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ISSN: 0963-8237 (print), 1360-0567 (electronic)

J Ment Health, 2015; 24(6): 414–422

! 2015 Taylor & Francis, LLC. DOI: 10.3109/09638237.2015.1078881

REVIEW ARTICLE

Migration and young people’s mental health in Canada: A scoping

review
Carla Theresa Hilario1, John L. Oliffe1, Josephine Pui-Hing Wong2, Annette J. Browne1, and Joy Louise Johnson3
1
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada, 2Daphne Cockwell School of Nursing, Ryerson University,
Toronto, Ontario, Canada, and 3Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada

Abstract Keywords
Background: Young people’s mental health is a public health priority. Given the influences of Mental health, mental illness, immigrant
migration and resettlement on mental health, synthesis of current research with young people
from migrant backgrounds can help inform mental health promotion initiatives that account History
for and are responsive to their needs.
Aims: This article distils the results of a review of published literature on the mental health of Received 3 December 2014
adolescent immigrants (ages 10–19) living in Canada. Revised 25 May 2015
Method: Scoping review methods were used to define inclusion and exclusion criteria; inform Accepted 9 June 2015
the search strategies; and extract and synthesize key findings. Published online 16 October 2015
Results: Fourteen articles met criteria for inclusion. Analysis of the studies indicate diversity in
mental health indicators, e.g., mental distress, emotional problems and behavioral problems, as
well as a wide range of influences on mental health from age at migration and length of stay to
place of residence, income and discrimination.
Conclusions: Findings support the need to account for the array of influences on young people’s
mental health in relation to migration and to augment initiatives beyond the level of individual
intervention.

Introduction (Statistics Canada, 2013).1 Mental health in young people

In the 2014 report Health for the World’s Adolescents by the
World Health Organization (WHO), young people’s mental
health was identified as an important public health priority.
Mental illness and related challenges are the top risk factors for
premature mortality and leading causes of disability for
adolescents (10–19 years old) worldwide (WHO, 2014). A
wide range of factors influence young people’s mental health
and illness: age, gender, family and peer relationships,
communities, physical environment, and social determinants
related to policies, equity, human rights, and globalization
(WHO, 2014). In particular, transnational migration and
resettlement contributes to an increasingly complex set of
circumstances and social context in which young people
experience mental health and illness.
The impact of migration on young people’s health is a
significant topic in Canada where more than one-fifth
of the population was born outside of the country
Correspondence: Carla Theresa Hilario, School of Nursing, University of
British Columbia, Vancouver, British Columbia, Canada. E-mail:
carla.hilario@nursing.ubc.ca
who have experienced transnational migration may be
influenced by factors directly or indirectly related to migration.
Population-based research conducted in western Canada
suggests that migration, indicated by foreign-born status,
does not significantly influence self-reported emotional
distress in young people (Smith et al., 2011). In contrast,
province-wide data from Ontario suggests that immigrant
youth report higher rates of emotional distress compared to
their Canadian-born peers (Hamilton et al., 2009). Similarly,
findings suggest that length of stay contributes to likelihood of
experiencing extreme despair among particular migrant groups
(Hilario, Vo, Johnson, & Saewyc, 2014). Despite these
variations in findings (depending on specific outcome,
sample, or setting), the purpose of this review is to understand
the range of influences on mental health in this population
rather than establishing migrant2 young people as a ‘‘high-
risk’’ group with poor mental health.
1
In 2013 alone, over 258 000 people, including immigrants and refugees,
became permanent residents of Canada and over 10 300 people filed
refugee claims (Citizenship and Immigration Canada (CIC), 2014). Over
the past decade, the top three source countries for permanent residents in
Canada have been China, India and the Philippines (CIC). The top three
countries of citizenship for refugee claimants have been China, Pakistan
and Colombia (CIC).
2
In this review, the terms ‘migrant’ or ‘migration’ refer to transnational
migration via economic and family class migration, government-assisted
refugee and refugee claimant channels (http://www.cic.gc.ca/).
