When a person move to a new country, what are the challenges they face, and how does it impact their mental health?
The world hasn’t been smaller than now. In a mere 36 hours, a person can get from one end of the world to the other. Migrants are ubiquitous – people migrate for education, work or pleasure. There are times, however, when migration is forced due to climate change, violence, fear of persecution etc and is usually fraught with complexities.
In my early twenties, I moved to the United States of America for higher studies in clinical psychology. I was very excited and looked forward to this new adventure, though saying goodbye to family and friends wasn’t easy. It was my first trans-Atlantic journey which made it more special.
Adventure or stress?
For people who enjoy travelling, relocating to other countries can be an enjoyable endeavor. At the same time, coming from a culture where ‘settling [down]’ is a priority, some of us who moved every few years felt like we are floating around. Migrating often meant being uprooted from the familiar to acclimatizing ourselves to the new place and starting from scratch. While old learnings come handy, one might still experience culture shock. When I had moved to Australia after living in the US for over four years, I appreciated many of the similarities. Yet, it took me a while to adjust to simple things like the weather, their accent – the idioms, slang and phrases they use, and driving on the left side of the road again, just like India. This, when I’d trained myself to drive on the right side during my stay in the US. It was disorienting.
But back to the story of my first move. After I landed in the United States of America, I people with different skin color and different clothes. Their accents were better in person, and somewhat different from the TV shows I had watched. I was fortunate enough to have someone pick me up and help me settle in.
Settling down in a new country can take time. Apart from the culture, there are other practical stressors that come with it – finding a job, keeping it, renting a house or perhaps even owning one, learning to drive, health insurance, etc. Financial situations can be more stressful in a new country. I know of students who worked beyond the legal 20-hour work limit in the US because they had to save adequate to pay university fees and have a living. There are other stressors -- of measuring up to colleagues, getting promotions, buying that house in a similar neighborhood that your peers have bought in, having parents or family over to visit and all the other things one may need to portray for the ‘settled abroad’ image.
In a new country, it is common to feel lonely and friendless. For the most part, these things are stark realities. It suddenly hits you that there is no one waiting for you back home, or that if you are sick, no one would know. There are cultural and language barriers that might be in the way of making friends easily. For a while, it may be the new independence that one savors after moving, but it can turn lonesome, with no friends or family to call for help.
Vulnerability to mental illness
Migrants can be susceptible to common mental disorders like depression and anxiety, due to lack of social support, social isolation, etc. (Kirmayer, et al., 2011). Women immigrants are two to three times more at risk for postpartum depression (Ahmad, et al., 2004) and in general more susceptible in developing mental health issues than the local population (Abebe, Lien & Hjelde, 2012). It is also not uncommon for migrants to feel pushed against the wall without support and thereby lead to suicidal ideation.
But, all is not bleak. 'Healthy migrant effect' speaks about how some migrants were less susceptible to common illnesses compared to the settled population, due to the strong social support and family ties they had with their homes. A migrant's susceptibility to developing mental health issues can depend on a host of factors: social support, gender, socio-economic condition and life experiences before migration (e.g. exposure to trauma, etc.) Hence, as migrants, it is crucial to build a social support network as early as possible. It may be as simple as introducing yourself to people you meet that day, having a conversation with your co-commuters on trains or people who have assisted you at the checkout in a store.
Asking for help
As a migrant, if you take the first step and put yourself out there, slowly things will work themselves out. It is important to not be shy to ask for help – personal or professional. For example, all the grocery shopping help that some of my not-yet-friends gave me (years ago) not only got me through the two years living in a semi-rural part of the United States, but it also gave me friends for life.
I learned that making friends and creating that social support is not all that hard, but does require work. If one is at a university, then, friends at the university – whether or not they are in your own cohort -- might be an easy place to start. Similarly, at workplace – find one or two people you can relate you at first and ask them if they’d like to grab a cup of coffee with you or maybe go out for lunch.
Take part in sports either at the local community or at university. Now, it is also easier to find and make friends through online social groups that meet often. There are other avenues – meetup groups, facebook groups for own ethnicity or interests etc. There are also people who want to help and reach out to immigrants, including professional health practitioners.
Being an immigrant can be a very pleasurable experience. I think it is worthwhile to try living in a different country than your own, as it can certainly teach us important life lessons as well as teach us a bit about ourselves!
Revathi N Krishna is a clinical psychologist with over give years of experience and is currently a PhD student at Monash University Accident Research Center (MUARC), Monash University, Australia.
This story is from Beyond Relocation, a series on migration and how it impacts our emotional and mental health. Read more here:
1. We need to acknowledge the emotional impact of migration: Dr Sabina Rao
2.Organizations must help employees transition: Maullika Sharma
Ahmad, F., Shik, A., Vanza, R., et al. (2004). Popular health promotion strategies among Chinese and East Indian immigrant women. Women Health, 40, 21–40
Kirmayer, L. J., Narasiah, L., Munoz, M., et al. (2011). Common mental health problems in immigrants and refugees: general approach in primary care. Canadian Medical Association Journal, 183(12), E959-E967. doi:10.1503/cmaj.090292.
Sandhu, S., Bjerre, N. V., Dauvrin, M., Dias, S., Gaddini, A., Greacen, T.,…Priebe, S. (2013). Experiences with treating immigrants: a qualitative study in mental health services across 16 European countries. Social Psychiatry Psychaitr Epidemiology, 48, 105-116.