Understanding immigrants' reluctance to use mental health services: a qualitative study from Montreal

Can J Psychiatry. 2006 Mar;51(4):205-9. doi: 10.1177/070674370605100401.


Objective: Studies suggest that non-European immigrants to Canada tend to under use mental health services, compared with Canadian-born people. Social, cultural, religious, linguistic, geographic, and economic variables may contribute to this underuse. This paper explores the reasons for underuse of conventional mental health services in a community sample of immigrants with identified emotional and somatic symptoms.

Method: Fifteen West Indian immigrants in Montreal with somatic symptoms and (or) emotional distress, not currently using mental health services, participated in a face-to-face in-depth interview exploring health care use. Interviews were analyzed thematically to discern common factors explaining reluctance to use services.

Results: Across participants' narratives, we identified 3 significant factors explaining their reluctance to use mental health services. First, there was a perceived overwillingness of doctors to rely on pharmaceutical medications as interventions. Second, participants perceived a dismissive attitude and lack of time from physicians in previous encounters that deterred their use of current health service. Third, many participants reported a belief in the curative power of nonmedical interventions, most notably God and to a lesser extent, traditional folk medicine.

Conclusion: The above factors may highlight important areas for intervention to reduce disparities in immigrant use of mental health care. We present our framework as a model, grounded in empirical data, that further research can explore.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Caribbean Region / ethnology
  • Cross-Sectional Studies
  • Emigration and Immigration / statistics & numerical data*
  • Female
  • Health Services Misuse / statistics & numerical data*
  • Humans
  • Male
  • Mental Disorders / ethnology*
  • Mental Disorders / therapy*
  • Mental Health Services / statistics & numerical data*
  • Patient Acceptance of Health Care / ethnology*
  • Quebec / epidemiology
  • Surveys and Questionnaires