DOI: 10.3109/09638237.2015.1078881
Some findings suggest that migrant young people, in fact,
show resilience within their circumstances. One study found
that, although more likely to live in poverty, there are lower
levels of emotional and behavioral problems in foreign-born
children compared to Canadian-born counterparts (Beiser
et al., 2002). Notwithstanding, poverty has been shown to
have a significant direct negative effect on emotional
problems in immigrant children that cannot be explained by
factors such as lone parent status, parental depression, and
ineffective parenting, which mediate the effect of poverty on
emotional problems among non-immigrant children (Beiser
et al., 2002). Statistics also show increasing evidence of social
and economic inequities associated with immigrant status3.
This has an impact on both mental health and access to mental
health care services, such as counseling, which are costly and
not comprehensively covered in medical service plans.
Canada’s mental health strategy has called for the
improvement of mental health initiatives and the reduction
of disparities in risk factors and access to mental health
services for ‘immigrants, refugees, members of ethnocultural
groups or those who are likely to be racialized’ (Mental
Health Commission of Canada, 2012). Because a large
proportion of immigrants may experience racialization as
‘‘visible minorities’’4, it is critical to develop mental health
promotion strategies that are inclusive and accessible to
migrant populations. We argue that initiatives must be
responsive to the needs of young people from immigrant
and refugee communities, account for the array of influences
that impact mental health and illness, and be informed by
existing empirical research. At present, there is limited
empirical evidence about the diverse mental health challenges
among migrant young people, an underserved population in
Canada. In this vein, we make the case for conducting a
scoping review of recent research in Canada on mental health
in this population.
The aim of this review was to map recent empirical
research on mental health and illness in relation to migration
among young people, specifically adolescents (ages 10–19).
Although we focus this review on research conducted in
Canada, in light of migration and resettlement policies that
are unique to nation-states, we contextualize our findings
within other research on young people’s mental health and
illness. The current article provides an overview of the
findings, limitations of the current literature, and some ideas
for how this review could inform mental health promotion
initiatives and future research.
In this review, we aimed to address two research questions:
 What empirical evidence exists regarding mental health
in young people from migrant backgrounds living in
Canada?
3
For instance, children growing up in recent immigrant families
experience levels of poverty as high as 49.6% compared to 16.4%
among children in non-immigrant families (First Call, 2011).
4
The term visible minority refers to ‘‘persons, other than Aboriginal
peoples, who are non-Caucasian in race or non-white in colour", as
defined by Canada’s Employment Equity Act of 1986; these groups
include Chinese, South Asian, Black, Arab, West Asian, Filipino,
Southeast Asian, Latin American, Japanese and Korean people (Statistics
Canada, 2012).
Migration and young people’s mental health 415
 What are some of the influences on mental health and
illness in this population?
Methods
A scoping review approach was selected in conducting this
study (Kastner et al., 2012). Scoping reviews can be used as a
means to providing a summary of research findings drawn
from existing literature wherein the primary aim is to identify
research gaps and/or to determine the value of undertaking a
full systematic review, including appraisal of the methodo-
logical quality of studies (Arksey & O’Malley, 2005;
Grimshaw, 2010). The current scoping review is informed
by these aims, focusing on identifying broad themes and
patterns, amid offering suggestions to frame efforts toward
mental health promotion by mapping existing empirical
findings (Levac et al., 2010). Specific steps included outlining
literature review objectives and criteria for inclusion, design-
ing and implementing search strategies, applying inclusion
criteria, data extraction, and analysis of included studies.
Search strategies
Three academic databases were searched: Cumulative Index
to Nursing and Allied Health Literature (CINAHL),
PsycINFO, and MEDLINE PubMed. Examples of search
headings and keywords include: ‘‘mental health’’, ‘‘mental
illness’’, ‘‘mental health promotion’’, ‘‘immigration’’,
‘‘immigrant*’’, ‘‘refugee*’’, and ‘‘newcomer’’5. Details of
the search strategy are described in Table 1. Articles retrieved
from these searches were exported to RefWorks, a reference
management software program, in which abstracts were
evaluated using the inclusion criteria:
(1) Focused on or reported disaggregated data on mental
health in migrant adolescents.
(2) Published in a peer-reviewed journal in the period of
2003–2013 (inclusive).
(3) English language publication.
