Pre and Post Migration Mental Health Issues within the Refugee Population of Canada

In 2019, Canada once more displayed itself as the world leader with regard to resettlement of refugees; subsequently, ranking number one among 26 countries. (UNHCR, 2022). In 2021, Canada delivered 30,082 refugees with opportunities to create new lives and beginnings for themselves and their families (UNHCR, 2022). Notwithstanding Canada’s inclination to receive refugees and encourage the resettlement process, refuges still experience discrimination and subsequent deterioration of mental health due to racism and traumatic experiences in Canada. In my clinical experience within Addiction and Mental Health, the subgroup of Black refugees, “is particularly at risk for deteriorating mental health because of the combination of anti-Black racism and traumatic experiences, which further disadvantage them in accessing resources and services they desperately need to successfully resettle in the host community” (King et al., 2021, p. 2). In Calgary on February 19th, 2022, a Sudanese refugee was shot and killed by a Calgary Police Service (CPS) member. This individual was experiencing mental health issues at the time the CPS officer deployed their weapon (Herring, 2022). It is unfortunate when these tragic situations occur and subsequently become the catalyst for conversation around the deficiencies of mental health and addiction supports for our refugees overall.

Numerous factors guide refugees’ access to mental health care in Canada, particularly those conceptualized within a social ecological model of health. Pre-settlement trauma may predict mental disorders and PTSD; however, the post-settlement context and environment may be just as powerful as a determinant of mental health. Moreover, post-settlement factors may moderate the ability of refugees to recover from pre-settlement trauma (Hynie, 2018). Pre and post settlement trauma is an example of how the individual level of the SEM impacts the refugee population, as this trauma may impede with ability and willingness for refugees to access care (Jannesari et al., 2020).

Furthermore, mental health care in Canada for refugees is often impacted on the relationship and community level of the SEM, as refugees may be inhibited by the lack of translators or the use of inappropriate translators such as friends and family, or male interpreters for women’s sexual health services (Jannesari et al., 2020). With regard to the organization and policy level, refugees seeing relocation are required to engage in a process associated with many stressors and subsequent poor mental health outcomes. Refugee applicants often are faced with awaiting a preliminary acceptance of their claims prior to accessing any kind of employment, let alone a temporary permission for employment (Hynie, 2018). As a reflection, refugees may spend months or even years without access to gainful, legal employment, increasing their vulnerability towards obtaining permanency (Hynie, 2018). Despite mental health issues, stability, and distress as predicted factors related to post-migration, “visa status was the strongest predictor of anxiety and depression, thus emphasizing the importance of stability and security in mental health” (Hynie, 2018, p. 4).

The combination of experiences within the SEM in addition to the prevalence and re-occurring nature of the social determinants of health are suggestive Canadian refugees experience multifaceted and multilayered barriers to accessing healthcare. Any attempt to deconstruct these barriers should be addressed with all levels of a SEM, displaying a collaborative approach to the domain of immigration and refugee asylum of which Canada proudly attributes towards its’ identity.

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https://www.unhcr.ca/in-canada/refugee-statistics/