Dr. Ahmed Munib, PhD candidate, Supervisors:

1. The Effects of Immigration and Resettlement on the Mental Health of South-Asian Communities in Melbourne. • Dr. Ahmed Munib, PhD candidate, Supervisors: Assoc. Prof. Harry Minas & Assoc. Prof. Steven Klimidis, Centre for International Mental Health & Department of Psychiatry, The University of Melbourne.

2. South-Asian countries of migrant origin • India 29,414 • Pakistan 2,794 • Bangladesh 1,317 • Sri-Lanka 25,969 Australian Bureau of Statistics census data, 2001 [statistical local areas for metropolitan Melbourne]

3. Factors in the home country predisposing to migration from the South Asia region • Economic uncertainty • Low quality of life • Lack of higher educational opportunities • Limited career advancement • Political and social instability • Family members/relatives settled overseas

4. Pre-migration factors affecting settlement outcome • Age at the time of migration • Gender of the immigrant • Socio-cultural and educational background • Occupational status • Psychological preparation prior to migration • Prior experience of migration • History of physical and/or psychiatric illness • Individual personality traits • Family composition • Future expectations • Perceptions and attitudes towards the host community

5. Post-migration scenario (Observations in Bangladesh) • Inadequate social support mechanisms • Social isolation and cultural alienation • Predisposition of anxiety/depression • Concealment of mental illness due to stigma • Impaired coping and adjustment • Aggravation of psychiatric problems • Unsuccessful resettlement • Return to home country • Inadequate/delayed therapeutic intervention • Rehabilitation failure • Social disability

6. Post-migration factors affecting settlement outcome • Reception by the host community • Host societies’ attitudes towards immigrants • Perceived discrimination • Language competency • Recognition of professional skills and qualifications • Economic stability (job opportunities) • Presence of co-ethnic communities • Social networking • Adjustment with individualistic social expectations

7. Outlines of the Study design • Target group: Adult Indian and Bangladeshi Australian permanent residents/citizens located in metropolitan Melbourne. • Qualitative approach • One-on-one in-depth interviews • Number of participants-38 • Selection through community contacts • Analysis and extraction of themes utilising NVivo software

8. Summary of Research objectives • Exploration of immigration and resettlement experiences among South-Asian migrants, and any association with psychiatric illness, primarily anxiety and depression. • Investigation of psychosocial protective mechanisms and common coping strategies. • Examination of factors relevant to both successful and unsuccessful resettlement, and the effect on psychological well-being.

9. Cultural profile of study group Indian community • Native languages-Hindi as well as Tamil, Gujrati, Bengali. • Predominantly Hindu, some Muslims and Christians • Strong religious and South-Asian cultural beliefs • Hierarchal social caste system with conservative family values • Extended social networks with collectivist ideals Bangladeshi community • Ethnic Bengali, predominantly Muslim. • Strong Islamic identity and Bengali/South-Asian cultural beliefs • Conservative family values • Extended social networks with collectivist ideals • Both communities in Melbourne comprise mostly skilled migrants

10. Deductions from case studies(Resettlement difficulties) • Regret and self-reproach regarding decision to migrate • Feelings of antagonism towards Australian society • Anxiety, apprehension and uncertainty about the future • Feelings of social isolation and cultural alienation • Reinforcement of preconceived stereotypes about perceived discrimination • Dysfunction in inter-personal relationships • Adverse impact on psychological well-being

11. Factors affecting emotional well-being in migrants • Inadequate psychological preparation prior to immigration • Cultural and linguistic barriers • Concealment of mental illness due to stigma • Reluctance to utilize psychiatric services in the host country • Preference to seeking psychiatric services in the native country

12. Themes relating to psychological distress • Blame • Resentment • Regret • Remorse • Loneliness • Helplessness • Low self-esteem • Dysphoria • Anger • Agitation • Antipathy • Concealment

13. Resettlement

14. Post-settlement adjustment stress

15. Racial discrimination (impact on the individual) • “…certainly racism in general in Australia has affected me a lot…just from growing up…the inevitable racism which migrants face…besides superficial racism at school or in the workplace…subtle discrimination is much harder to pinpoint because you never know if people are reacting to you for a certain way…but certainly in terms of overt racism that has always been in the form of racial abuse or racial slurs or things like that. I would say that…that the discrimination I have faced has been based on literally the colour of my skin above anything else.” - Bangladeshi male

16. Racial discrimination (impact on the family) • “…because of our colour they treat us differently...which makes me really upset and sometimes my son...he’s in year 11 now...last year he used to say that I wish that I had white skin...I don’t want...like to be a brown boy in the class”. -Bangladeshi female

17. Role of the family • I don’t think South-Asian families are designed for external intervention…I just…I think an Anglo family…because of their culture and their acceptance of…psychiatric or therapeutic intervention, I think they would be much more comfortable in seeking outside help, but I think there is a great deal of pride associated with the integrity of the family unit…in South-Asian communities…and to seek some kind of outside assistance, I think would be a huge admission of failure…on part of both the family units. So I think ultimately differences would have to be straightened out by the family”. - Bangladeshi male

18. Non-recognition of professional skills • “...we think we have everything and walk over to Australia and we can’t find a job or something…general kind of people, some are frustrated because they couldn’t find the placement equal to what they were doing...some people find it very frustrating because they believe that they got the highest degree...and they come here and nobody will accept it”. - Indian male

19. Psychological distress • “...I feel I’m like out of my own culture, I don’t belong here, I don’t belong with my friends...I feel really depressed...I’m having some medication for depression because it gets really bad and as I told before, now I feel my family very much. I feel this here the life is so mechanical, you have to follow the same routine day after day…and I feel like I’m just working like a machine.” -Bangladeshi female

20. Cultural incongruity • “...Australians’ way of life is entirely different from our way, especially from the subcontinent and their sense of humour is different and how they speak is different, how they behave, how they react to the...suppose if I say one thing, a same thing to Indian and Australian, Indian may laugh at that but Australian don’t understand that. He may think in a different way”. - Indian male

21. Attitudes towards host society • “ The best thing about Australian society, Australian people is…they feel you…you know, they make you better. They feel that, they make you feel you know…very friendly, even a stranger they will talk to you, ‘how are you mate...going mate’. So you feel comfortable talking with them, get along with them. So that’s the best thing about Australia you know. They are very friendly even though you know by heart they may not be very friendly but for day to day conversation, for the day to day things, for moving around they are friendly.” - Indian male

22. Successful strategies for coping • Social interaction and networking with co-ethnic communities • Co-ethnic social support networks (sharing and discussion of problems) • Spiritual pursuits (eg, meditation, prayer) • Community volunteer activities (eg, charity work) • Acculturation: interaction with local Australian communities • Help-seeking behaviour: family, friends, chaplain, counsellor, GP, clinical psychologist, psychiatrist.

23. Long-term goals of the study and suggestions • Promote awareness about mental health concerns within the South-Asian community in Australia. • Increase awareness within the professional mental health community about South-Asian mental health issues. • Emphasizing that help-seeking is culturally acceptable and appropriate. • Dispelling the preconceived association of mental illness with stigma. • Social networking is an important buffer for migrants. • Resettlement in a new country is psychologically challenging, but does not necessarily predispose to mental illness.

24. Thank You