The abstracts of articles retrieved from the literature search
were reviewed for relevance and full texts of articles retrieved
for closer review. In both stages of review, articles were
excluded if they were not conducted in Canada; did not focus
on adolescents or did not disaggregate findings based on age;
or did not have a significant focus on immigration or mental
health. Although we acknowledge the interrelatedness of
maternal health and mental health, studies focusing on
postpartum depression or pregnancy-related depressive symp-
toms were excluded because of the unique challenges related
to maternity and to clarify the scope of the review. Similarly,
while we recognize linkages between tobacco use and mental
health, studies focusing exclusively on tobacco use as the
phenomenon of interest were excluded in this review since
tobacco use is not commonly viewed as a mental health
challenge.
Due to practical considerations, only articles for which full
texts were available online were included. Editorials and
commentaries were excluded. Following scoping review
5
Asterisks (*) were used in some search terms as a wildcard symbol. In
Boolean Searching, this functions to make the search more effective by
including variations of the term.
416 C. T. Hilario et al.
Table 1. Literature search strategies.
CINAHL (n ¼ 42 articles)
[(Headings: mental health, mental disorders, mental health promotion,
community mental health nursing, mental health care, research,
mental health or attitude to mental illness) OR (keywords in abstract:
‘‘mental health’’ or ‘‘mental illness’’)] and [(headings: emigration
and immigration, immigrants or refugees) or (keywords in abstract:
‘‘immigrant*’’ or ‘‘newcomer’’)]
Limiters: Scholarly (Peer Reviewed) Journals; Published Date: 2003–
2013; Geographic Subset: Canada; Language: English; Age Groups:
Adolescent: 13–18 years
PsycINFO (n ¼ 23 articles)
[Thesaurus: mental health, community mental health, mental dis-
orders, primary mental health prevention or chronic mental illness]
and [(Thesaurus: immigration) or (keywords in abstract: ‘‘immi-
grant*’’ or ‘‘newcomer’’)] Limiters: Scholarly (Peer Reviewed)
Journals; Publication Year: 2003–2013; English; Subject Age:
Adolescence (13–17 years)
PubMed (n ¼ 44 articles)
[(Medical Subject Headings: mental health, mental disorders) or
(keywords in abstract: ‘‘mental health’’ or ‘‘mental illness’’)] and
[(Medical Subject Headings: emigration and immigration or emi-
grants and immigrants) or (keywords in abstract: ‘‘immigrant’’ or
‘‘immigrants’’ or ‘‘newcomer’’)] Limiters: journal articles, publica-
tion dates within 10 years, humans, English language, adolescents 13–
18 years
methods, methodological quality of the studies was not
appraised or used as a basis for exclusion. For the purpose of
this synthesis, review articles were excluded.
Data extraction and analysis
Standardized data extraction tables were developed and used
to guide data collection in regards to specific information in
the studies: setting, population, study purpose, research
design and key findings. Analysis was primarily descriptive.
Extracted data were analyzed and described according to
study population, design and key findings related to mental
health. Characteristics including study setting and methods
are summarized. Conceptualizations of and influences on
mental health are presented in the results section to reflect the
focus and key findings of the studies. The data extraction
tables were used to facilitate the process of selecting and
organizing the findings synthesized in this review.
Search results
A total of 14 articles met the inclusion criteria and were
included in the synthesis. Six articles reported on studies
conducted across Canada (Abada et al., 2008; Beiser et al.,
2010, 2011; Oxman-Martinez et al., 2012; Pahwa et al., 2012;
Patterson et al., 2013) and eight articles reported on regional
studies in Ontario (Beiser et al., 2012; Berman et al., 2009;
Hamilton et al., 2009; Hamilton et al., 2011; Khanlou &
Crawford, 2006; Montazer & Wheaton, 2011) and Quebec
(Rousseau et al., 2008; Rousseau et al., 2009). Several studies
focused on young people from specific regions or countries,
such as Hong Kong, Mainland China, Ethiopia, Philippines
and the Caribbean.
Three studies used qualitative in-depth interviews
(Berman et al., 2009) or mixed-methods including surveys,
focus groups and/or one-on-one interviews (Khanlou &
J Ment Health, 2015; 24(6): 414–422
Crawford, 2006; Rousseau et al., 2009). The majority of
articles (n ¼ 12) report on results from correlational studies
conducted using quantitative survey methods. Characteristics
of the included studies are summarized in Table 2.
