Dr. Ahmed Munib, PhD candidate,

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The Effects of Immigration and Resettlement on
the Mental Health of South-Asian Communities in
Melbourne.

• Dr. Ahmed Munib, PhD candidate,
• Supervisors
• Assoc. Prof. Harry Minas Assoc. Prof. Steven
  Klimidis,
• Centre for International Mental Health
  Department of Psychiatry,
• The University of Melbourne.

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South-Asian countries of migrant origin

• India 29,414
• Pakistan 2,794
• Bangladesh 1,317
• Sri-Lanka 25,969
• Australian Bureau of Statistics census data,
  2001
• statistical local areas for metropolitan
  Melbourne

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Factors in the home country predisposing to
migration from the South Asia region

• Economic uncertainty
• Low quality of life
• Lack of higher educational opportunities
• Limited career advancement
• Political and social instability
• Family members/relatives settled overseas

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Pre-migration factors affecting settlement outcome

• Age at the time of migration
• Gender of the immigrant
• Socio-cultural and educational background
• Occupational status
• Psychological preparation prior to migration
• Prior experience of migration
• History of physical and/or psychiatric
  illness
• Individual personality traits
• Family composition
• Future expectations
• Perceptions and attitudes towards the host
  community

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Post-migration scenario (Observations in
Bangladesh)

• Inadequate social support mechanisms
• Social isolation and cultural alienation
• Predisposition of anxiety/depression
• Concealment of mental illness due to stigma
• Impaired coping and adjustment
• Aggravation of psychiatric problems
• Unsuccessful resettlement
• Return to home country
• Inadequate/delayed therapeutic intervention
• Rehabilitation failure
• Social disability

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Post-migration factors affecting settlement
outcome

• Reception by the host community
• Host societies attitudes towards immigrants
• Perceived discrimination
• Language competency
• Recognition of professional skills and
  qualifications
• Economic stability (job opportunities)
• Presence of co-ethnic communities
• Social networking
• Adjustment with individualistic social
  expectations

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Outlines of the Study design

• Target group
• Adult Indian and Bangladeshi Australian
  permanent residents/citizens located in
  metropolitan Melbourne.
• Qualitative approach
• One-on-one in-depth interviews
• Number of participants-38
• Selection through community contacts
• Analysis and extraction of themes utilising NVivo
  software

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Summary of Research objectives

• Exploration of immigration and resettlement
  experiences among South-Asian migrants, and any
  association with psychiatric illness, primarily
  anxiety and depression.
• Investigation of psychosocial protective
  mechanisms and common coping strategies.
• Examination of factors relevant to both
  successful and unsuccessful resettlement, and the
  effect on psychological well-being.

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Cultural profile of study group

• Indian community
• Native languages-Hindi as well as Tamil, Gujrati,
  Bengali.
• Predominantly Hindu, some Muslims and Christians
• Strong religious and South-Asian cultural beliefs
• Hierarchal social caste system with conservative
  family values
• Extended social networks with collectivist ideals
• Bangladeshi community
• Ethnic Bengali, predominantly Muslim.
• Strong Islamic identity and Bengali/South-Asian
  cultural beliefs
• Conservative family values
• Extended social networks with collectivist ideals
• Both communities in Melbourne comprise mostly
  skilled migrants

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Deductions from case studies(Resettlement
difficulties)

• Regret and self-reproach regarding decision to
  migrate
• Feelings of antagonism towards Australian society
• Anxiety, apprehension and uncertainty about the
  future
• Feelings of social isolation and cultural
  alienation
• Reinforcement of preconceived stereotypes about
  perceived discrimination
• Dysfunction in inter-personal relationships
• Adverse impact on psychological well-being

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Factors affecting emotional well-being in migrants

• Inadequate psychological preparation prior to
  immigration
• Cultural and linguistic barriers
• Concealment of mental illness due to stigma
• Reluctance to utilize psychiatric services in the
  host country
• Preference to seeking psychiatric services in the
  native country

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Themes relating to psychological distress

