The Immigrant and Refugee Mental Health Project facilitates a virtual Community of Practice (CoP) comprised of health, settlement and social services providers across Canada who support the mental health of immigrants and refugees. The CoP online discussion board allows providers to pose questions to the Project’s panel of subject matter experts (SMEs). We will be bringing you some of the questions posed by providers and answers provided by the SMEs.   

Question

Is there a timeframe or period where refugees and immigrants feel relaxed or better (sigh of relief) after their arrival to host country? How long does it take to adjust in a new environment for refugees and is it different for those who migrate?

Dr. Debra Stein, Staff Psychiatrist (children and adolescents), SickKids Centre for Community Mental Health, writes:

Thank you for this interesting question. The timeframe for refugees and immigrants to feel "relaxed or better" after arrival to a host country is extremely variable, as one might imagine. The question brings us to the notion of resilience in individuals and families, which essentially refers to coping well in the face of adversity. 

Our clients come to us with a number of resilience-promoting and resilience-challenging factors, which can guide us in helping them make the transition to a new country easier and hopefully even enjoyable. I'll describe one very important resilience-promoting factor: a felt sense of personal safety. Without this, it is hard for clients to "relax" and explore their surroundings, learn a language, and make connections. Generally, asylum-seeking clients who fear violence and death in their countries of origin and who do not yet have protected status have a more difficult time. Other examples are clients who currently live in unsafe situations-for example situations of domestic violence or living in a dangerous neighborhood. 

To add to this idea, I am often struck by the change in clients and families along each step of the process toward becoming a fully-fledged citizen in Canada. Little shifts begin with getting a work permit, then being officially designated as an asylum seeker and having access to medical care and prescriptions. There is a significant shift for most, when an asylum claim or a humanitarian and compassionate claim is accepted and permanent residence status is granted. This is not simply because clients feel personally safer, it also means they can now sponsor family members to come to Canada and have access to post-secondary education. This is where I see clients and families really settling in. However, for some, it is not until citizenship that there is the "sigh of relief" as you mentioned. So even here, there is variability.  

Resilience-challenging/promoting factors can be identified at the individual, family, social and systemic levels. Clients bring all kinds of personal attributes to the challenge of resettlement, including language skills, a secure attachment style, and varying degrees of mental health. High levels of individual symptoms of depression, anxiety or trauma are important here. On the level of the family, we have conflict, separations and losses, which may be making it hard to settle. Socially, there is the quality of relationships outside the individual and family, for example the level of social support, the extent to which schools are welcoming, and the presence of a community. Systemically, poverty and discrimination are important factors. 

So, with each client sitting with us, there exists a confluence of different factors which will influence how they will cope and hopefully thrive in the new country. We can support clients by helping them to identify and enhance resilience promoting factors that are tailored to their particular situation.