Mental health conceptualizations and influences
A range of conceptualizations were used to investigate mental
health: mental or psychological distress (Hamilton et al.,
2009; Pahwa et al., 2012); depressive symptoms (Abada, Hou,
& Ram, 2008); 12-month prevalence of mood, anxiety or
substance use disorder (Patterson et al., 2013); emotional
problems (Beiser et al., 2010, 2011, 2012; Hamilton et al.,
2011; Rousseau et al., 2009; Montazer & Wheaton, 2011);
physical aggression and behavioral problems (Beiser et al.,
2010; Hamilton et al., 2011; Montazer & Wheaton, 2011;
Rousseau et al., 2008); substance use (Hamilton, Noh, &
Adlaf, 2009); and self-esteem (Khanlou & Crawford, 2006;
Oxman-Martinex et al., 2012). These conceptualizations or
outcomes may, in part, reflect the disciplines in which the
studies are situated, e.g., psychology, psychiatry and nursing.
Mental health influences include but are not limited to
immigrant generation, length of stay and age at migration,
country of origin and level of economic development in
country of origin, place of resettlement and urban residence,
parental ability to speak one of the Canada’s official languages,
family income, family relationships, school and neighborhood
environment, experiences of harassment and racism, experi-
ences of uprooting and disconnection, and sex. The following
section provides an overview of the study results organized by
some of the key hypothesized influences on mental health.
Immigrant generation
Studies examined the relationship between immigrant gener-
ation and psychological distress and substance use (Hamilton
et al., 2009); and externalizing (e.g., aggression, hostility) and
internalizing (e.g., anxiety, depression) mental health symp-
toms (Montazer & Wheaton, 2011). Hamilton and colleagues
found that first-generation (foreign-born) immigrant youth
reported higher levels of psychological distress than second-
generation (Canadian-born with at least one foreign-born
parent) youth and that there was no significant difference in
distress between second and third or later generations
(Canadian-born with Canadian-born parents). The reverse
pattern was found for substance use and delinquency, which
were lowest among first-generation youth compared to second
or subsequent generations. In contrast, Montazer and
Wheaton found no significant differences in symptoms by
generation except among youth from countries of origin at the
lowest levels of economic development.
Length of stay and age at immigration
Four studies examined mental health in relation to length of
stay and/or age at immigration. Length of stay was not
associated with emotional distress or physical aggression
(Hamilton et al., 2011) or with self-esteem (Oxman-Martinez
et al., 2012). Pahwa et al. (2012) found an inverted U-shaped
relationship between length of stay and mental distress in
which immigrants who have been in Canada for less than two
DOI: 10.3109/09638237.2015.1078881 Migration and young people’s mental health 417
Table 2. Characteristics of included studies.

Study sample
Age
References Countries of origin Outcomes Influences Design & methods
Abada et al., 2008 16–17 Depression Harassment Longitudinal
National Immigrant status Canadian Longitudinal
Not stated Sex Survey of Children and
Parental age Youth
Parental education
Single-parent family
Low-income status
Neighborhood cohesion
Parental nurturance
Peer support
Attachment to school
Harassment at school and other
influences
Beiser et al., 2010 11–13 Emotional problems Age cohort Cross-sectional
National Physical aggression Sex NCCYS
Hong Kong, Parental education
Philippines, China Parental marital status
Country of origin
Region of resettlement
Parental
English/French fluency
Parental resettlement stress
Parental perceived prejudice
Ethnic concentration
Low income
Parental depression
Positive family function
Neighborhood cohesiveness
Parental social support
Beiser et al., 2011 11–13 Emotional problems Region of resettlement Cross-sectional
National Sex NCCYS
Hong Kong, Parental social capital
Philippines, China Household income
Work-related stress
School relationships
Marginalization
Neighborhood quality
Beiser et al., 2012 11–13 Emotional problems Sex Cross-sectional
