Author: Donald Obasuyi, BSc student, Bachelor of Healthcare, Nursing, Novia UAS
Supervisor: Anita Wikberg, RN. RM. PhD, Senior Lecturer, Novia UAS

Abstract

This article is intended to review the risk factors and strategies in approaching mental health problems among immigrant and enlighten readers on how migration can influence immigrant’s mental health. This topic is important for both immigrants and healthcare providers, because early recognition of risk factors, signs and symptoms associated with mental health issues among migrants have the possibility to be treated before situation becomes worse. This article has recognized some mental health issues associated with immigrants that were exposed to various factors such as stress during their migration journey and integration process such as language barrier, cultural disparities, post-traumatic stress disorder (PTSD), labour market discrimination etc.  It is confirmed in this article that migration can cause long-lasting effects to immigrant’s mental health due to individual’s encounters during migration process.

Introduction

Migration can in various ways influence human life and its environment; one of the various ways it influences human life is through mental health, which is the main focus of this article. Identifying the risk factors and strategies in approaching mental health problems among immigrants can help prevent and treat mental health challenges among migrant’s populace at different level; it is very necessary for both immigrants and healthcare providers. Research on migration shows evidence that suggest higher rates of mental health disorder among immigrant population, for example, refugees (Gilliver, Sundquist, Li & Sundquist, 2014).

Migration is a phenomenon that has existed over decades, and it is still on the increase around the globe. It has been existing since the subsistence of human being. The type of migration process involved by migrants and the reason for such migration determines how the concept of migration is used. For example, immigrants, emigrants, refugees, asylum seekers are all synonymous concepts in migration studies. However, people migrate from one place to another due to several reasons but the most common goal among immigrants is to improve their living conditions or escape from danger/persecution (Nirmala, Kumar & Virupaksha, 2014).

All over the world, the occurrence of mental health issues (anxiety, stress, depression, and post-traumatic stress disorder) are increasing among immigrant populations compared to the host populace. Migration is a concept that involves processes to go through. For example, the pre-migration stage, migration stage, and the post migration stage. Often, lack of preparedness, negative encounters during migration and integration into the new environment can indirectly or directly affect immigrants’ mental health. The encounters of numerous stressors associated with migration process, settlement, and integration in receiving countries are report to be linked with mental health disorders (Gilliver, Sundquist, Li & Sundquist, 2014).

Recognizing and accurately treating mental health problem among immigrant’s groups within healthcare sector has become one of the major priorities in our modern-day societies. These challenges can be due to barrier or cultural differences, and it could also be as a result of some specific stressors that are linked to migration and resettlement (Nirmala, Kumar & Virupaksha, 2014). There is need to further explore some of the aforementioned factors that are relevant to the topic of this article in order to gain and understand the embedded knowledge that connects immigrants and mental health. The post traumatic stressor disorder (PTSD) has been found to be connected to several mental illnesses.

Post-traumatic stressor is a mental condition that is triggered by a terrifying incident, either by witnessing it or experiencing it. For example, rape-incident during migration, detention in camps, war, death of loved ones, limited access to healthcare during migration, and torture in the pre-migration stage (Mayo Clinic "Mental illness - Symptoms and causes", 2022; Nirmala, Kumar & Virupaksha, 2014). Rape incident, war, death of loved ones, were also linked to poor social integration in the host countries, economic problems, worries over family and friends that were left behind, and loneliness (Siriwardhana, 2017). For a better understanding of the subject matter, the next paragraph is set to explain mental health and how it connects to immigrants (Gilliver, Sundquist, Li & Sundquist, 2014).

Mental Health and Immigrants

Mental health is a prominence topic in most of the countries all over the world especially in terms of policy development for immigrants. Mental health is defined as the state of individual’s well-being (in terms of self-potential realization, how well he or she can cope with normal daily/life stresses, how he or she can work productively and fruitfully) and how well he/she is able to contribute positively to the community where he/she belongs (Nirmala, Kumar & Virupaksha, 2014). The importance of mental health has been given a greater prominence in terms of global health policies and some of these global health policies are connected to immigrants due to the rising influx of migrants globally. Mental health entails our emotions, social and psychological well-being (Gilliver, Sundquist, Li & Sundquist, 2014).

Mental health can affect how we feel, think, and respond to circumstances as individuals. Mental health also helps determine how we handle stress and relate with others. It can influence our decision making, and it is very important at every stage in life. God mental health is necessary to both male and female. There is difference between poor mental health and mental disorder but sometimes, both are used interchangeably. Human beings can experience poor mental health without being diagnosed of mental disorder. For example, a person can be experiencing episodes of physical, mental, and social well-being but still diagnosed of mental disorder (Gilliver, Sundquist, Li & Sundquist, 2014).

Effects of Migration on Immigrant’s Mental Health

The process of migration is unavoidably stressful, and stress is one of the factors that can prompt mental health issues.  Immigrant’s mental health is affected in some stages of migration (pre-migration stage, during migration, and in the post-migration stage).  Studies have shown that immigrants are more susceptible to mental disorder due to the traumatic encounters or events in their migration processes. These traumatic events could be war or torture in their previous country of residence. Other traumatic events could be witnessing people dying (the death of loved ones) and rape encounters during migration (this often happen especially to those who travel illegally through deserts and sea). All these traumatic events or encounters contribute directly and indirectly to mental health issues among immigrant’s populace in host countries (Mwanri et al., 2022).

The acceptance by the host country (integration process) is another factor that can stimulate the onset of mental health problem. A major aspect of integration in host country is communication; this is a difficult challenge that affects many immigrants at the post-migration stage. Cultural condition is another challenge that immigrants experienced during the integration process (coping, adaptation, and acculturation to new environment) at the host countries (Gilliver, Sundquist, Li & Sundquist, 2014).

