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‘I thought we would be cherished and safe here’: understanding the multi-faceted nature of mental health among Arab immigrants/refugees in Ontario, Canada— the CAN-HEAL study

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Abstract

Purpose

Mental health (MH) is a critical public health issue. Arab immigrants/refugees (AIR) may be at high risk for MH problems owing to various unique stressors, such as post-September/11 demonization. Despite the growing AIR population in Western countries, there is a lack of AIR-MH research in these nations. The CAN-HEAL study examined MH experiences and needs among AIR in Ontario, Canada.

Methods

This study employed a cooperative community-based participatory research and integrated knowledge translation approach. The study used photovoice, qualitative interviews and a questionnaire survey. Sixty socio-demographically diverse AIR adults partook in this study. The research was informed by the “social determinants of health” framework and the “years since immigration effect” (YSIE) theory.

Results

The term “mental health” was deemed offensive for participants aged > 30 years. Participants proposed other culturally-appropriate words including “well-being” and “emotional state”. The prevalence of poor mental well-being in the sample was alarming (55%). Of first-generation immigrant participants, 86.8% reported negative changes in MH since migration. The negative changes are not straightforward; they are complex and dynamic, and mainly related to micro/macro-aggression, cross-cultural pressures, dissatisfaction with the health and social care system, and poor living conditions. Intersections between different socio-demographic factors (e.g., gender, length of residency, income, parenthood, religion) amplified the negative changes in MH and exacerbated inequities.

Conclusions

MH needs among AIR are distinct and intersectionality aggravated inequities. Culturally and structurally competent healthcare and structural/policy reformation are required to tackle MH inequities. This can be fulfilled through intersectoral cooperation and including AIR in decision-making.

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Acknowledgements

Deep thanks to the collaborators, partners, and participants who shared their valuable insights. Special thanks to the CAN-HEAL team members.

Funding

This paper draws on research that was in part supported by the Social Sciences and Humanities Research Council.

Author information

Authors and Affiliations

  1. Department of Anthropology, Faculty of Social Sciences, McMaster University, Chester New Hall, Hamilton, ON, L8S 4L9, Canada

    Sarah Elshahat, Tina Moffat & Basit Kareem Iqbal

  2. School of Earth, Environment and Society, McMaster University, Hamilton, ON, Canada

    K. Bruce Newbold

  3. Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

    Mahira Morshed, Aya Mohamed, Naya Nadeem, Zena Shamli Oghli, Sriyasri Varadarajan & Megan Laing

  4. Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada

    Haneen Alkhawaldeh

  5. Department of Neuroscience, Faculty of Science, Carleton University, Ottawa, ON, Canada

    Olivia Gagnon & Nour Kanaa

  6. Department of Psychological and Health Sciences, University of Toronto, Scarborough, ON, Canada

    Mafaz Gehani

  7. Integrated Biomedical Engineering and Health Sciences Faculty, McMaster University, Hamilton, ON, Canada

    Keon Madani

  8. Department of Criminology and Sociolegal Studies, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada

    Tony Zhu

  9. Department of Biomedical and Molecular Sciences, Faculty of Arts and Science, Queen’s University, Kingston, ON, Canada

    Lucy Garabedian

  10. Department of Biology, Faculty of Science, McMaster University, Hamilton, ON, Canada

    Yumnah Jafri & Jessica Kaloti

  11. Physiology and Pharmacology Department, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Salima Zabian

  12. Department of Psychology, Faculty of Sciences, University of Toronto, Mississauga, ON, Canada

    Amal Shah

  13. Department of Political Science, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada

    Asil Samhat

  14. The Munk School of Global Affairs and Public Policy, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada

    Sahiba Khaira

  15. Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada

    Hussyin Jelal

  16. Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada

    Youyou Xu

Authors
  1. Sarah Elshahat
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  2. Tina Moffat
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  3. Basit Kareem Iqbal
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  24. Youyou Xu
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  25. Megan Laing
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Contributions

S.E. conceptualized the study and methodology, led the project administration, curated, analyzed, and visualized the data, as well as wrote the original draft. T.M., B.K.I. and K.B.N. contributed to critical study conceptualization and methodology, as well as led critical revision and editing. M.M., H.A., O.G., M.G., K.M., T.Z., L.G., Y.J., N.K., A.M., N.N., Z.S.O., S.Z., A.S., A.S., S.K., H.J., J.K., S.V., Y.X., M.L. contributed to methodology, data analysis and visualization, as well as review/editing.

Corresponding author

Correspondence to Sarah Elshahat.

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The authors declare no competing interests.

Ethical approval

Ethical clearance was received from the McMaster Research Ethics Board. The procedures contributing to this work follow the tenets of the Declaration of Helsinki.

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Elshahat, S., Moffat, T., Iqbal, B.K. et al. ‘I thought we would be cherished and safe here’: understanding the multi-faceted nature of mental health among Arab immigrants/refugees in Ontario, Canada— the CAN-HEAL study. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-024-02668-4

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