New country, desperate feeling
Oct. 16, 2006. 06:12 AM
A doctorate in nuclear engineering from prestigious Purdue University hadn’t gotten Jiang Guobing very far in Canada. He’d settled for a research job at the University of Toronto while trudging toward a second post-graduate degree.
At midnight on July 21, the 44-year-old Chinese immigrant leapt off a Don Mills overpass into Highway 401 traffic, leaving behind a wife and two children — and the multiple disappointments of the life he began here five years ago.
Jiang’s suicide, thanks to a fundraising effort for the family, became an unusually public event in a community much influenced by “shame culture” and an impulse to sweep unpalatable subjects below the surface of public scrutiny.
It was the latest of several high-profile suicides among skilled Chinese immigrants in Toronto — a phenomenon many fear is only the tip of the iceberg, given the poor job this country sometimes does of integrating newcomers and addressing their mental-health needs.
“We are now seeing the same sense of hopelessness among immigrants as exhibited among our aboriginal communities,” says Debbie Douglas, executive director of the Ontario Council of Agencies Serving Immigrants.
“The acculturation process is very difficult, whether you come here by choice or not. It’s about developing a sense of belonging and being able to integrate economically, socially and politically into the society.”
The disconnect between settlement services — the job of the federal immigration department — and health services, a provincial responsibility, is part of the problem, Douglas says.
Jiang’s suicide is an extreme case. But social workers, health workers and community advocates say mental health is an often-overlooked aspect of the settlement process. Depression and stress tend to be dismissed as a “normal and passing” phase.
“There’s so much stress and anxiety as a result of the resettlement process,” says Deqa Farah, a mental-health promoter with Community Resource Connections of Toronto. “Without proper intervention, it could trigger a downward spiral and turn into a crisis.”
One Statistics Canada study estimates an immigrant suicide rate about half that of native-born Canadians, and Health Canada research suggests that rates of depression and alcoholism are also lower than the national average. But the research has significant shortcomings.
For one thing, certain cultures may view mental health quite differently, and sometimes the stigma attached to mental illness produces stiff resistance to seeking help — which means the statistics are inconclusive.
“Newcomers to Canada have their self-confidence and pride eaten away by their failure in this country,” says Michael Huang, a director with the Chinese Professionals Association of Canada, which led the fundraising for Jiang’s widow. “Not only do they lack knowledge and awareness about mental-health issues; they are afraid they’d be further marginalized if they admit to others that they need mental help.”
The Ontario Coroner’s Office doesn’t gather data on the immigration status of suicide cases, but Huang says he knows of at least a dozen Chinese immigrants who took their own lives over the past few years.
Dr. Jose Silveira, a psychiatrist who is part of the University Health Network’s multicultural mental-health team, says 70 per cent of his patients suffer from major depression, while 30 per cent, many of them refugees, have symptoms of post-traumatic stress disorder.
“The loss of status from their home countries can have a great impact on their self-perception,” says Silveira, who heads the Portuguese team at Toronto Western Hospital.
A study commissioned by the Chinese Canadian National Council, released in May, found newcomers often used phrases like “loss of self,” “no face,” “no future” and “waste of life” to describe their experiences.
`Even if we wanted to get help, we wouldn’t know where to go for help’
Ling, native of China
Hemant Panchpor, who came here alone from Mumbai in 2003, knows the feeling well.
An economist with a master’s degree and 15 years’ corporate experience, he ended up working at an auto-parts factory for six months before landing a job as a bank customer-service rep.
“You just feel lonely, depressed, hopeless and helpless,” says Panchpor, 42, who enrolled in a business program at Ryerson University after the bank laid him off last year.
He has struggled to be allowed to sponsor his mother and wife — whom he wed after his immigration papers were processed — for a visit.
“I can only talk to my wife on the phone. In March, she threatened to commit suicide if I didn’t bring her to Canada. I’ve tried,” Panchpor says.
The challenges of resettlement also strain families.
Ling (who asked that her real name not be used) and her husband, both engineers, came to Canada from China with their then 7-year-old son in 1998.
“I’ve done some labour work in Canada, but I couldn’t handle the physical part of it. I ended up staying at home to look after our son,” Ling, 40, says in Mandarin. “My husband wanted to go back to school to get a better job, but we couldn’t afford it. Then he blamed me for being lazy and selfish.”
One day five years ago, when his verbal abuse escalated into shoving, Ling called 911.
“You worry about how to survive, how to bring food to the table,” says Ling, now divorced. “Even if we wanted to get help, we wouldn’t know where to go for help.”
The shortage of linguistically and culturally competent mental-health services can be a huge barrier, says Raymond Chung, executive director of the Hong Fook Mental Health Association, a partner in the University Health Network’s multicultural team.
Hong Fook was founded in the late 1970s in response to reports that Chinese patients were being mistakenly institutionalized because of cultural and language barriers. It delivers services in Cambodian, Chinese, Korean and Vietnamese.
“Most settlement workers are not trained in mental health. Some of them are scared to talk about mental-health issues because of the social stigma, or they believe that their clients’ mental health isn’t really part of their job,” Chung says.
Refugees and people without legal status face additional issues: fearing deportation or living in limbo while the asylum claim process crawls along.
“Most refugees are here in complete isolation, without friends or families. They may suffer post-traumatic stress disorder but were never treated in refugee camps. When they get here, they face a whole new set of problems that trigger their flashbacks and nightmares,” says Dr. Esther Elliott, a psychiatrist at Toronto General Hospital — part of a Spanish/Italian mental-health team that treated 273 new cases last year, with a wait time of up to three months.
“Many of them go underground and are afraid to go out, fearing that some immigration officers are waiting for them downstairs.”
Given the complexity of the mental-health challenges newcomers face, experts say what’s needed is a holistic, integrated approach.
Both the University Health Network hospitals and Access Alliance, an inner-city health clinic, put together teams that include psychiatrists, medical people and social workers, so clients can get mental-health treatment along with help accessing housing, job and counselling services.
“At the end of the day, they need to feel connected to the community and (believe) there’s hope in life,” says Sonja Narad, community health program manager at Access Alliance. “The last thing they need is to feel excluded and powerless.”