Regional Parental education NCCYS
Ethiopia Parental depression and somatization
Poverty
Dissonance re: ethnic way of life
Perceived prejudice
Perceived discrimination
Berman et al., 2009 14–19 Implications for mental Themes Qualitative
Regional health nursing Group and individual
Saudi Arabia, interviews
Somalia, Korea, Iran, Iraq
Hamilton et al., 2009 12–19 Psychological distress Immigrant generation Cross-sectional
Regional Substance use Sex 2005 Ontario Student Drug
Not stated Age Use Survey
Family (biological or adoptive par-
ents)
Parental education (university degree)
Urban/rural residence
Hamilton et al., 2011 11–13 Emotional distress Sex Cross-sectional
Regional Physical aggression Age NCCYS
Hong Kong, Philippines, Parental perception of school envir- Subsample in Ontario
China onment
Family dysfunction
Parental depression
Years since immigration
English fluency
Relative living conditions
Ethnicity of parent
Parental education
Household income

(continued )
418 C. T. Hilario et al. J Ment Health, 2015; 24(6): 414–422

Table 2. Continued

Study sample
Age
References Countries of origin Outcomes Influences Design & methods
Khanlou & 17 (average) Self-esteem Self-concept Cross sectional
Crawford, 2006 Regional Relationships Survey, focus groups and
Korea, China, Russia, School individual interviews
Taiwan, Macao Achievements
Lifestyle
Montazer & 9–16 Externalizing & Immigrant generation Cross-sectional
Wheaton, 2011 Regional internalizing symptoms Country of origin 1993–1996 data from the
81 countries of origin Family conflict Toronto Study of Intact
Close and caring family Families Survey
Social involvement
Peer and social influence
Sex
Age
Maternal mental health
Maternal education
Ethnicity
Socioeconomic status
Oxman–Martinez 11–13 Self-esteem Perceived discrimination Cross-sectional
et al., 2012 National Social exclusion NCCYS
Hong Kong, Philippines, Age
China Sex
Ethnicity
Family structure
Parental education
Region of settlement
Length of time since arrival
Pahwa et al., 2012 15 and over Mental distress Ethnicity Cross-sectional
National Immigrant status 1994/1995 to 2004/2005
Sex Canadian National
Age Population
Marital status Health Survey
Rural/urban residence
Length of time in Canada
Geographical areas
Education
Income
Social support
Smoking history
Household smoking
General health status
Time point (survey cycle)
Patterson et al., 2013 15 and over 12 month prevalence of Immigration at age 56 Cross-sectional survey 2002
National mood, anxiety or substance Immigration at age 6–17 Canadian Community
North America (other than use disorder Region of origin Health
Canada); South & Central Current age Survey, Mental Health and
America and the Caribbean; Sex Well Being
Europe; Africa; Asia and Education
Oceania. School attendance
Marital status
Urban/rural residence
Household income
Household size
Visible minority status
Rousseau et al., 12–19 Conduct disorder Sex Cross-sectional
2008 Regional Externalizing behaviors: Age
Caribbean, Philippines rule breaking, aggressive Ethnic group
behaviors Immigrant generation
Years in Canada
Separation by migration
Family conflict
Family cohesion
Collective self-esteem
Experiences of racism
Parental education
Income

(continued )
DOI: 10.3109/09638237.2015.1078881
Table 2. Continued
Study sample
Age
References Countries of origin Outcomes
Rousseau et al., 12–19 Internalizing & externaliz-
2009 Regional ing symptoms
Caribbean, Philippines
years or over 20 years were less likely to report moderate/high
levels of mental distress than those who had lived in Canada
for two to 20 years. However, immigrating before the age of
six years old was associated with higher risk for mood,
anxiety and substance use disorders, even after controlling for
length of stay (Patterson et al., 2013).
Country of origin and ethnicity
Prevalence of emotional problems and physical aggression
differed between migrant youth from the Philippines,
Mainland China and Hong Kong (Beiser et al., 2010).
Similarly, rates of internalizing symptoms differed between
Caribbean and Filipino youth (Rousseau et al., 2009). Some
findings also suggest higher odds of current mood disorders
among immigrants from South or Central America or the
Caribbean compared to Europe (Patterson et al., 2013).
