Through conceptualizing migration as a social process, this dissertation examines the role of social support among urban migrants. Existing research examining social support is often framed in North American or European contexts and ignores its connectivity with migration or mobility. There remains critical opportunity for research to examine how social support paradigms function in Low and Middle Income Countries (LMICs) and from the perspective of urban migrants, including refugees and economic migrants. By expanding the frame of both migration and social support research, this dissertation endeavors to enrich the empirical knowledge surrounding the role of social support among urban migrants. To accomplish this, this dissertation examines the intersection of trauma, social support, and depression among two urban migrant populations. Through its integration of data from female Syrian refuges in Jordan and male economic migrants in Kazakhstan, this dissertation aims to describe social support, potentially traumatic events (PTEs), and depressive symptomology; identify the direct association of social support and depressive symptomology, and; examine the moderating role of social support on depressive symptomology related to PTEs. This dissertation is guided by the Push-Pull Theory, the Stress-Buffering Hypothesis, and van Brenda’s conceptualization of resilience. Findings from this dissertation suggest that social support plays a critical role, both directly and indirectly, in influencing outcomes of depressive symptomology. Findings have several implications for social support measurement and direct practice of mental health clinicians, as well as informing how community-based interventions and mental-health policies within LMICs can integrate social support within their resiliency frameworks.

We are in a new global era, framed and shaped by migration and record movements across borders. The intersection of migration, mental health, and psychosocial wellbeing represents an increasingly important matter in the humanitarian space. Global rates of migration are at an all-time high, with internal and cross-border migration hitting record figures (United Nations Department of Economic and Social Affairs, Population Division, 2020). Mexico is a country that has been particularly affected by migration, as a top country of transit, as well as destination for migrants and asylum-seekers from the Americas and across the globe. The rise of displaced people traveling to Mexico and the United States, in combination with limited protection and legal support for migrants, has resulted in an unprecedented situation requiring attention. Population displacement results from an array of push factors, including political instability, climate degradation, natural disasters, and economic/physical insecurity. As growing numbers of people migrate to and through Mexico in search of protection and improvements in livelihoods, it is crucial to consider gaps in access to support services for migrants and asylum-seekers. Access to health care has long been a challenge for migrant populations in Mexico (Infante, 2022), and in particular, barriers have been reported in relation to Mental Health and Psychosocial Support (MHPSS) for people migrating while seeking asylum further North (Allande, 2022). Thus, there exists a need for the provision of improved and adapted MHPSS programs for migrants in Mexico, with particular attention to those from outside of Mexico seeking asylum in the United States. Working in collaboration with local partners, this Integrated Learning Experience (ILE) summarizes findings from a multi-stage exploratory assessment. The overarching goal of this ILE was to identify opportunities for improving the design and implementation of MHPSS for migrant populations in Mexico. To do so, this research focused on addressing three specific aims: identify major gaps and challenges in delivering MHPSS services from the perspectives of practitioners and scholars (Aim 1); assess perceptions of existing MHPSS services from the perspective of intended users through in-depth inquiry with migrant communities (Aim 2); and, map barriers and facilitators to accessing MHPSS services as well as co-creating implementation strategies, tools and key recommendations through participatory workshops with key actors (Aim 3). The specific research methods utilized in this assessment included: A) synthesis of 3 years of survey data gathered from service providers, along with key informant interviews (KIIs) with service providers to identify existing programs, gaps, and challenges; B) focus group discussions with migrant populations combined with ethnographic observations to assess support and how they are perceived, and C) participatory workshops with key actors to co-create implementation strategies to improve supports from a systems perspective. By mapping existing MHPSS supports in key locations and engaging with different stakeholders through participatory methods, this ILE presents a systematic, conceptual approach to identify leverage points for improvements in programs that fit the unique situation and lived experiences of people on the move. The final recommendations outline practical steps to promote more coherent and comprehensive approaches to MHPSS programming while recognizing and responding to overlapping risks of violence, discrimination, and other challenges this population may face. Key takeaways reveal overall shortages in availability of services, and gaps in information-sharing and coordination. Most importantly, findings show a cultural disconnect with many MHPSS programs, calling for a rethink of how to design and implement services in a manner that better fit the realities and preferences of migrant communities. Ways forward include promoting cultural humility, community engagement, listening, and promoting agency in order to strengthen MHPSS practices that are grounded in and sensitive to the views of those migrating.

