Focusing on Resilience in Canadian Immigrant Mothers’ Mental Health

Abstract

Introduction: Women’s migration is increasing globally. In spite of recent reports to the contrary, it is often believed that the lives of immigrant women and their families improve steadily after immigration, with enhanced health and mental health a logical consequence to settling in prosperous countries such as Canada.

Main Body: When immigrant women present with deteriorating health, this is often attributed to personal factors. In this chapter, we describe two studies to support an alternative paradigm when addressing the mental health of immigrant mothers.

Discussion: A shift is needed from an individualized, pathologizing approach to mothers’ mental health to a model that considers the often unacknowledged broader social and economic challenges faced by women as they take care of their families, and the cultural strengths that underlie their resilience.

Implications: Recognizing that resilience in diverse immigrant communities requires strengthening the resources available to especially the women in those communities, any discussion of immigrant mental health must address issues of policy.

Response

• Leigh Armour 

1. Aisling Discoveries Child and Family Centre, Toronto, ON, Canada

   Leigh Armour

In my role as a Child and Family Therapist, I have seen how social, economic, and systemic stressors impinge on the mental health of immigrant mothers and their children, and correspondingly, how an expanded understanding of personal, familial, social, and societal determinants of resilience can inform mental health intervention and promote well-being. I share this illustrative case study with the consent of Farha, a mother with whom I had the privilege of working. Her name and her daughter’s name have been changed to protect their identity and privacy.

Farha sought services from our children’s mental health agency because she was concerned about the impact of their family immigration stresses on her infant daughter, Nilofar. The family had faced persecution and Farha had had been forced to withdraw from medical school. The family then emigrated from Afghanistan, had been denied refugee status in Canada, were applying for status on Compassionate and Humanitarian Grounds, and were facing possible deportation. Farha recognized that she was feeling physically, emotionally, and mentally stressed and depressed as a result of her pre--and post migration experiences, and sensitively and rightly worried that this might be adversely affecting her relationship with her daughter. She eloquently described to me how “the stress of the situation is impacting on our parenting—sometimes it is hard to look after Nilofar; I feel so bad; it is hard to control” and “we want to be happy for her but this is hard to force when we are worried, sad, busy.” Farha further stated “when a refugee lands to this country they are treated like a sort of criminal while they are victims looking for justice. Because of our ill approach they are forced to be depressed and put into an open jail”.

Parenting a young child in and of itself can be very demanding and Farha was aware that these parenting challenges were intensified by her stressful immigration situation. Understandably, Farha found that the immigration worries and resettlement efforts took over “everything” leaving room for little else. She shared how this stress left her depressed, and protectively, Farha withdrew from Nilofar in order not to have her emotional difficulties impact on her daughter. In response to this very difficult situation, Farha exercised her personal resilience by seeking services for herself and her family, by finding fulfillment in her job, and by connecting to her local neighborhood by attending events, and developing a sense of community belonging for her and her family. These coping strategies and health seeking efforts to build her own welcoming community and construct her “Canadian” identity made it possible for Farha to wrest control from economic, systemic, and social stressors to identify the choices and opportunities she had in her life. Regaining this locus of control, with the help of the counseling intervention, buttressed Farha’s worry about her immigration situation and her family’s future and enabled her to be able to live more in the present with her family. Feeling less stressed, overwhelmed, and depressed meant Farha was able to change her parenting responses to Nilofar and strengthen her connection with her. Wonderfully, this strengthened relationship made a very positive difference for both Farha and Nilofar. Family gains were then such that the behavioral and emotional concerns that Farha originally identified for Nilofar dissipated as Farha reported feeling more confident, encouraged, and positive in her personal, work, and family life.

Upon termination of our intervention service, I asked Farha to share her views on how her family achieved the progress they made. She described firstly “I helped myself—I pushed myself to keep a balance”, and “we realized change wasn’t easy but it wasn’t impossible”. Farha then explained the importance for her of “putting immigration issues aside; before immigration was covering everything” and by doing so “my confidence increased as Nilofar’s mom; my confidence as a worker increased too; I am contributing to my family—there are many ways to do something good—I don’t let immigration issues stop me”. When asked for her view of what she found to be the most helpful intervention method, Farha replied “we wanted this goal—I needed someone to help me with my confidence—I was feeling indecisive—we had lots of conversations and now I have the confidence back that I had before—we went through so much with immigration”.

In reflecting upon all that Farha and her experience taught me, my understanding that individual and family mental health is best considered in the context of systemic stressors was confirmed. My belief that depression experienced by immigrant women is best tackled by reclaiming the opportunities and choices that women have in the face of systemic barriers they face was also strengthened. Beyond addressing individual psychological concerns, mental health intervention can support women to find agency in their family and work lives and build a sense of belonging through encouraging women to reach out to resources—often by beginning with accessing services for their children—to create their own communities of welcome. Farha’s ability to re-balance focus on her day-to-day life in the context of her very real immigration limbo and resettlement stress was testament to Farha’s personal qualities as well her family strengths. For Farha, as it may be for other immigrant women, depression was a personal, familial experience best ameliorated through a systemic understanding of moving from service need to family resilience. Her recovery was fueled by her ability to reclaim her confidence, and by finding identity and meaning in her positive contribution to her family life, to her work, and to her new Canadian home and society. In this view, mental health intervention must interweave individual treatment and the development of coping strategies with the provision of a social relationship facilitative of immigrant women’s resiliencies as they adjust to their new way of life, build social networks, and integrate into their community to support them in managing with the specters of immigration challenges, economic uncertainties, and societal stressors.