Canada is a diverse population. In 2011, one out of five people in Canada were foreign-born and another one in five were part of an ethnic minority. The following year saw around 250,000 new immigrants came to Canada. Canada is open to immigration and multiculturalism.

However, immigration is a stressful process, particularly for those who suffer from mental illness. According to Dr. Jessica Dere, the relationship between acculturation and mental health is complex.

“Acculturation can be stressful,” Dere said.“Refugees and immigrants do face certain relatively unique challenges, and sometimes those can be very stressful and that can lead to, or contribute to mental health difficulties for some people.”

Dr. Dere, together with Drs. Laurence Kirmayer and John W. Berry, agree that sometimes immigrants have better mental health than those born in Canada. After all, they were courageous to leave behind their social and financial resources to settle down in a new country. Dr. Kirmayer also notes that the terms “culture” and “acculturation” are not necessarily easy to understand.

“Canadian Indigenous peoples use the word ‘ culture’ to refer to traditional knowledge, ways of life, values, spirituality, and a lot of things that have historical roots and that are intrinsic to their collective identity as peoples and nations and so on,” Kirmayer said.

By contrast, “acculturation” refers to changes in one or both groups as a result of continuous first-hand contact. Changes in both groups are considered.

Dr. John W. Berry coined the term “acculturation strategies” to refer to the different ways immigrants acculturate. There are four main strategies: integration; segregation; assimilation; marginalization.

At an individual psychological level, integration is favoured when someone tries to maintain ties with both cultures. When they maintain ties with their original culture, but sever ties with the new culture, is how they become segregated. Assimilation is when someone assimilates into a new society, but loses ties with their original culture. Marginalization occurs when the individual is separated from both cultures.

For both first and second generation of immigrants in Canada, those pursuing the integration strategy have better mental health (and life satisfaction) than those using the other strategies. In sharp contrast, those who are attached to neither culture (being marginalized) have poorer mental health and life satisfaction.

“Acculturation can be stressful … Refugees and immigrants do face certain relatively unique challenges” -Dr. Jessica Dere

According to these three experts, other factors that may influence immigrants’ mental health are language skills, whether the immigration is voluntary or involuntary, lower financial status, and feelings of loneliness.

The understanding of the individual in a cultural context reflects the values of new movements in mental health. Drs. Kirmayer, Dere and Berry feel that cultural approaches reflect a recovery orientation, but that they are not unique to recovery.

According to Drs. Myra Piat and Skye Barbic, the recovery framework is one of the areas of mental health reform. Dr. Piat was a co-investigator on the National Research team for At Home/Chez Soi. The At Home project aimed to house people who are homeless and have a diagnosis of serious mental illness.  There are over 100 publications coming out of this study. Dr. Barbic believes we need to meet patients’ desires, including their cultural values.

“We only meet 11 per cent of what patients need,” Dr. Barbic said. “We need to consider 100 per cent of what their needs are. It’s important to realize and recognize what their full range of needs are, and try to practice services for them.”

The relationship between mental health and culture is not clear, but the philosophy of multiculturalism is part of current Canadian mental health policies. Indeed, a recovery-oriented mental health system is one that considers culture.

By Ioana Arbone and Alireza Jamshidi

Photo by Adley Lobo

Categories: Articles