing Immigrant and Refugee Women's Mental Health

“…Studies reveal that as a result of the migration process, many immigrant and refugee women suffer serious mental health problems, such as depression, schizophrenia, posttraumatic stress disorder (PTSD), suicide, and psychosis (Beiser, 2005;Bhui et al, 2003;Grisaru, Irwin, & Kaplan, 2003;Li & Browne, 2000;Lin & Cheung, 1999;Shepherd, 1992;Thurston & McGrath, 1993). However, these women have difficulty getting their mental health care needs met (Donnelly, 2004;Morrow & Chappell, 1999;O'Mahony & Donnelly, 2007a, 2007b. Barriers influencing immigrant and refugee women's mental health care include low socioeconomic status (Chiu, Ganesan, Clark, & Morrow, 2005;Dhooper & Tran, 1998;Pilowsky, 1991;Zelkowitz et al, 2008), unemployment and underemployment (Beiser, Johnson, & Turner, 1993;Bhui et al, 2003;Thompson, 2000), marginalization, 279 280 T. T. DONNELLY ET AL.…”

“…Barriers influencing immigrant and refugee women's mental health care include low socioeconomic status (Chiu, Ganesan, Clark, & Morrow, 2005;Dhooper & Tran, 1998;Pilowsky, 1991;Zelkowitz et al, 2008), unemployment and underemployment (Beiser, Johnson, & Turner, 1993;Bhui et al, 2003;Thompson, 2000), marginalization, 279 280 T. T. DONNELLY ET AL. discrimination, gender issues, language barriers (Chiu et al, 2005;Dhooper & Tran, 1998;O'Mahony & Donnelly, 2007b;Ziguras, Stankovska, & Minas, 1999), cultural differences (Anderson, 1987a;Dhooper & Tran, 1998;Li & Browne, 2000;O'Mahony & Donnelly, 2007a), social stigma, and lack of knowledge regarding available mental health care services (Chiu et al, 2005;O'Mahony & Donnelly, 2007a, 2007b. In this paper, the term "immigrants" refers to persons who seek lawful admission to Canada to live as permanent residents (Citizenship and Immigration Canada [CIC], 2000).…”

“…The different environments and circumstances from which immigrants come have created many health problems and barriers to accessing health care (Chiu et al, 2005;Stephenson, 1995). A study that investigated immigrant women's mental health care experiences from the health care providers' perspective (O'Mahony, 2005;O'Mahony & Donnelly, 2007a, 2007b revealed that (a) immigrant women face many difficulties when accessing mental health care services due to insufficient language skills, cultural and social stigma, unfamiliarity with Western biomedicine, low socioeconomic status, gendered roles, and structural barriers, (b) the health care provider-client relationship exerts great influence on how immigrant women seek mental health care, and (c) cultural background exerts both positive and negative influences on how immigrant women seek mental health care.…”

Barriers Accessing Mental Health Services Among Culturally and Linguistically Diverse (CALD) Immigrant Women in Australia: Policy Implications

“…As a result, prevalence of specific mental health disorders among ethnic women in Australia remains poorly understood and under researched, despite evidence of a range of mental health disorders among this cohort such as depression, schizophrenia and stress [6,7]. Despite an enabling healthcare policy [8], CALD immigrants underutilise mental health services compared to other Australians [9,10].…”

A scoping review of mental health issues and concerns among immigrant and refugee youth in Canada: Looking back, moving forward

“…8 Post-migration determinants of mental health and illness among immigrants and refugees have been identified at various levels: individual (e.g., age, gender, language fluency, ethnicity, knowledge of the health care system); familial (e.g., family (in)stability, socio-economic status, intergenerational conflict); institutional (e.g., availability (or lack) of access to appropriate care and services, (non)acceptance of foreign credentials); and societal (e.g., discrimination, racism, poverty). [8][9][10] Although both groups may be affected by the same post-migration determinants of mental illness, refugees may experience these determinants in "acute and unique ways," which may result in more mental health problems. 3 To date, findings from different studies about mental health among immigrant and refugee youth in Canada have not been consolidated.Therefore, we conducted a scoping review to assess the current state of knowledge about various aspects of mental health among immigrant and refugee youth in Canada, identify gaps within the literature, and provide implications for research, practice and policy.…”