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Female newcomers’ adjustment to life in Toronto, Canada: sources of mental stress and their implications for delivering primary mental health care

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Abstract

Stress disorders and other mental ill health may be brought on by the disruption caused by resettlement. We examine female newcomers’ experiences of adjusting to a new place, metropolitan Toronto, Canada and a new health care system. We consider sources of mental stress experienced during adjustment. We frame this adjustment as a process that happens over place and through time. Thematic findings of interviews (n = 35) with female newcomers from five cultural-linguistic groups are reported. Sources of stress in adjusting to life in Toronto include: navigating a new place, personal safety concerns, adapting to a new lifestyle, and finding employment. Sources of stress in adjusting to a new health care system include: learning how to access care, not having access to specialists, and adapting to a new culture of care. We conclude by considering the implications of what newcomers report for the delivery of primary mental health care (i.e. ‘first contact’ care).

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Notes

  1. We use the term ‘newcomer’ to refer to immigrants within their first 6 years of arriving in Canada. Citizenship requires a minimum of 3 years residence over the past 4 years, with at least 2 years of permanent residence. Using a 6 year window allowed us to look at stressors for newcomers in all possible residential circumstances, and thus all possible entitlements, including new citizens.

  2. Two participants were not newcomers. Centre 2 requested that we include a limited number of immigrants who were not newcomers in the sample. We asked these women to speak about their years as a newcomer.

  3. Approval for this study was granted by research ethics offices at Simon Fraser University and York University.

  4. While in Canada health care is publicly funded, immigrants to Ontario in their first 3 months of residency, refugee claimants whose refugee claims have been refused and are awaiting appeal, and those who are in Canada without status are not eligible to receive health insurance. In Ontario, they can only receive free care at community health centres and, in Toronto, municipal public health clinics, which offer a limited number of social and primary care services.

  5. It is important to note that these same issues are faced by many Canadians and not newcomers or immigrants alone. Schellenberg and Maheux (2007) point this out in their report.

  6. It should be acknowledged that given the applied nature of this CBPAR study our next steps as a research team are to work with the community partners on putting into practice what we recommend here and to consider further the implications of the analytic findings for their day-to-day operations.

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Acknowledgments

The authors must first thank all participants. Funding was made available through the Lupina Foundation. We are grateful for the ongoing assistance of Centres 1, 2, and 3. Numerous individuals have made contributions, including: Jackeline Barragan, Niru Domani, Nighat Gilani, Nancy Johnston, Susan McGrath, Soheila Pashang, Paula Pinto, and Cristina Santos.

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Authors and Affiliations

  1. Department of Geography, Simon Fraser University, RCB 6141, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada

    Valorie A. Crooks & Melissa Giesbrecht

  2. York Institute for Health Research, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada

    Michaela Hynie

  3. Department of Psychology, 233 Vanier College, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada

    Kyle Killian

  4. Department of Geography, Technology Enterprise Facility, University of Victoria, Room 132, 2300 McKenzie Avenue, Victoria, BC, V8P 5C2, Canada

    Heather Castleden

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  1. Valorie A. Crooks
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Correspondence to Valorie A. Crooks.

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Crooks, V.A., Hynie, M., Killian, K. et al. Female newcomers’ adjustment to life in Toronto, Canada: sources of mental stress and their implications for delivering primary mental health care. GeoJournal 76, 139–149 (2011). https://doi.org/10.1007/s10708-009-9287-4

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