The number of people moving between and within countries is growing rapidly. However, despite the fact that communication and transportation systems are becoming more efficient and making migration easier, the fact remains that migration is always stressful and at times traumatic. The situation is being made worse as a result of the politicization of migration and the tendency to present migrants as the root of current financial and inter-cultural problems.
To date most of the focus on migration and migrants has centered around issues such as employment, housing and remittances. Psychosocial adaptation issues have been seen as far less important. At ICMHD, the psychosocial aspects of migration are considered a high priority. Studies have repeatedly shown that the risk of physical morbidity and mortality is higher among migrants than indigenous populations and migrants are far more likely to be subject to chronic anxiety, depression, psychosomatic complaints, posttraumatic stress disorders and other psychoses.
Migrants are exposed to stressors throughout the different stages of migration. Prior to migration they often come from harsh living conditions in their country of origin and have experienced marginalization, social disruption and physical violence. During the migration process, which can take months and even years, they are often exposed to even greater stressors such as poverty, living in political limbo, job insecurity, extreme exploitation in the work situation and violence. Even after migration, they often encounter additional difficulties such as cultural conflict, occupational insecurity, social marginalization and in the case of some countries, political hostility in the countries they settle in. Barriers such as language, religion, culture differences serve to accentuate these problems, amplifying the negative experience even more. Studies also reveal that migrants have less easy access to local health care systems due to their lack of knowledge, problems of insurance, legal status and poor education. Coping with these problems is never easy and many migrants turn to behaviors that while helping them deal with these immediate problems, nevertheless present serious threats to their overall health and well-being. This is not to say that social support mechanisms are not available to migrants, for indeed these can be found in many forms. Evangelical church movements, for example, are increasingly evident in migrant communities everywhere and are rapidly playing the role that formal health care systems and mental health specialists might otherwise have played. One of the difficulties that mental health specialists have encountered in the past has being their lack of training in cultural competency. Their lack of familiarity with different cultures and customs has often led to major problems in terms of poor diagnosis and inappropriate treatment of migrants. In a world that is increasingly heterogeneous in terms of culture, social background, language and beliefs the health sector must adjust its policies and practices and do everything possible to look at the arrival and eventual integration of migrants in a far more rational and long term vision manner.
At ICMHD, we believe that more research is called for this area and that the findings of good research need to become the basis for national policies and programs in the area of psychosocial welfare and integration of migrants.
Manuel Carballo and Madiha Nasir