Although Montazer & Wheaton (2011) found no significant
relationship between mental health symptoms and ethnicity,
there was a significant interaction effect between immigrant
generation, level of economic development in the country of
origin (defined as gross national product per capita) and
mental health.
Place of resettlement and urban residence
Place of residence was associated with emotional problems
and correlates of mental health such as social capital,
neighborhood social organization and marginalization
(Beiser et al., 2011, 2012). For instance, living in Toronto
or Montreal was associated with higher levels of emotional
problems among recent immigrants compared to living in
Vancouver or the Prairies (Beiser et al., 2011). Similarly,
higher levels of emotional problems and perceived discrim-
ination were found among immigrant Ethiopian youth living
in Toronto compared to peers in Ethiopia (Beiser et al., 2012).
In contrast, Oxman-Martinez et al. (2012) found no signifi-
cant relationship between place of resettlement and self-
esteem.
Findings also suggest a relationship between urban resi-
dence and higher odds of reporting moderate/high levels of
mental distress (Pahwa et al., 2012). Urban residency was
associated with higher odds of a current substance use
disorder but not with a current mood or anxiety disorder
(Patterson et al., 2013). In another study, it was not
Migration and young people’s mental health 419
Influences Design & methods
Sex Cross-sectional
Age Mixed methods: survey
Immigrant generation focus
Years in Canada groups
Separation by migration
Family conflict
Family cohesion
Collective self-esteem
Experience of racism
School attitude-bonding
Parental education
Income
significantly associated with psychological distress or sub-
stance use (Hamilton et al., 2009).
Parental linguistic proficiency and education
Parental fluency in the official language of the region of
resettlement (i.e., English or French) was associated with
emotional problems (Beiser et al., 2010, 2011) but not with
physical aggression (Beiser et al., 2010). In contrast, another
study found that English language fluency was not related to
emotional distress or physical aggression (Hamilton et al.,
2011). In terms of parental level of education, two studies
found that it was significantly associated with psychological
distress (Hamilton et al., 2009) and with emotional problems
before controlling for migration-related factors (Beiser et al.,
2010). However, parental education was not related to
emotional problems among migrant youth from Ethiopia
(Beiser et al., 2012).
Household income
Montazer & Wheaton (2011) found that higher household
income was related to lower odds of reporting internalizing
symptoms but not to odds of externalizing symptoms. Other
studies found that low annual income (measured as total
household income below $15 000–$30 000) was not related to
likelihood of reporting emotional problems or physical
aggression (Beiser et al., 2010, 2011; Hamilton et al.,
2011). Similarly, there was no significant association between
household income and current mood, anxiety, or substance
use disorder (Patterson et al., 2013).
Family relationships
Family relationships, specifically levels of conflict, were
associated with problem behaviors (Rousseau et al., 2008) as
well as with internalizing and externalizing symptoms of
mental health (Rousseau et al., 2009). Montazer & Wheaton
(2011) also found that family conflict and parental care were
related to externalizing and internalizing symptoms. Hamilton
et al. (2011) found a relationship between family dysfunction
and emotional distress but was no longer significant after
controlling for migration-specific variables (e.g., length of
stay, ethnicity). In contrast, Beiser et al. (2010) found that
positive family function was not related to physical aggression
420 C. T. Hilario et al.
but was significantly associated with emotional problems
even after controlling for migration-specific variables.
Parental depression
In all five studies that examine the role of parental depression
it was found to be associated with poorer mental health in
children and youth. Parental depression was associated with
emotional problems (Beiser et al., 2010, 2011, 2012;
Hamilton et al., 2011) and physical aggression (Beiser
et al., 2010; Hamilton et al., 2011). Similarly, maternal
depression was related to higher levels of externalizing and
internalizing mental health symptoms (Montazer & Wheaton,
2011).
School and neighborhood environment
Parental perceptions of school environment were associated
with physical aggression but not emotional problems
(Hamilton, Marshall, Rummens, Fenta, & Simich, 2011).
Mental health was also related to youth’s attitudes toward
their teachers, schoolwork, and sense of safety at school
(Rousseau et al., 2009). Perceived neighborhood cohesive-
ness, defined as the extent to which neighbors were perceived
to help each other, was not associated with emotional
problems or physical aggression (Beiser et al., 2010).
