A recent research (2019) conducted by the Finnish Institute for Health and Welfare (THL) revealed that immigrants use Finnish mental health services significantly less than those born and raised in Finland. The research also highlights the fact that, among those who have resided in Finland longer, the percentage of usage of mental health services is closer to that of the general population. The research does not provide answers to why this might be so, but asks relevant questions. Is it because some immigrant communities are mentally healthier than those who are born and raised in Finland; might it be due to stigma attached to mental illness; or is it due to lack of information on mental health services in Finland among immigrant communities? One might also add could it be the lack of services for immigrant communities or the heresay that mental health service providers ”simply don’t get” immigrants’ needs in mental health support?
Shortly after I started working for MIELI Mental Health Finland as a project officer I met Paola Elefante. Paola contacted me while working on a petition with a group of friends she had met online in a Facebook group. The petition was calling for equal opportunities for mental health care for all residents of Finland. Recently published National Mental Health Strategy (Feb, 2020) also draws attention to the very same objective. Among the priorities the strategy puts forward combatting prejudices, discrimination, misunderstandings and polarisation as well as putting forth coordinated services that correspond to individuals’ needs ensuring early access are highlighted. Paola and her friends were happy to see these points being raised in official papers but are worried about how suggested measures will be taken into practice. ”There is still long way to go”, she says.
I was curious to hear Paola’s story so we met.
We started talking about the petition first. She stressed on two things on the topic of mental health services and migrants: lack of accessibility to existing mental health services which is partly due to the lack of information provided for immigrant communities, and the perceived low level of proficiency of service providers in encountering diversity. The petition they published with the hashtag #iamSuomitoo received over 1000 signatures within the first couple of days after it was published on 6th of March.
As we talked on mental health in general, stigmas attached to mental health and mental health of migrants, Paola confessed me one thing; that she had learned what mental health really means and how important it actually is for everything, in Finland during her process of integration or settling in to Finland – as she put it.
”I’m one of the few lucky ones, I’ve never been unemployed in Finland. I came to study, decided to stay and continued with my PhD here. My then boyfriend, current husband, joined me later and we became a family with two children – one bio one adopted – and a support child, here in Finland. My kids and I are Finnish citizens now and this is where our lives are centred. I love Finland.”
Relatively speaking Paola’s settling in has been smooth. She has her family here. She has had work ever since she moved to Finland. She is an active blogger, a consciously active citizen volunteering in several NGOs, has a wide social network. Yet she told me the downsides of having chosen to live in a country where she did not grow up.
”You do not have your childhood friends near you nor your extended family members… Surely it does affect. Even though we have a wide network of friends, the stability of it is questionable. We’ve had a lot of friends who have left, moved elsewhere after several years living in Finland. People come and people go. That is tiresome after a while… we sometimes think whether we will have any friends close by when we are old.”
Paola speaks Finnish and has Finnish friends but it is different she says. ”Feels like there is always something missing. No matter how much you click with a Finnish friend, things you are familiar with are different – a person who has moved to Finland will always get you slightly better than someone who has always been here.”
And it is not about the language. Language indeed is a barrier, often listed as the number one barrier to integration. But it is not language; it is the grasping of how things are and work – that is more of a barrier to integration, thinks Paola.
”It never even occurred to me, for example, that I could go to Terveyskeskus (local health centre) for feeling low and depressed. No one even suggested to me that I could go there for other reasons than having a flu and fewer. For an Italian this system is very unfamiliar.”
”Although I speak Finnish I do not feel in control when everything around happens in Finnish. That will never be my mother tongue. Reading in Finnish will take triple the amount of time for me and trying to explain myself in Finnish to a doctor will never feel as natural. It does get demotivating…”
Paola, herself, likes to be there for people who have moved to Finland – may they identify themselves as refugees, immigrants or expats. She shares her experience, the practical information she has gained and the knowledge she has come to possess since 2010 – to make it slightly easier for the newcomers.
”It is not easy to do volunteer work in an all Finnish speaking environment either, but it is not only about self-empowerment, it is about empowering others too and giving something back.”
It probably was this very motive that triggered Paola and her friends to speak up and call for action.
”Finnish system works way better in many aspects, there are public mental health services to begin with; preventive and rehabilitating. But within the system migrants fall through cracks. It is designed by and for people who are born and raised in Finland. Let us pinpoint the cracks that exist, to make it better for all”.
Our discussion with Paola confirmed me, once again, the need for further cooperation in the field among different actors, raising awareness not only among immigrant communities but also among the local service providers on the diverse needs of the service users and the need for genuine inclusion at all levels. This is exactly what we strive for in MIOS project* (link in Finnish). While we hope to root the good practices emerging from MIOS project nationwide with the help of our member associations, we call for others working in the mental health sector also to develop their services with immigrants to be more inclusive of and easier to reach for immigrants.
*MIOS project provides group activities and online platforms for immigrants where one is allowed to stop and concentrate on their own mental health, where one can acquire new tools in strengthening their mental health and thus wellbeing; where one can expand his/her network and discover new places to rest one’s mind close by. The project wants to build bridges between people like Paola, who have moved to Finland and want to give something back to society, and member associations across Finland. MIOS encourages cooperation among those who have less experience working with diverse groups and multicultural work with those who are more experienced with diversity, mobility and inclusion.
TEKSTI: Melis Ari-Gurhanli
KUVA: Paola Elefante
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