• At some point, the country where I'd been born started feeling like an unwelcome guest. (Getty Images )Source: Getty Images
The toxic cocktail chipping away at a migrant's psychological well-being.
Kamran Ahmed

18 Oct 2018 - 8:27 AM  UPDATED 13 Mar 2020 - 1:09 PM

The week I moved to Sydney four years ago, I got talking to some young women in a bar who advised me not to live in Redfern as it was ‘full of Abos’. When I enquired why that was a problem, one of them explained that ‘we were up here’ and gestured to her (clearly rather empty) head, while ‘they’ were ‘down here’, pointing somewhere around her waist. 

I was shocked and appalled, but since then it will probably come as no surprise that on many occasions I have found attitudes to racial difference to be less than favourable and the discourse around migration hostile. 

There was the colleague at a hospital I worked at who told me she feared for her life when she visited Brixton in London because it was ‘full of black people’. Then there was the pub manager who laughed and asked if I was actually one of the cooks because of my appearance on letting me in to his establishment. 

The list of casually and sometimes aggressively racist comments I’ve received and witnessed here is long and nauseating, and this racism sadly extends to Australian radio, television and politics. 

"Where are you really from?" and other comments that I'm sick of hearing
Casually racist comments - such as "your English is really good" or "where are you really from" - are like mosquito bites you can't stop itching.
Why people of colour should prioritise self-care
In a world that continues to show a gross disinterest in taking care of minorities, self-care can be a radical act, writes Neha Kale.

Racism is a mental health hazard to all people of colour in western nations. Minority stress theory, which was first described in relation to the gay community, explains that ethnic minorities also face three additional types of stress not experienced by the majority. The first is the objective experience of racial abuse, secondly, “perceived stigma” or the expectation of discrimination which leaves them on edge, and finally the internalisation of negative attitudes fostering a sense of inferiority within them. These combine to form a toxic cocktail that chips away at a migrant’s psychological well-being. 

Back in medical school I became interested in migrant mental health when I learnt that the rate of self-harm was much higher in South Asian women in the UK than their white counterparts. What was the cause for this difference? My search for the answer set me off on a path of psychiatric research which helped me understand much of my own experience as a second-generation Pakistani living in Britain at the time.  

Along the way I discovered that various factors can affect the mental health of migrants the world over, making migration a well-recognised risk factor for a range of mental illnesses. In Australia, according to the National Survey of Mental Health and Wellbeing, over a quarter of a million first-generation adult Australians from culturally and linguistically diverse backgrounds are estimated to experience some form of mental disorder in a 12-month period. 

As well as culture-specific factors which can pose a risk and will vary between cultures, for first-generation migrants moving to a new country where the language and customs are unfamiliar is an obvious stressor. The economic strain of starting afresh often coupled with a drop in social status adds to the difficulty. For both first- and second-generation migrants, acculturation - or the process of balancing two competing cultural influences, can be a particular challenge.  

Learning about the concept of acculturation was a real eye-opener for me; growing up I had the Pakistani cultural influence of my parents and white British cultural influence from my friends and society at large competing within me. The acculturation process can be a difficult one and can have a number of possible outcomes; ranging from deculturation where all connection to the culture of origin is lost, to assimilation where a loose connection is retained, or integration which maintains stronger ties and finally rejection, where migrants reject the culture of their new home entirely. The outcome is influenced by an individual migrant’s peer group, family, personality and life experiences, including racism.  

Despite all the mental health risks associated with migration, migrants in need of support often don’t receive any due to a lack of awareness of mental illness and understanding of the health system, or the stigma associated with a diagnosis and choosing alternatives to mainstream health services. 

As well as tackling these barriers to seeking help for mental health problems in migrant populations, we need a concerted effort to stamp out racism in Australia and innovative ways of making the acculturation process less arduous, because when migrant mental health improves, everyone benefits.

Dr Kamran Ahmed is a psychiatrist, film-maker and entrepreneur with a research interest in culture and mental health. He runs music technology startup www.ravereviewz.net and is the founder of the Medfest  film festival. You can follow him on Twitter @dockamran .

Mental health support services:

Black Dog Institute

Lifeline - 13 11 14 

The new SBS series 'How 'Mad' Are You?' takes a unique look at mental health. It will be broadcast on SBS from October 11 at 8:30pm on SBS.

I've been in therapy for more than a decade and it's been worth every cent
I am an out and proud person with problems, unlike those who may prefer to keep them closeted, or who jump on the problems of others as a way of not taking responsibility for their own: “well, you’re autistic, so you wouldn’t get it,” and “you just analyse too much,” and “you’re being paranoid.”
I accepted my anxiety out of pure exhaustion
When my doctor first suggested anxiety, I was horrified. As I was obviously dying of some terrible fatal illness that was stopping me from being able to function as an adult.
The time I flew over the cuckoo's nest
When your arm is broken, it's easy to gain sympathy from others - it's not as easy when people can't physically see the pain you’re going through.
What's life really like in a psychiatric hospital?
There are no padded rooms, but precautions are made. This is how I found myself sitting in the bathroom clipping my toenails under the watchful eye of a nurse.

How to find the right psychologist for you
A practical guide to finding a therapist.
When all the psychologists are white and you're not
Mental health professionals are not immune from internalising social assumptions and stereotypes about Muslims.
More Indigenous psychologists needed to address gaps in mental health
In the aftermath of the APS’s apology to Aboriginal and Torres Strait Islander Peoples in September, former APS president Mike Kyrios urges there is still a long road ahead in bridging Indigenous mental health gaps.