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From culture to counselling: Navigating mental health in immigrant households

Words by Maya Zaid

Visuals by Brithi Sehra & Jerry Zhang

The morning light bleeds through the window, casting shapes onto the floor of a bedroom. Everything feels still and tranquil within Idrees Raheem as he lays in bed—his mind a blank canvas wiped clean of the previous day’s thoughts and worries.

He opens his eyes and the inevitable tasks awaiting him loom in his thoughts.

There’s nothing you can’t accomplish, the fifth-year business technology management student repeats to himself over and over in an affirmation. When he’s finally gained enough motivation, he can rise with the day to face what’s ahead. For Raheem, these daily affirmations are a “critical component” to maintaining his mental health.

Raheem’s mental health has always been important to him, but opening up to his parents hasn’t always been easy. In fact, this is a challenge that many students in immigrant households face daily.

In an immigrant household, mental health can be a difficult concept to learn as conversations around the topic are often dismissed. Cultural barriers can loom large, which can create barriers between a child and their parent(s) while preventing them from seeking mental health services.

According to the Canadian Medical Association Journal, “In general, immigrants and refugees are less likely than their Canadian-born counterparts to seek out or be referred to mental health services, even when they experience comparable levels of distress.”

Mental health continues to be both an important conversation and an inconsistent one. While some households find it easy to discuss, others face significant challenges, particularly in immigrant households where these conversations may not be normalized due to societal differences.

Marshia Akbar, a research area lead on labour migration at Toronto Metropolitan University (TMU), says while universities invest some money to support the mental health and wellbeing of international students, it isn’t enough.

Over the years, TMU has proposed increased funding for mental health services to reduce wait times. However, students waited an average of 14 weeks for a counselling appointment from 2022-2023, which is an increase of more than 12 per cent from pre-pandemic times, according to On The Record.

Akbar says she found that some students emailed TMU’s International Student Support (ISS) asking for mental health services and stating they were experiencing anxiety and isolation—but the waiting period was so long that they gave up on seeking help from the school.

She adds that students tend to find support in community-based organizations instead, where they’re provided the services that their universities should be giving them.

“They don’t follow up because after two weeks, they don’t get any reply to their email,” Akbar says. “Even when they go to the office, there’s a huge queue and then there aren’t enough resources for them.”

While some international students are vocal about their personal challenges, there are still many who don’t feel comfortable sharing or discussing their mental health issues with family due to cultural taboos.

Along with his affirmations, Raheem also relies on the power of prayer to practice caring for his mental health. As a Muslim man, he prays five times a day. While these prayers all have a similar effect on him, he feels that the very first prayer, Fajr, is the most peaceful.

“Praying that morning prayer [specifically] is the perfect way for me to start my day,” he says. “I feel fresh after and I’m ready to take on anything that comes my way.”

While caring for his mental health is one of his strongest values, the practice wasn’t emphasized much in his family in the past. He was raised in a Muslim Trinidadian and Guyanese household and conversations surrounding mental health were vastly different for his parents when they were growing up.

“I think my parents never really had that kind of focus growing up and they couldn’t go to their parents for those kinds of issues,” he says.

“If you’re going through something. you kind of just have to deal with it. You don’t really talk to people about it,” Raheem says. “And from a religious standpoint, you would talk to God about your problems and he’ll have the answers for you, but it would never be something that you would go talk to another family member about.”

Initially, communicating mental health issues to his parents proved to be challenging, but as he matured, he became less reluctant to speak to them about his struggles. Eventually, the barriers began to diminish.

“It came down to the understanding that they’re not going to be judging me, they just want to help me,” he says.

Growing up, Raheem says he faced significant challenges from being overweight and would often be bullied at school. Comments were made both behind his back and to his face about his appearance. Despite the hurtful remarks, Raheem reached a pivotal moment where he had to decide whether to listen to the opinions of others or be confident in who he was.

“I am who I am,” he says. This is where his self-love journey began, but it took time for Raheem to become fully aware of his mental health needs. “Every day I tried to implement different things that would help me feel better about myself,” he reflects.

