Why is mental health a concern for immigrant workers? What are some of the factors that impact mental health among immigrant workers?

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AS@W...FOR IMMIGRANT WORKERS Why is mental health a concern for immigrant workers? Prevalence estimates have shown that mental illness is elevated among immigrant workers, particularly those engaged in migratory, seasonal or temporary employment Immigrant status and a limited support system have been found to be associated with psychological disability following accidents in the workplace. What are some of the factors that impact mental health among immigrant workers? There are a number of factors that can increase immigrant workers risk of depression or other mental health disorders and the likelihood that they will successfully access appropriate diagnosis and treatment. These include: o Lack of mental health literacy: Workers coming from other countries may lack knowledge about the prevalence, signs and treatments for mental health disorders or how to access appropriate assessment and care within the Canadian system. o Stigma: The negative judgment associated with having a mental health disorder is particularly pronounced in some cultures; thus preventing impacted individuals or caregivers from seeking help. o Language or cultural barriers: Mental health resources need to be available in ways that are sensitive to the educational, ethnic and religious beliefs of diverse populations. This includes availability of translation services to facilitate communication. o Unemployment/underemployment: The stresses created by the necessity of holding multiple jobs, instability of temporary employment, or failure to find a position commensurate with immigrant workers skills, education and training, all contribute to compromised mental health. o Lack of supports for mental health: Immigrant workers are often relegated to self-employment or migratory, temporary, part-time or menial positions that do not have the benefits and supports for workplace psychological health and safety afforded to employees who have the protection of organized labour agreements, on-the-job training and education, and appropriate and comprehensive benefits for themselves and their families.

o Discrimination: Immigrant workers are at greater risk of harassment, bullying and other forms of discrimination by employers as well as fellow employees, customers and the public. o Isolation: Immigrant workers may be working in jobs that are away from one s immediate or extended family, friends and native culture. The sense of alienation and lack of a support group contribute to poor psychological health. What do international studies tell us about immigrant worker mental health? It has been reported that recent immigrants to Canada with high levels of education are under-employed in peripheral jobs (jobs that include self-employed, temporary or part time workers with insecure access to hours of work). It was also reported that they have little access to training on the job that provide opportunities for promotion. One study conducted in the United States amongst migrant farm workers found that 38% of participants had significant levels of stress, and over 41% met diagnostic criteria for depression. It was also found that social anxiety and working conditions were associated with anxiety and depressive symptoms. Social isolation was more significantly linked with anxiety while working conditions were more significantly linked with depression. A survey conducted by The National Latino and Asian American Study (NLAAS) in the United States found that psychiatric disorders and mental distress were significantly less likely in individuals who were employed and were more likely to occur in individuals who were absent from work on a regular basis. An European Union review of mental health amongst migrant workers showed that immigrants were found to experience significantly greater levels of depression than the general population. Another European study found that immigrant youth who had experienced long-term unemployment, in comparison to their non-immigrant counterparts, in four countries of Europe (Finland, Sweden, France, Germany) were less likely to find employment; faced greater risk of financial deprivation; and experienced greater mental health problems.

What can employers do to support the mental health of immigrant workers? There are a number of things that employers can do to protect and promote the mental health of immigrant workers. These include: o Ensure that immigrant workers are aware that they have the same rights and protections afforded to native Canadian workers. o Provide health and mental health information and educational materials in the main languages of your employees. (Antidepressant Skills @ Work: Dealing with Mood Problems in the Workplace [AS@W] is currently available in French and English, the companion self-care guide the Antidepressant Skills Workbook is available in English, French, Punjabi and both simplified and traditional Chinese). o Create a respectful workplace, i.e., a workplace where there is an appreciation of diversity of race, language, culture and beliefs and zero tolerance for discrimination, tolerance or bullying. o Provide immigrant workers with appropriate orientation to their job requirements and benefits and offer regular feedback and supervision that allows for early identification of any personal or job-related signs of mental health issues. If possible, arrange for mentoring opportunities for new immigrant workers to pair up with an existing fellow worker from the same geographic or linguistic background. o Celebrate the cultural and ethnic diversity of your workforce. This can include information in company newsletters, staff meetings or lunch and learn opportunities that acknowledge and support the cuisine, practices and contributions of the visible minorities in the workplace. References Chatterji, P., Alegria, M., Lu, M, & Takeuchi, D. (2007). Psychiatric disorders and labor market outcomes: evidence from the national Latino and Asian American study. Health Economics, 16, 1069-1090. Government of Canada. (2006). The human face of mental health and mental illness in Canada. http://www.phac-aspc.gc.ca/publicat/human-humain06/index-eng.php Hiott, A., Grzywacz, J., Davis, S., Quandt, S., & Arcury, T. (2008). Migrant farmworker stress: mental health implications. National Rural Health Association, Winter 2008.

Malmberg-Heimonen, I., & Julkunen, I. (2006). Out of unemployment? A comparative analysis of the risks and opportunities longer-term unemployed immigrant youth face when entering the labour market. Journal of Youth Studies, 5, 575-592. Mazzoni, S., Boiko, P., Katon, W., & Russo, J. (2007). Depression and disability in seasonal and migrant Hispanic agricultural workers. General Hospital Psychiatry, 29, 450-453.

ABOUT AS@W How was Antidepressant Skills at Work developed? The guide was developed by British Columbia Mental Health and Addiction Services (BCMHAS), an agency of the Provincial Health Services Authority. The guide and accompanying materials have been authored by Dr. Dan Bilsker, Dr. Merv Gilbert, and Dr. Joti Samra registered psychologists and scientist-practitioners with expertise in issues relating to workplace mental health. These psychologists are with the Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University. The guide was written on the basis of a review of the scientific literature; consultation with employers, unions, mental health providers and employee groups; and adaptation of existing self-care depression programs. How can the manual be accessed? The manual is available for viewing and free download at www.carmha.ca/antidepressant-skills/work/ or from www.bcmhas.ca/research. Individuals or organizations are free to print and make multiple copies of the guide, with permission from CARMHA (publications@carmha.ca). Print copies and audio CDs are available at a low cost from our ordering page at www.carmha.ca/ordering. For further information about AS@W and associated resources and materials, please visit www.carmha.ca/selfcare. This information will be updated on a regular basis.