The voices and experiences of immigrant and refugee women in Canada have been conspicuously absent from policy issues, programme planning, and mental health literature. However, more immigrant and refugee women than men, from traditional cultures, are considered to have mental health needs, because of risk factors such as stress at the time of migration, and because of Canadian policies and programmes which disadvantage them. This study explores from the consumers perspective the reasons for disparate mental health service utilization between South Asian and Latin American women in Vancouver. Using a cross-sectional, exploratory, case study approach, and a feminist perspective, ten South Asian and ten Latin American women who have used mental health services were interviewed in depth. Sixty percent of the participants were survivors of violence and torture. Five Latin American women were survivors of pre-migration catastrophic stress. Their mental health needs were characterised by traumatic experiences, grieving and depression. Except for the three who were married, they had no traditional support networks. In contrast with the South Asian group they appeared to have less shame and covert behaviour. Mental illness, considered a ‘house secret’, carries great stigma in the South Asian community, and has serious ramifications for the immediate as well as the extended family. Among South Asian participants seven had been subjected to wife battering, and four of their spouses had a substance abuse problem. Their mental health needs were also triggered by traumatic experiences, grieving and depression. The more established South Asian women had extended family living in Vancouver, yet social support was still lacking. Having ‘no one to turn to’ was a pervasive theme across both groups of women; their experiences characterised by loss. Analysis of data exploring the decision to use services illustrates stages in a process of recovery from experienced violence. Post migration domestic violence and pre-migration violence have devastating, life-shattering consequences which require culturally sensitive interventions by social workers and other health care professionals. An obligatory stage in the clinical intervention process is to explore the issue of violence. Finally, policy decisions which impact upon women from ethnocultural communities in Canada must embrace a philosophy which considers well-trained, culturally-sensitive, linguistically—competent workers a priority.

The voices and experiences of immigrant and refugee women in Canada have been conspicuously absent from policy issues, programme planning, and mental health literature. However, more immigrant and refugee women than men, from traditional cultures, are considered to have mental health needs, because of risk factors such as stress at the time of migration, and because of Canadian policies and programmes which disadvantage them. This study explores from the consumers perspective the reasons for disparate mental health service utilization between South Asian and Latin American women in Vancouver. Using a cross-sectional, exploratory, case study approach, and a feminist perspective, ten South Asian and ten Latin American women who have used mental health services were interviewed in depth. Sixty percent of the participants were survivors of violence and torture. Five Latin American women were survivors of pre-migration catastrophic stress. Their mental health needs were characterised by traumatic experiences, grieving and depression. Except for the three who were married, they had no traditional support networks. In contrast with the South Asian group they appeared to have less shame and covert behaviour. Mental illness, considered a ‘house secret’, carries great stigma in the South Asian community, and has serious ramifications for the immediate as well as the extended family. Among South Asian participants seven had been subjected to wife battering, and four of their spouses had a substance abuse problem. Their mental health needs were also triggered by traumatic experiences, grieving and depression. The more established South Asian women had extended family living in Vancouver, yet social support was still lacking. Having ‘no one to turn to’ was a pervasive theme across both groups of women; their experiences characterised by loss. Analysis of data exploring the decision to use services illustrates stages in a process of recovery from experienced violence. Post migration domestic violence and pre-migration violence have devastating, life-shattering consequences which require culturally sensitive interventions by social workers and other health care professionals. An obligatory stage in the clinical intervention process is to explore the issue of violence. Finally, policy decisions which impact upon women from ethnocultural communities in Canada must embrace a philosophy which considers well-trained, culturally-sensitive, linguistically—competent workers a priority. / Arts, Faculty of / Social Work, School of / Graduate