Disconnection and displacement
In Berman et al. (2009), newcomer girls described the need
for safe spaces in their community and to be able to speak
about their migration and resettlement experiences as they
relate to belonging and marginalization. These experiences
were linked to notions of identity and space, articulated in
themes described as uprooting, disconnection and displace-
ment. Uprooting referred to migration from their countries of
origin, which required them to leave behind families, friends,
and a familiar country. Disconnection from community and
culture often stemmed from a sense of ‘‘being different’’.
Lastly, themes of displacement referred to newcomer spaces
often marked by downward mobility, financial challenges, and
a constant reminder of their marginal space in Canadian
society. The authors describe the need for newcomer girls to
negotiate spaces of belonging through a sense of community
and for social conditions in Canada that would allow
newcomers to achieve their hopes and dreams.
Harassment and racism
Several studies examined the role of harassment, racism, and
ethnic discrimination. Oxman-Martinez et al. (2012) found
that perceived ethnic discrimination, particularly from
teachers, was associated with lower self-esteem among
young immigrants. Similarly, Beiser et al. (2010) found that
parental perceptions of prejudice (e.g., ‘‘A lot of Canadians
tend to look down on people from my country’’) were
associated with higher levels of emotional problems and
physical aggression. Perceptions of racism, particularly self-
reported experiences of aggression motivated by racism, were
associated with problem behaviors (Rousseau et al., 2008) and
with externalizing and internalizing mental health symptoms
(Rousseau et al., 2009). Furthermore, the impact of
J Ment Health, 2015; 24(6): 414–422
harassment on mental health was greater among immigrant
than non-immigrant youth, that is, immigrant youth were
more likely to report depression if they had experienced
harassment including verbal aggression, threat, and/or assault
(Abada et al., 2008).
Sex
Biological sex, defined as male or female in the articles and
referred to as gender in some articles, was consistently
investigated in the studies. Findings suggest that male sex is
associated with higher odds of externalizing symptoms
(Montazer & Wheaton, 2011) and physical aggression
(Beiser et al., 2010; Hamilton et al, 2011) and lower odds of
internalizing symptoms (Montazer & Wheaton, 2011), psy-
chological distress (Hamilton et al., 2009), and moderate/high
mental distress (Pahwa et al., 2012). In Oxman-Martinez et al.
(2012), immigrant boys reported higher rates of discrimination
than girls, which in turn predicted lower levels of self-esteem
and perceived social competence in peer relationships.
However, other studies found no significant sex-based differ-
ences in emotional distress (Hamilton et al.), emotional
problems (Beiser et al.), problem behaviors (Rousseau et al.,
2008), internalizing or externalizing symptoms (Rousseau
et al., 2009), or substance use (Hamilton et al.).
Discussion
This article outlines findings from a systematic search and
scoping review of peer-reviewed published literature on
migration and mental health, a key public health priority,
among young people in Canada. To the authors’ knowledge,
no such review has been conducted in recent years. Findings
from our review indicate a range of influences on mental
health in young people from migrant backgrounds in Canada.
Key findings from the studies pertain to immigrant gener-
ation, length of stay and age at migration, country of origin
and level of economic development in country of origin, place
of resettlement and urban residence, parental ability to speak
one of Canada’s official languages, family income, family
relationships, school and neighborhood environment, experi-
ences of harassment and racism, experiences of uprooting and
disconnection, and sex.
Our analysis of the literature suggests that current empir-
ical evidence on the mental health of young people from
migrant backgrounds is mostly based on cross-sectional
designs using survey methods. The ‘snapshot’ findings may
hinder knowledge exchange efforts due to challenges in
effectively applying and contextualizing results. The predom-
inance of quantitative survey studies identified through the
current review reflects a view of evidence that assumes
researchers are able to ask culturally and socially relevant
questions, and accurately discern the underlying issues and
correlational relationships. In many studies, data was col-
lected from parents and mental health was measured using
existing scales. How mental health and illness are experienced
and described by youth still merits exploration. In this regard,
studies that foreground rich in-depth information are needed
to augment survey data to advance understandings of the full
range of experiences and contexts influencing mental health,
DOI: 10.3109/09638237.2015.1078881
including strategies that young people would find most
relevant and supportive. Qualitative research offers a promis-
ing set of strategies to help contextualize population data. In
addition, incorporating research focused on process and
change across time might also garner benefits to provide
some guidance about insertion points (e.g., time, place and
sub-group) for targeted mental health promotion initiatives
(MHCC, 2012) that are inclusive and responsive to the needs
of all young people.
