Immigrants, refugees, and asylum seekers are one of the most vulnerable social groups in the U.K. Most of these people are fleeing their home countries because of poverty, civil war, or a ruthless government. Many of these countries are third world nations in which there are high incidences of disease, crime, torture, and separation from families. As a consequence, some may have developed mental illness to some degree. Others may have acquired some mental health issues owing to the stress of adapting to a new culture, system, lifestyle, and social treatment in their adoptive countries.
In the U.S., a high number of Asian American immigrants show depressive symptoms. This is according to a 30-year old study, one reported by the University of Hawaii in 2011. These people are stressed by the loss of their support system in their home countries and the pressing need to learn a new language and adapt to a foreign system. Most of these immigrants may not have had mental health issues to begin with; but, the piling up of all the stressors from moving to a totally different country and society can contribute to the decline of mental health. Children are particularly vulnerable to immigration stressors.
In the U.K., the African and African Caribbean communities have a high prevalence of depression and anxiety. Everyday, people in these communities have to live with racism, difficulty in finding employment, bad housing conditions, and other stressors which can make many people, mentally ill.
Among African refugees and asylum seekers, PTSD is the most ubiquitous mental problem. Mood disorders come second. Some, being torture survivors, may be experiencing hallucinations, nightmares, panic attacks, sexual issues, acute phobias, and major depression. These individuals may have difficulties forming relationships and developing trust.
Why Immigration Can Lead to Development of Mental Health Problems
When a person immigrates to another country or place, they face huge changes that they need to cope with:
- Upheaval of their social network and the need to re-establish personal, social, and business ties with new people
- Adapting from one type of socio-economic system to another
- Adapting to a new cultural system
Migrants have to leave the social ties they have built and try to forge new ones in the new host country. Whatever role or profession they had occupied in their old place may have to drastically change to a lower profession or even a totally different one. For instance, a respected dentist in her country may come to find herself having to occupy a much lower level position, such as a dental receptionist, in the new place. The migrant may also have migrated to a place where her certification as a professional dentist holds no value or recognition. In order to be certified as a dentist in the new country, she may have to study again to get the credentials. Often, the migrant does not have the necessary financial means to fulfil such requirements.
The immigration process also puts a great strain on the migrant as his citizenship status and his economic status is highly uncertain. Institutions may question his legality of stay in the country which in turn could impact his employment options, not to mention his options as a person without citizenship privileges. He may also be vulnerable to situations involving violence, especially if he finds himself in refugee camps or detention centres where resources are meagre and conditions are harsh. Such environments and the reality of powerlessness can trigger or create chronic depression, anxiety, trauma, and other mental health issues, even in mentally healthy people.
Psychiatric treatment of immigrants needs to be approached from a cultural perspective. Since most immigrants come from a different cultural background, it is important to understand how a migrant patient communicates. Sometimes, patients with depression or panic attacks focus on unexplained physical symptoms such as pain, stomach upsets, fatigue, and the like. When interviewed in a more relaxed social rather than clinical setting, the patient may reveal being burdened by social and situational stressors which they are usually reluctant to talk about as culturally, these may be deemed inappropriate medical topics. Some cultures also highly stigmatise mental illnesses so that seeking professional attention on the matter is not something individuals may want to acknowledge they need or want to talk about.
Language is another barrier to treating migrants who do not adequately speak the tongue of the host country. In this case, language interpreters and culture brokers can effectively assist and vastly improve diagnosis and treatment by helping to span both cultural and communication gaps.