While he can’t recall exactly when he began telling his parents he was struggling, he remembers addressing his need for a lifestyle change and pursuing support to help him maintain it.

“They showed me support through their actions,” Raheem says. For example, they provided him with a gym membership and would offer him words of encouragement with every milestone he achieved. At this point in his life, Raheem is very open with his family and will go to them for advice when faced with a problem.

He describes their relationship as “effortless” with “no real hesitation” to confide in them. He values their closeness because he knows a lot of people don’t have this privilege and wants to make sure he doesn’t take it for granted.

Akbar says immigrant households often want to integrate into society and go beyond their cultural and generational traditions.

“On the other hand, there is a pulling of the traditional system and there [are] kind of stigmas in terms of talking about feeling anxiety because often parents or even grandparents don’t understand what this person is talking about,” Akbar says.

Raheem reflects on his experiences from his standpoint as a Muslim man, expressing that people from Muslim households in varying countries may not always be as close to their parents as he is. He believes this can make it difficult for individuals to reach out to their parents about their mental health struggles.

Raheem says his parents weren’t raised to openly speak about their mental health struggles, so they provided him and his sister the opportunity to have what they never did.

According to the Institute for Muslim Mental Health, there is a misconception that mental health is a “taboo” in the community and that it leads to shame among those who are struggling with their mental health. This cultural norm can prevent Muslim people from seeking the support they need, whether it be talking to a friend or a professional service.

In Nigeria, fourth-year psychology student Toluwani Adeniyi was never accustomed to the idea of being alone. Her younger sister was like a roommate and she lived in a boarding school with eight other girls growing up. However, when she moved to Canada to pursue a Bachelor of Arts in psychology, she remembers feeling as if “everyone’s just minding their own business.”

When she started at TMU, she made sure to maintain a high grade point average, work a part-time job and volunteer so she would stand out when applying to graduate school. As time went on, Adeniyi’s plan for success was disrupted when she wasn’t meeting certain expectations to excel among her peers.

With her siblings working towards obtaining science degrees, her brother often jokes about her decision to pursue an arts degree. “I was trying to prove something to them, that I never needed to prove to anybody,” she says when talking about the possibility of success in her chosen career.

“Even good parents can give trauma. Even [in] the most loving households…if you’re in an environment where everyone is doing exceedingly well…you’re going to feel like something’s wrong with you if you’re not able to maintain [that excellence].”

Akbar believes that international students who don’t live with their families are more prone to express their mental health struggles with others since they are surrounded by people who have had similar experiences. Adeniyi reached a point where she began to miss work and her classes, unable to ignore the toll it was taking on her. She had screeched to a halt.

“I couldn’t pretend like I was okay,” Adeniyi says. This is what prompted her to begin seeking therapy, which she recalls feeling very foreign. Her therapist had told her to “forgive herself, to be weak, to fail and not blame herself for once.”

She says she felt like a walking contradiction to her past beliefs because, in Nigeria, she felt like she would only be considered successful if she was visibly struggling while figuring out her life on her own.

Ashika Niraula, a senior research fellow and project lead of Canada Excellence Research Chair at TMU, emphasizes how important the conversation surrounding mental health is in immigrant households. “We need to ask [and] we need to look for help, before it’s too late. I think having this conversation [and] starting an open dialogue is very, very important,” she says.

Niraula says when someone is not feeling well, their pain may not be fully understood when speaking to a healthcare practitioner who doesn’t understand their cultural contexts and beliefs. “When people don’t have access to culturally appropriate services, they don’t have trust in the [overall] system [making it] difficult to go and approach and be able to access the care [they need].”

When Adeniyi went through the counselling services at TMU, she had been set up with someone who was also Black-identifying. However, even though the person was Black-identifying, they didn’t come from the same cultural background. “There is so much that makes up a person that finding the right therapist for each and every one is going to be a big challenge,” Adeniyi says.

“If I’m saying something…someone who’s not from the culture may not understand [the importance of each experience].” Adeniyi felt the counsellor just couldn’t understand the cultural experiences that came with being Nigerian.