Limitations of the review pertain to our methodological
approach and review of studies that include various migrant
populations. First, our review does not provide an appraisal of
the methodological quality of the studies, which is consistent
with scoping review approaches, but may limit interpretation
of the findings in regards to research quality and significance
of mental health influences investigated in these studies. We
also viewed a narrative style of summarizing key findings to
be appropriate given the emergent nature of the field. Since
our aim was to explore the scope of the current literature,
rather than determine the most significant influences on
mental health, we suggest that this review provides a starting
point for further analysis of the literature. Second, we
recognize the limitations and potential implications of
drawing on more inclusive definitions of ‘migrant’ and
migration, i.e., economic and family class migration as well
as government-assisted refugee and refugee claimant chan-
nels. In doing so, our aim was not to conflate the unique
experiences of different migrant groups but rather to explore
the scope of research conducted with young people who have
experienced a range of personal migration biographies. We
acknowledge great heterogeneity within this grouping and
argue for the need to carefully consider this diversity as a
lynchpin to devising relevant interventions that address
unique needs of particular groups.
The emergent literature in Canada suggests that, while
mental health in migrant young people may be associated
with similar influences that have been identified among non-
immigrant populations, important insights can be gleaned
from investigating migration-specific variables and the rela-
tionships between ‘‘universal’’ factors such as sex as they
intersect with migration. For instance, there were no signifi-
cant sex-based mental health differences in several studies in
the review, a finding reflected in another study with
immigrant youth in Canada (Nguyen et al., 2011) but which
contrasts with prevailing notions of higher rates of depression,
distress and internalizing symptoms among females. In our
review, we found that sex was primarily investigated as a
covariate or background variable in the studies. Although this
type of analysis provides information on sex-related trends,
there is a large gap in research that employs an explicit gender
relational framework to unpack mental health and illness.
Gender relational approaches may help better understand the
presence or absence of sex-based differences in mental health
status and provide further insights for the development and
evaluation of mental health initiatives for young men, women
and gender diverse people.
Future research is also needed to further examine the
relationships between mental health, racism and other forms
of discrimination (Edge & Newbold, 2013). Previous research
has shown that among adult immigrants those who have
Migration and young people’s mental health 421
experienced racism and/or discrimination and who are visible
minorities are most likely to experience declines in mental
health compared to other recent immigrants (DeMaio &
Kemp, 2010). Similarly, findings from this review suggest
that migrant youth who face discrimination, prejudice or
racism are significantly more likely to experience higher
levels of emotional problems and physical aggression. Studies
on the pathways in which discrimination influences mental
health among young migrants in the context of their everyday
lives are needed to inform policy and practice.
In summary, the current review is a synthesis of recent
empirical literature on mental health and migration among
young people in Canada. The overall findings indicate that
mental health in this population is shaped by a myriad of
social and economic factors at the individual, family,
community and societal levels. Evidence suggests that
mental health services and supports might focus on first-
generation migrant youth and those who migrate before age
six to address the high levels of distress and odds of
experiencing mental illness, respectively. While some sex-
based differences reflect patterns observed in other studies
with non-migrant populations, this review also found no
significant differences in a number of mental health out-
comes. Though sex differences are contested in this regard
there may be benefit to pilot-testing gender-specific
approaches to formally evaluate interventions targeted to
young men and young women. In addition, the post-migration
mental health of young people is influenced by the settlement
experiences of their parents in terms of employment, house-
hold income and integration. Parental depression is consist-
ently associated with poorer mental health among migrant
youth, suggesting that the experiences of youth living with
parental mental illness is an important focus for future
research and targeted interventions. Given the increasing
national and international efforts towards young people’s
mental health, the current review findings offer some insights
to guide future services and research.
Declaration of interest
The authors report no conflicts of interest. The authors
alone are responsible for the content and writing of this
article.
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