• Blame
• Resentment
• Regret
• Remorse
• Loneliness
• Helplessness
• Low self-esteem
• Dysphoria
• Anger
• Agitation
• Antipathy
• Concealment

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Resettlement
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Post-settlement adjustment stress
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Racial discrimination (impact on the individual)

• certainly racism in general in Australia has
  affected me a lotjust from growing upthe
  inevitable racism which migrants facebesides
  superficial racism at school or in the
  workplacesubtle discrimination is much harder to
  pinpoint because you never know if people are
  reacting to you for a certain waybut certainly
  in terms of overt racism that has always been in
  the form of racial abuse or racial slurs or
  things like that. I would say thatthat the
  discrimination I have faced has been based on
  literally the colour of my skin above anything
  else.
• - Bangladeshi male

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Racial discrimination (impact on the family)

• because of our colour they treat us
  differently...which makes me really upset and
  sometimes my son...hes in year 11 now...last
  year he used to say that I wish that I had white
  skin...I dont want...like to be a brown boy in
  the class.
• -Bangladeshi female

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Role of the family

• I dont think South-Asian families are designed
  for external interventionI justI think an Anglo
  familybecause of their culture and their
  acceptance ofpsychiatric or therapeutic
  intervention, I think they would be much more
  comfortable in seeking outside help, but I think
  there is a great deal of pride associated with
  the integrity of the family unitin South-Asian
  communitiesand to seek some kind of outside
  assistance, I think would be a huge admission of
  failureon part of both the family units. So I
  think ultimately differences would have to be
  straightened out by the family.
• - Bangladeshi male

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Non-recognition of professional skills

• ...we think we have everything and walk over to
  Australia and we cant find a job or
  somethinggeneral kind of people, some are
  frustrated because they couldnt find the
  placement equal to what they were doing...some
  people find it very frustrating because they
  believe that they got the highest degree...and
  they come here and nobody will accept it.
• - Indian male

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Psychological distress

• ...I feel Im like out of my own culture, I
  dont belong here, I dont belong with my
  friends...I feel really depressed...Im having
  some medication for depression because it gets
  really bad and as I told before, now I feel my
  family very much. I feel this here the life is so
  mechanical, you have to follow the same routine
  day after dayand I feel like Im just working
  like a machine.
• -Bangladeshi female

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Cultural incongruity

• ...Australians way of life is entirely
  different from our way, especially from the
  subcontinent and their sense of humour is
  different and how they speak is different, how
  they behave, how they react to the...suppose if I
  say one thing, a same thing to Indian and
  Australian, Indian may laugh at that but
  Australian dont understand that. He may think in
  a different way.
• - Indian male

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Attitudes towards host society

• The best thing about Australian society,
  Australian people isthey feel youyou know, they
  make you better. They feel that, they make you
  feel you knowvery friendly, even a stranger they
  will talk to you, how are you mate...going
  mate. So you feel comfortable talking with them,
  get along with them. So thats the best thing
  about Australia you know. They are very friendly
  even though you know by heart they may not be
  very friendly but for day to day conversation,
  for the day to day things, for moving around they
  are friendly.
• - Indian male

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Successful strategies for coping

• Social interaction and networking with co-ethnic
  communities
• Co-ethnic social support networks
• (sharing and discussion of problems)
• Spiritual pursuits (eg, meditation, prayer)
• Community volunteer activities (eg, charity work)
• Acculturation interaction with local Australian
  communities
• Help-seeking behaviour family, friends,
  chaplain, counsellor, GP, clinical psychologist,
  psychiatrist.

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Long-term goals of the study and suggestions

• Promote awareness about mental health concerns
  within the South-Asian community in Australia.
• Increase awareness within the professional mental
  health community about South-Asian mental health
  issues.
• Emphasizing that help-seeking is culturally
  acceptable and appropriate.
• Dispelling the preconceived association of mental
  illness with stigma.
• Social networking is an important buffer for
  migrants.
• Resettlement in a new country is psychologically
  challenging, but does not necessarily predispose
  to mental illness.

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• Thank You