Dr. Ahmed Munib, PhD candidate, Dr. Ahmed Munib, PhD candidate,

Supervisors:Supervisors:

Assoc. Prof. Harry Minas & Assoc. Prof. Steven Klimidis,Assoc. Prof. Harry Minas & Assoc. Prof. Steven Klimidis,

Centre for International Mental Health & Department of Centre for International Mental Health & Department of

Psychiatry,Psychiatry,

The University of Melbourne.The University of Melbourne.

The Effects of Immigration and Resettlement The Effects of Immigration and Resettlement

on the Mental Health of South-Asian on the Mental Health of South-Asian

Communities in Melbourne.Communities in Melbourne.

South-Asian countries of migrant originSouth-Asian countries of migrant origin

IndiaIndia 29,41429,414

PakistanPakistan 2,794 2,794

BangladeshBangladesh 1,317 1,317

Sri-LankaSri-Lanka 25,96925,969

Australian Bureau of Statistics census data, 2001[statistical local areas for metropolitan Melbourne]

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

Economic uncertaintyEconomic uncertainty

Low quality of lifeLow quality of life

Lack of higher educational opportunitiesLack of higher educational opportunities

Limited career advancementLimited career advancement

Political and social instabilityPolitical and social instability

Family members/relatives settled overseas Family members/relatives settled overseas

Pre-migration factors affecting settlement outcomePre-migration factors affecting settlement outcome

Age at the time of migrationAge at the time of migration Gender of the immigrantGender of the immigrant Socio-cultural and educational backgroundSocio-cultural and educational background Occupational statusOccupational status Psychological preparation prior to migrationPsychological preparation prior to migration Prior experience of migrationPrior experience of migration History of physical and/or psychiatric illnessHistory of physical and/or psychiatric illness Individual personality traitsIndividual personality traits Family compositionFamily composition Future expectationsFuture expectations Perceptions and attitudes towards the host communityPerceptions and attitudes towards the host community

Post-migration scenario Post-migration scenario (Observations in Bangladesh)(Observations in Bangladesh)

Inadequate social support mechanismsInadequate social support mechanisms Social isolation and cultural alienation Social isolation and cultural alienation Predisposition of anxiety/depressionPredisposition of anxiety/depression Concealment of mental illness due to stigmaConcealment of mental illness due to stigma Impaired coping and adjustmentImpaired coping and adjustment Aggravation of psychiatric problemsAggravation of psychiatric problems Unsuccessful resettlementUnsuccessful resettlement Return to home countryReturn to home country Inadequate/delayed therapeutic interventionInadequate/delayed therapeutic intervention Rehabilitation failureRehabilitation failure Social disabilitySocial disability

Post-migration factors affecting settlement outcomePost-migration factors affecting settlement outcome

Reception by the host communityReception by the host community

Host societies’ attitudes towards immigrantsHost societies’ attitudes towards immigrants

Perceived discriminationPerceived discrimination

Language competencyLanguage competency

Recognition of professional skills and qualificationsRecognition of professional skills and qualifications

Economic stability (job opportunities)Economic stability (job opportunities)

Presence of co-ethnic communitiesPresence of co-ethnic communities

Social networkingSocial networking

Adjustment with individualistic social expectationsAdjustment with individualistic social expectations

Outlines of the Study designOutlines of the Study design

Target group: Target group:

Adult Indian and Bangladeshi Australian permanent residents/citizens Adult Indian and Bangladeshi Australian permanent residents/citizens

located in metropolitan Melbourne. located in metropolitan Melbourne.

Qualitative approachQualitative approach

One-on-one in-depth interviewsOne-on-one in-depth interviews

Number of participants-38Number of participants-38

Selection through community contactsSelection through community contacts

Analysis and extraction of themes utilising NVivo softwareAnalysis and extraction of themes utilising NVivo software

Summary of Research objectivesSummary of Research objectives

Exploration of immigration and resettlement experiences Exploration of immigration and resettlement experiences

among South-Asian migrants, and any association with among South-Asian migrants, and any association with

psychiatric illness, primarily anxiety and depression.psychiatric illness, primarily anxiety and depression.

Investigation of psychosocial protective mechanisms and Investigation of psychosocial protective mechanisms and

common coping strategies.common coping strategies.

Examination of factors relevant to both successful and Examination of factors relevant to both successful and

unsuccessful resettlement, and the effect on psychological unsuccessful resettlement, and the effect on psychological

well-being.well-being.

Cultural profile of study groupCultural profile of study group

Indian communityIndian community Native languages-Hindi as well as Tamil, Gujrati, Bengali.Native languages-Hindi as well as Tamil, Gujrati, Bengali. Predominantly Hindu, some Muslims and ChristiansPredominantly Hindu, some Muslims and Christians Strong religious and South-Asian cultural beliefsStrong religious and South-Asian cultural beliefs Hierarchal social caste system with conservative family valuesHierarchal social caste system with conservative family values Extended social networks with collectivist idealsExtended social networks with collectivist ideals

Bangladeshi communityBangladeshi community Ethnic Bengali, predominantly Muslim. Ethnic Bengali, predominantly Muslim. Strong Islamic identity and Bengali/South-Asian cultural beliefsStrong Islamic identity and Bengali/South-Asian cultural beliefs Conservative family valuesConservative family values Extended social networks with collectivist idealsExtended social networks with collectivist ideals

Both communities in Melbourne comprise mostly skilled migrantsBoth communities in Melbourne comprise mostly skilled migrants