Discrimination was also presented as one of the integration stressors in host countries, as it impacts the mental health of the immigrant’s populace in the receiving societies (Mwanri et al., 2022). Research on immigrant’s mental health carried out among migrant’s populace in Australia also provides poor social integration, loneliness and concerns about families left behind (not been able to visit families in their country of origin) as major key stressors that is linked with mental health issues among migrant’s populace in the host countries. Additionally, poor mental outcome and psychological distress among unemployed immigrants were suggested to be higher, compared to the employed immigrants in host destinations (Mwanri et al., 2022).

Risk Factors for Poor Mental Health/Mental Health Disorder Among Immigrants

Studies have shown the following as risk factors for poor mental health outcome among immigrant’s groups in host countries: family related factor (disconnection from families, spousal relationships, and child issues; things can be very tough for some immigrants when it comes to being abandoned by their wife or husband, and this contribute negative impact on mental health outcome). The expectations of these set of immigrants concerning their relationships or marriages seems to be ruined by encounters or separations that facilitate chances for loneliness, and this can worsen the psychological state of individuals involved (Siriwardhana, 2017).

Spousal separation can affect or result in poor parenting especially in some instance where the children’s responsibilities turn out to be for only one of the parents (father or the mother). These children may sometimes experience violence from their fathers or mothers due to frustration (inadequate resources or social support). The children can sometimes be left without guardian as the sole parents responsible for the upbringing will go in search for alternative means that can improve their living condition. This is a risky situation because the children become vulnerable to various ills in the environment and the society at large (Mwanri et al., 2022; Wrede, Löve, Jonasson, Panneh & Priebe, 2021).

Financial challenge is another risk factor for poor immigrant’s mental health out-come as many immigrants encounter this challenge in the host countries due to underpayment or unemployment related factors; especially those who were rich or having a good job in their country of origin but were forced to leave their assets in their home country. These set of migrants finds it difficult to understand and manage the new economy system and the integration processes in receiving counties. The main reason most of these immigrants suffer in labour market is specifically due to language barrier (Mwanri et al., 2022). Accommodation issues are also a risk contributing factor for immigrant’s mental health problem due to lack of employment that can yield to financial stability as comfortable accommodation is connected to job and financial stability (Mwanri et al., 2022).

Promotion of Mental Health for Immigrants

To promote the mental health of immigrants, the first step to take is understanding the risk factors that contributes to poor mental health among immigrants in host countries and find possible and useful policy to develop intervention programs that can help support migrant’s populace with successful integration into the host society at large. Financial constraint is another problem that many immigrants encounter in host countries; especially those who were rich or having a good job in their country of origin but were forced to leave their assets in their home country. These set of migrants finds it difficult to understand and manage the new economy system and the integration processes in receiving counties. Possible measures should be taken in order to assimilate these groups into the labour market. Though most of these immigrants can also suffer in labour market specifically due to language barrier (Mwanri et al., 2022).

If we recall the language barrier depriving some of the immigrants from getting a job; it is still connected to accommodation problem because you cannot effectively work without good language profession and when you don’t work, there will be no money to get good accommodation. Discrimination is one of the integration stressors in host countries, as it impacts the mental health of the immigrant’s populace in the receiving societies (Mwanri et al., 2022). Enlightenment programs should be carried out regularly and immigrants should be given the privileges to live in the same environment with the citizens of the host country; this will help reduce discrimination rate in the society.

Conclusion

This article has highlighted that migration can in certain conditions be a risk factor for developing mental health challenges among immigrants. The stressors and risk factors do not only affect the mental health state at individual levels but also influence their connections with their family and communities since some of these immigrants were forced to leave their home countries (Mwanri et al., 2022). Their encounters with various immigration processes and the duration of stay in detentions camps, having limited or no access to healthcare service and social support have been reported as stressors for mental health problems.

Similarly, challenges with social integration and a weak social network in the host country can also contribute to poor mental health. Language barrier which happened during migration process is a big contributing factor for mental health disorders among migrant groups, followed by unemployment challenges. This article has suggested promotion of mental health of immigrants as a way to reduce mental health problems among immigrants in host countries. The first step in promoting immigrants' mental health is to understand the risk factors that contributes to poor mental health among immigrants and find possible and useful policies to develop intervention programs that can help support migrant’s populace with successful integration into the host society at large.

References

•  Bhugra, D., & Jones, P. (2001). Migration and mental illness. Advances In Psychiatric Treatment, 7(3), 216-222. doi: 10.1192/apt.7.3.216
•  Gilliver, S., Sundquist, J., Li, X., & Sundquist, K. (2014). Recent research on the mental health of immigrants to Sweden: a literature review. The European Journal of Public Health, 24(suppl 1), 72-79. doi: 10.1093/eurpub/cku101
•  Nirmala, B., Kumar, A., & Virupaksha, H. (2014). Migration and mental health: An interface. Journal of Natural Science, Biology and Medicine, 5(2), 233. doi: 10.4103/0976-9668.136141
•  Siriwardhana, C. (2017). Moderators of mental health of humanitarian migrants. The Lancet Psychiatry, 4(3), 175-176. doi: 10.1016/s2215-0366(17)30035-4
•  Wrede, O., Löve, J., Jonasson, J., Panneh, M., & Priebe, G. (2021). Promoting mental health in migrants: a GHQ12-evaluation of a community health program in Sweden. BMC Public Health, 21(1). doi: 10.1186/s12889-021-10284-z