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Visions Journal

Immigrants’ Mental Health

How the Changeways program can help

Irene Tang, RCC

Reprinted from the Recovery: Living Your Bestish Life issue of Visions Journal, 2022, 17 (4), pp. 7-8

Stock photo of a group of people talking

Can you imagine moving to a new country in your middle-age years without knowing many friends, customs or the language? Or cutting off connections and ties from your homeland? Many of us cannot, but immigrants do this every day. They may move to escape war or to find a better life for their children, but it is not easy to adapt and settle in a new environment. Immigrating can lead to distress and uncertainty.

With the Changeways program, a stress management service offered by S.U.C.C.E.S.S. (a multi-service agency), we set out to hear and empathize with the stories shared by immigrants who have experienced stress from immigration and settlement in Canada.

The program fills an important gap. In 2021 Edward Ng and Haozhen Zhang studied immigrant and refugee access to mental health services in Canada.1 They found that immigrants are less likely than their Canadian-born counterparts to report having had a mental health consultation. If the immigrant experience so often involves distress, what stands in their way?

Ng and Zhang named several possible obstacles immigrants might face in accessing mental health services, like transportation problems and getting time off work. Cultural obstacles might also factor in, such as a lack of culturally appropriate mental health services in their own language and stigma about mental health, which “can be more prevalent in many source countries among racialized immigrants.”1

At the Changeways program we try to overcome these hurdles. We help to bring awareness and prevent escalation of severe mental illness among immigrants. Through our work we’ve met individuals whose resilience has been tested in the settlement process:


Mei landed in Canada during the pandemic. The city was in shutdown mode and she could not commute to community services or attend English classes. She could only make minimal contacts in a new and strange city and developed no new friendships. Her loved ones in China were the only connections she had, but with a different time zone, there was only a short time frame to connect. Mei felt worried for her health and safety, and also about the pandemic. As a single person living in a new city, she felt very lonely, isolated and shut in by the four walls of her apartment. Gradually, she started developing symptoms of depression. She managed to find a family doctor who referred her to Changeways.


Gordon has lived in Canada for more than 10 years. He improved his English language skills and took courses to upgrade his professional skills. However, he was not satisfied with his work and career development. He did not find that his English-speaking employers acknowledged his hard work. Even though he took up more responsibilities than his English-speaking co-workers and was willing to shoulder more work, he did not get the promotion he desired. He questioned whether this was related to his interpersonal skills, or if he did not know how to “play the politics game.” There were subtle signs of discrimination and racism that Gordon did not dare to challenge.

With his frustration and feelings of unfairness Gordon often doubted his own abilities and spent more time perfecting his work. He could not sleep at night and lost his appetite. He lost weight over a short period of time and his emotions became unstable. Family members were worried and encouraged him to seek medical help. Gordon’s family doctor noticed his worsening emotional health and encouraged him to join the Changeways program.


Changeways is a seven-week group program offered to Chinese-speaking residents in Richmond and funded by Vancouver Coastal Health. Group participants meet in person weekly with the group facilitator to learn to cope with stress. Group exercises, sharing and discussions are just some of the many activities they undertake to become more familiar with the relations between thoughts, emotions and behaviours. Participants learn to recognize their own thinking and behaviour patterns, identify the underlying causes of their stress and manage these causes. Changeways also encourages participants to identify self-care strategies so they can find helpful means to reduce stress.

Since participants are immigrants to Canada they can easily share and understand the joy and pain of immigration and settlement in the new land. Many find support within the group and feel understood by other participants. Together, they often organize their own informal meetings and enjoy sharing and supporting each other.

Overcoming obstacles

Mei was glad that she joined the group and was able to make social connections with others. She was so isolated previously that her fears and anxiety had created physical health symptoms. With the completion of Changeways she made new friends and learned from others about Canada. She also became aware of the symptoms of depression and how these affect her body. This helped her to prevent escalation of future problems.

Gordon appreciated the facilitator and group members’ understanding of his frustrations. He became more aware of his own self-worth and value, and learned to find constructive means of expressing his emotions. Although there are many situations that he cannot change, Gordon learned to talk to some trusted group members and identify effective communication skills. He may consider finding another job and exploring channels within and outside his company to exercise his rights.

Managing one’s stress is a lifelong journey. Immigration is another journey that can produce more stressful experiences. Through the Changeways program we would like to help immigrants identify reasons behind their stress, learn means to manage it and find appropriate community resources. For more information, please contact the program through S.U.C.C.E.S.S., at 604.408.7274 ext. 2087, or email us at [email protected].

About the author

Irene has been a clinical counsellor for more than 20 years, working with individuals and families who suffer from depression, anxiety and relational difficulties. She also presents to diverse groups on addiction, parenting and stress management. Most recently Irene worked as program manager for counselling services at the BC multi-service agency S.U.C.C.E.S.S.

  1. Ng, E., & Zhang, H. (2021, June 16). Access to mental health consultations by immigrants and refugees in Canada. Health Reports 32(6).

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