Deductions from case studiesDeductions from case studies(Resettlement difficulties)(Resettlement difficulties)

Regret and self-reproach regarding decision to migrateRegret and self-reproach regarding decision to migrate

Feelings of antagonism towards Australian societyFeelings of antagonism towards Australian society

Anxiety, apprehension and uncertainty about the futureAnxiety, apprehension and uncertainty about the future

Feelings of social isolation and cultural alienationFeelings of social isolation and cultural alienation

Reinforcement of preconceived stereotypes about perceived discriminationReinforcement of preconceived stereotypes about perceived discrimination

Dysfunction in inter-personal relationshipsDysfunction in inter-personal relationships

Adverse impact on psychological well-beingAdverse impact on psychological well-being

Factors affecting emotional well-being in Factors affecting emotional well-being in migrantsmigrants

Inadequate psychological preparation prior to Inadequate psychological preparation prior to

immigrationimmigration

Cultural and linguistic barriersCultural and linguistic barriers

Concealment of mental illness due to stigmaConcealment of mental illness due to stigma

Reluctance to utilize psychiatric services in the host Reluctance to utilize psychiatric services in the host

countrycountry

Preference to seeking psychiatric services in the native Preference to seeking psychiatric services in the native

country country

Themes relating to psychological distressThemes relating to psychological distress

BlameBlame Resentment Resentment RegretRegret RemorseRemorse LonelinessLoneliness HelplessnessHelplessness Low self-esteemLow self-esteem DysphoriaDysphoria AngerAnger AgitationAgitation AntipathyAntipathy ConcealmentConcealment

ResettlementResettlement

Post-settlement adjustment stressPost-settlement adjustment stress

Racial discrimination (impact on the individual)Racial discrimination (impact on the individual)

“…certainly racism in general in Australia has affected me a lot…just from

growing up…the inevitable racism which migrants face…besides superficial

racism at school or in the workplace…subtle discrimination is much harder to

pinpoint because you never know if people are reacting to you for a certain

way…but 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 that…that the

discrimination I have faced has been based on literally the colour of my skin

above anything else.”

- Bangladeshi - Bangladeshi

malemale

Racial discrimination (impact on the family)Racial discrimination (impact on the family)

“…“…because of our colour they treat us differently...which makes me really because of our colour they treat us differently...which makes me really

upset and sometimes my son...he’s in year 11 now...last year he used to say upset and sometimes my son...he’s in year 11 now...last year he used to say

that I wish that I had white skin...I don’t want...like to be a brown boy in the that I wish that I had white skin...I don’t want...like to be a brown boy in the

class”. class”.

-Bangladeshi -Bangladeshi

femalefemale

Role of the familyRole of the family

I don’t think South-Asian families are designed for external intervention…I

just…I think an Anglo family…because of their culture and their acceptance

of…psychiatric 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 unit…in South-Asian communities…

and to seek some kind of outside assistance, I think would be a huge admission

of failure…on part of both the family units. So I think ultimately differences

would have to be straightened out by the family”.

- Bangladeshi male- Bangladeshi male

Non-recognition of professional skills

“...we think we have everything and walk over to Australia and we can’t

find a job or something…general kind of people, some are frustrated

because they couldn’t 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 - Indian

malemale

Psychological distressPsychological distress

“...I feel I’m like out of my own culture, I don’t belong here, I don’t belong

with my friends...I feel really depressed...I’m 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 day…and I feel like I’m just working like a machine.”

-Bangladeshi female

Cultural incongruityCultural 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 don’t understand that. He may think in a different way”.

- -

Indian maleIndian male

Attitudes towards host societyAttitudes towards host society

“ The best thing about Australian society, Australian people is…they feel you…

you know, they make you better. They feel that, they make you feel you know…

very 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 that’s

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- Indian male

Successful strategies for copingSuccessful strategies for coping

Social interaction and networking with co-ethnic Social interaction and networking with co-ethnic

communitiescommunities

Co-ethnic social support networks Co-ethnic social support networks

(sharing and discussion of problems)(sharing and discussion of problems)

Spiritual pursuits (eg, meditation, prayer)Spiritual pursuits (eg, meditation, prayer)

Community volunteer activities (eg, charity work)Community volunteer activities (eg, charity work)

Acculturation: interaction with local Australian Acculturation: interaction with local Australian

communitiescommunities

Help-seeking behaviour: family, friends, chaplain, Help-seeking behaviour: family, friends, chaplain,

counsellor, GP, clinical psychologist, psychiatrist.counsellor, GP, clinical psychologist, psychiatrist.

Long-term goals of the study and suggestionsLong-term goals of the study and suggestions

Promote awareness about mental health concerns within Promote awareness about mental health concerns within the South-Asian community in Australia.the South-Asian community in Australia.

Increase awareness within the professional mental Increase awareness within the professional mental health community about South-Asian mental health health community about South-Asian mental health issues.issues.

Emphasizing that help-seeking is culturally acceptable Emphasizing that help-seeking is culturally acceptable and appropriate.and appropriate.

Dispelling the preconceived association of mental illness Dispelling the preconceived association of mental illness with stigma.with stigma.

Social networking is an important buffer for migrants.Social networking is an important buffer for migrants. Resettlement in a new country is psychologically Resettlement in a new country is psychologically

challenging, but does not necessarily predispose to challenging, but does not necessarily predispose to mental illness.mental illness.

Thank YouThank You