Experiences of Isolation and Inequality

Immigrant and refugee women experience structural, institutional and interpersonal forms of disadvantage that significantly impact their ability to experience good mental health. The evidence indicates that migrant women experience poorer health outcomes compared with Australian-born women and that this health disparity is likely to extend to mental health. In addition, the COVID-19 pandemic has highlighted and accentuated the gendered inequalities that exist in the Victorian community and health system. Migrant and refugee women, already disadvantaged, have now been disproportionately impacted by the COVID-19 pandemic, not only missing out on timely and accurate multilingual information about COVID-19, but also facing increased risk of infection, accentuated social isolation due to the digital divide, significant financial disadvantage and an increased risk of family violence.

The research shows that race and gender inequality, violence against women, settlement stress and trauma, and perinatal mental health are particularly important issues for migrant women. In addition, the evidence confirms that immigrant and refugee communities face multiple barriers to accessing mental health support, at all levels. At the policy and programming level, migrant and refugee populations are often overlooked or treated as a homogenous group, which fails to consider the differing needs of both individuals and communities. Moreover, organisational and sector-level barriers such as lack of cultural and gender responsive policies, lack of trained bilingual practitioners working in health services, lack of flexibility, and unaffordability of services have been found to limit the utilisation of services for migrant and refugee women.

There is strong evidence that demonstrates that racism and discrimination are important postmigration factors that impact negatively on migrant and refugees’ mental and physical health. A recent Victorian study found that people who frequently experience racism are almost five times more likely than those who do not experience racism to have poor mental health.

Migrant women are impacted by race and gender inequality and discrimination which in turn affects their mental wellbeing. Migrant and refugee women have higher rates of mental distress, PTSD, anxiety and depression than migrant and refugee men. Gendered assumptions about caring (migrant and refugee carers of family members or friends who are frail, elderly, and/or living with a disability, chronic illness or mental illness) influenced the level of informal (from friends and family) and formal (from medical and other human services) support that migrant women are offered – carers were identified as a group who have a higher risk of experiencing poor mental health.

In addition to race and gender inequality, other forms of discrimination, including sexual orientation and gender identity-based discrimination can impact women’s mental health, their health-seeking behaviour and experiences with mental health care providers. Past experiences of discrimination and abuse related to race, religion, gender identity and sexual orientation or fear of such discrimination can prevent migrant and refugee women from seeking appropriate support.

Evidence consistently indicates that migrant and refugee women experience higher rates of perinatal depression and anxiety. Migrants who are from non-English speaking backgrounds in particular, are at risk of experiencing perinatal depression and anxiety. Shorter length of residency, social isolation, and socioeconomic or financial insecurity are also key risk factors for perinatal mental health conditions, however these factors are compounded by migration-related stressors including immigration status and family separation. In addition, trauma and family violence also appear to be associated with perinatal mental-ill health among migrant and refugee women.

The reported health impacts of family violence for migrant and refugee women include reduced or impaired mental health and an increasing and persistent fear of the perpetrator committing further violence, returning after separation, or seeking retribution. For migrant and refugee women, health and wellbeing impacts of family violence occur across a continuum; high levels of stress, fear and anxiety persist, regardless of the frequency or severity of the perpetrator’s violence. Migrant women also experience feelings of isolation, depression, guilt and self-blame, low self-esteem, loss of confidence and suicidal thoughts. Migrant women experiencing family violence are also seriously impacted by conditions on temporary visas, which means they often cannot access income support, public housing, healthcare including mental health support, and childcare services.

Reference: Multicultural Centre for Women’s Health Policy Brief: Immigrant and Refugee Women’s Mental Health, November 2020. University of Melbourne, School of Population and Global Health. Pages 2 – 5.