When you're an immigrant or refugee, opening up about mental illness in some cultures can be difficult, even taboo.
Shasini Gamage, an 18-year-old immigrant from Sri Lanka, remembers when she hit rock bottom.
“It started with thoughts, and then mutilation which is worse,” she said.
Gamage came to Canada as a one-year-old and was raised by a single mother. In her early teens, things started to change.
“I had body image issues and my home was a toxic place to be,” she said, adding that he couldn't open up about what was going on in her mind.
“Not that it's non-existent, but it's taboo to talk about it, especially in Sri Lanka,” she said.
Help and resources are now tailored specifically to those needs.
Transcultural child psychiatrist Dr. Cecile Rousseau is part of a network of clinics that works with immigrants and refugees.
In general, she said, they tend to under-use mental health services here.
“It's not evident for people from other cultures – migrants, refugees – coming to see them to trust us. Why? Because our institutions reflect our society, which is a society in which unfortunately, there's still discrimination. There's still prejudice and we have to understand that people coming to us may not feel safe.”
Language is even more of a barrier, added Dr. Sophia Koukoui. The psychologist and post-doctoral researcher on transcultural work, saidtherapy in one's mother tongue is always the best choice.
“The first language is the language of emotions, of affect,” she said. “So we see when individuals speak their mother tongue and then switch to another language, the repertoire of emotions they bring to the table is not the same.”
Koukoui uses an interpreter whom she meets with before beginning work with a patient.
“To make sure if there is anything that they sense, a choice of words, a specific way of expressing things that I will not understand because I don't know the language that they alert me to it,” she said.
The mental health issues some immigrants suffer from can stem from their experience in Canada.
“Adaptation, language barriers, poverty, difficulty in gaining employment… discrimination, as well, is definitely one of them. It makes it such that it takes a toll on people's psyche,” said Koukoui.
Both doctors agree that while resources do exist , there needs to be more outreach to the cultural communities - in their own language
“If you don't do the promotion in a language that the person understand then there's no point, right?” said Koukoui