In her third year, Adeniyi realized that she needed to stop sacrificing her wellbeing to make others happy. She slowly began having more open conversations with her family, while keeping in mind that she needed to seek out support for herself.

She now keeps her family updated with her internal conflicts and they’ve given her more grace. These conversations have slowly reframed Adeniyi’s family dynamics and resolved the preconceived notions she had about her parents’ experiences with mental health.

“I used to think they were perfect, but they opened up about their struggles and issues, showing me that they’re not as flawless as I thought.”

Sitting in a sea of nervous university students, Cheryl Leung couldn’t help but focus on the scribbling of pencils and rustling of papers that echoed around her as she waited to write her exam in the Mattamy Athletic Centre.

The then first-year business management student restlessly looked around at her peers while trying to contain her worry—a feeling that would persist throughout the rest of the exam season.

Currently living with her aunt and uncle, the now third-year student from Hong Kong realizes that this was the turning point for her to come to terms with her mental health struggles and give them the attention they deserve.

Leung feels that her aunt and uncle don’t fully grasp the stress she experiences in university. Despite their good intentions, they sometimes question why she feels stressed, assuming that she doesn’t have much work to do.

Leung believes their generational gap and different lifestyles—seeing as they are retired and have a lot of free time—make it difficult to fully comprehend the pressure of the academic responsibilities, volunteer work and jobs she has to juggle all at once.

She says the academic pressure she experienced in Hong Kong was significantly different from her experience in Canada. When she was in high school back home, she faced a lot of pressure, but upon moving to Canada, she found that the pressure she felt was more self-imposed than from her family.

Despite her parents’ leniency with academics, Leung feels a responsibility to make the most of her opportunity in Canada by excelling academically.

The financial strain of international tuition fees adds to Leung’s stress, as she worries about managing her expenses without burdening her family. Leung understands there are often stereotypes associated with the financial circumstances of international students, which in her situation, are not true.

Akbar says considering that international students hold a study permit and are temporary migrants in Canada, they have to pay higher tuition fees compared to domestic students, which can result in increased stress.

Leung acknowledges that discussions revolving around mental health would have been less likely to occur back home in Hong Kong. She recalls her family never highlighting the significance of reaching out for help in any way.

“If you were [having] a breakdown, you would just deal with it yourself,” she says.

In high school, if Leung was ever feeling down, she would play sports to relieve her stress, but since coming to Canada, she learned about the additional resources available to her, such as TMU’s counselling services, which she says have been helpful.

Another way she approaches mental health is through the use of social media, where she looks for affirmations and meditation videos, especially before going into an exam.

While social media has become an integral part of everyone’s lives, according to an article from BMC Psychology, “There is neither a negative nor positive consensus regarding the effects of social media on people.”

While social media can have great sources for how to improve your psychological wellbeing, the article also states that there are certain factors relating to over-consumption on social media that need to be addressed. Finding that balance is crucial.

Leung often talks to her mom about what’s going on in her life, as they share an open relationship and she considers her mother to be a friend.

While she doesn’t explicitly discuss her mental health struggles, she keeps her mom updated about how she’s feeling by communicating with her frequently. However, Leung says she doesn’t feel equipped to reach out for help when she’s struggling mentally.

“I don’t think…I would need anyone to give me advice, I just need someone to listen,” she says. As for her parents, they rarely discuss their own struggles, Leung says. “I think they’re just not used to speaking about it.”

Adeniyi’s parents have now moved to Canada and are living with her, sometimes making her feel as though she has to explain herself more than before. Even though she knows they still don’t completely understand her struggles, they still want to show that they love and accept their daughter, despite the fact they may not always be on the same page.

Although therapy may have not been what she needed at the time, Adeniyi has found support within her extended family and warmly recalls the comfort they provide her, such as receiving hugs from her little cousin. To be surrounded by people who know her, care about her and notice the little changes in her makes her feel like she’s not alone.

“It’s so important to just take it day-by-day, not only for [yourself] today but live for [yourself] tomorrow.”

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