Migration and Mental Health

Migration is an important intersection to consider in Muslim experiences of mental health: in 2011, just over half (53%) of the Muslim population of Britain were born outside the UK (ONS, 2013).

As described in an earlier step, some Muslim families have been living in Britain over decades and include two or more generations whilst others are closer to the point of migration. In this step, we consider the mental health implications for those who migrate, and for subsequent generations (their children or grandchildren).

Primary migration and mental health problems

The process of migration can be complicated and stressful. It involves leaving the home country and adapting to a different environment, culture, and life situation. The process of departure, arrival, and integration is particularly difficult for refugees and asylum-seekers (WHO 2018). Refugees in particular may have been exposed to stressful events such as wars and other forms of armed conflict, persecution, discrimination, or natural disasters before migrating (WHO 2018). Alongside coping with worries for their families and communities who remain, refugees and asylum-seekers must deal with the bureaucratic procedures and uncertainty around status-determination in the immigration system of the destination country.

The Refugee Council, who provide specialist mental health support to refugees, state that refugees can suffer acute anxiety about the complex asylum process. Common concerns include accommodation, money, education, access to legal advice and they may also fear detention, deportation, destitution, and homelessness (Refugee Council website).

Research suggests that asylum seekers are five times more likely to have mental health needs than the general population and more than 61% will experience serious mental distress, however, they are less likely to receive support than the general population (Mental Health Foundation 2016). Asylum seekers and refugees, are more likely to experience depression, anxiety, and post-traumatic stress disorder than the general population. It is not only at, or around, the point of migration that mental health problems are experienced. A lack of socio-economic integration, particularly through social isolation or unemployment, over the long term can also be a significant risk factor for migrant groups. WHO (2018) suggest that social integration is likely to significantly reduce the development or deterioration of mental health problems.

Barriers to accessing support

The complexities and difficulties associated with international migration, as well as other factors during the course of life, mean that migrants can suffer from mental health problems. However, they may face several barriers in seeking support, including:

• language barriers
• lack of information about the health care system in the host country
• limited entitlements to receipt of free care
• different explanatory models of mental distress, and different attitudes to medical and psychological treatments.

The diagnosis of mental health problems is almost entirely based on verbal communication and language can pose a significant barrier to accessing mental health support for migrant groups. Misunderstandings in communication can arise between people with mental health problems and the support-provider, which can lead to under or overestimation of mental health problems and therefore reduced efficacy of treatment. Among migrant Muslims, beliefs around supernatural causes of mental and emotional distress may not be layered with widely available public health information around ‘mental health literacy’ in Britain, and this may make the diagnostic process more difficult.

Protective factors for migrants

The prevalence of mental health problems varies among migrants. Characteristics such as socio-economic background, education, professional qualifications, and skills can act as protective factors against the development of mental health problems. These factors can also help to reduce barriers to accessing health support because migrants with these characteristics are likely to be able to express their mental health problems, understand their diagnosis and engage appropriately with any treatment plans.

The second generation

It is recognised in the literature that the children of Muslim migrants living in Western contexts, the second-generation, may experience mental health problems as a result of reconciling their ‘Western’, ethnic and religious identities. This is sometimes known as a ‘culture clash’, where the cultural and social norms of wider society contradict those the requirements of a ‘good Muslim’. As a result, young people may experience internal conflict and distress, and face negotiation and argumentation with their parents and others in their local ethno-religious communities.

Young people may also experience the effects of racial or religious discrimination (Islamophobia) differently to their migrant parents. Their British birth, identity, and education may mean that negative treatment in wider society is experienced as a social injustice in particular ways that affects their sense of belonging to the country in which they were born (Sharing Voices Bradford 2018). Islamophobia and the experiences of Muslim young people around mental health are covered in more detail in Week 2 of this course.

Through education and public health information, British-born Muslims are likely to have a greater awareness of the causes of mental health problems and the availability of mental health support than the first-generation. However, they may still be affected by mental health stigma in their local ethno-religious communities.

A research project conducted by the Centre for the Study of Islam in the UK and the School of Social Sciences at Cardiff University, showed that transmission of Islam from parents to children is higher among British Muslim families than those of other religions (Scourfield, Gilliat-Ray et al 2013). Their religious identity and beliefs are therefore likely to be as central in the lives of younger and second-generation Muslims as for their parents, and therefore an important factor in their mental health and wellbeing.

Finally, and importantly, low levels of socio-economic integration among Muslim migrants mean that the second-generation are likely to have been brought up in household contexts of disadvantage and relative poverty. Indeed, there is limited evidence to suggest substantial generational improvement around this important predictor of mental health problems (Karlsen, Nazroo et al 2021). So, socio-economic disadvantage is likely to remain an important part of the day-to-day context and mental health of second (and subsequent) generation Muslims.

Over to you

Please share your experiences, or observations, on the mental health experiences of migrant communities, what role does religion play in these experiences? Is there anything you have learnt in the course so far that might be useful for your practice?