Like in all communities, mental illness is an uncomfortable topic to talk about for Bangladeshis. There is a predominant belief that mental illness doesn’t touch us. We look at the outside community and say mental illness is something that affects them, not us.
I think we need to reconsider this notion. According to a national survey carried out in Bangladesh, it’s estimated that about 16% of the population is affected by mental health problems. This is not very different from the 1 in 5 Canadians statistic we often hear about for mental illness.
For my PhD research, I set out to understand some of these issues further by surveying and interviewing members of the Bangladeshi immigrant community living in the Victoria Park and Danforth area two summers ago. I was heartened by how many people welcomed me into their homes and thoughtfully engaged in the conversation. I spoke to both newcomers (less than 3 years in Canada) and longer-term immigrants (3 or more years in Canada). The majority of the participants were between the ages of 20-40 years old and female (75%). I asked people to fill out a survey that determines how positive one’s attitude is towards seeking mental health services. I also carried out in-depth interviews with community members.
Many community members spoke about mental health stigma and the belief that personal problems should not be discussed outside the family. Many said they would be mortified if someone from the community discovered that they were seeking treatment. It would have far reaching social consequences. There is a fear that if one is labeled by the community as having a mental illness or “pagol” (crazy) they will ruin the family’s reputation and risk becoming social outcasts.
Migration and resettlement bring profound stress. Most families take years, if not decades to establish themselves. Finding a job in this economic climate is challenging for everyone but especially so for newcomers. Research show that these economic and resettlement stressors can tear families apart and cause many mental health issues including depression, anxiety, lower self-rated mental health, lower self-esteem, sleep disorders, and suicidal ideation (Aycan & Berry, 1996; Canadian Paediatric Society, 2005; McKenzie, 2009). Newcomers can face discrimination and struggle with renegotiating their identity in a new land (Jibeen & Khalid, 2010). Migration can lead to intergenerational conflict and culture clash, where many parents find that they don’t recognize their children anymore (Islam, 2011; Samuel, 2009). Wouldn’t it be helpful if people could seek mental health care in this time of need so they have effective tools to cope?
I found that while everyone believed mental health was an important topic and that mental health services were useful and needed in the community, the economic worries of trying to settle in a new country took precedence for newcomers and immigrants. Lack of employment and economic supports were a major cause of stress for the Bangladeshi community. In addition, raising children in a new country was a constant source of worry for parents. As the quote below illustrates, sometimes the stress can become unbearable and people may commit suicide. (If you are experiencing stress and finding it difficult to cope, please click here for resources.)
Interestingly, I found that men were more open to the idea of seeking psychological help than women in the community. Many people in the community spoke about how women are more prone to hiding problems. Bangladeshi men being more comfortable with the idea of seeking mental healthcare is a unique finding and has important service planning implications. I would recommend future research studies look into this further.
Most participants felt the Bangladeshi community is relatively isolated and attitudes towards mental illness and seeking mental healthcare would take time to change. When I asked community members if they had any familiarity with mental health services, the vast majority did not have any knowledge of available mental health resources beyond the suicide crisis link service found in the TTC subway.
Recommendations from the participants are synthesized below into a four-pronged strategy. Solutions include increasing awareness of mental health issues and knowledge of mental health resources, better tailoring of the mental health system to be responsive to the specific needs of Bangladeshi immigrant communities (for example, culturally safe workshops to reduce stigma associated with mental health), and improve programs support at the government and community levels. These initiatives need to overcome the socio-economic root causes of the mental health stressors the Bangladeshi community in Canada faces (for example, swift policy action to stop employers from not recognizing foreign credentials/experiences, increase funding for job-skill matching programs, etc.).
The bottom line is that mental health issues are a major concern for our Bangladeshi immigrant community. However, we lack the accessible and culturally safe mental health information, services, and supports needed to enable us to openly and effectively talk about our concerns. One concrete step is to get mental health information and resources translated in Bengali using non-stigmatizing language and circulate them broadly, while working closely with Bangladeshi community leaders. We also need proactive policy actions to address the root socio-economic causes of the mental health concerns, including targeted programs to reduce the high rates of poverty and un/underemployment that the Bangladeshi immigrant community experiences. Migration and resettlement in a new country is hard, and people need all the help they can get, both in terms of economic, as well as, mental health support. We all encounter struggles in life and seeking help is difficult for everyone, but I urge my community to have courage in taking that step forward.
Farah Islam is a Postdoctoral Fellow in the Social Aetiology of Mental Illness Training Program at the Centre for Addiction and Health and the University of Toronto. She received her PhD in the field of Epidemiology from York University. Farah centers her research and community work on breaking down the barriers of mental health stigma.