Mental health at the intersections: understanding South Asian Muslim youth mental health in Peel Region, Toronto, Canada

• Date: 03 October 2024
• Pages: 613-633
• DOI: https://doi.org/10.1108/IJMHSC-04-2024-0046
• Published date: 03 October 2024
• Subject Matter: Health & social care,Vulnerable groups,Inequalities & diverse/minority groups,Sociology,Race & ethnic studies,Minorities,Multiculturalism,Racial identity,Work,economy & organizations,Labour movements
• Author: Farah Islam,Kashmala Qasim,Amal Qutub,Saamiyah Ali-Mohammed,Munira Abdulwasi,Yogendra Shakya,Michaela Hynie,Kwame McKenzie

Mental health at the intersections:

understanding South Asian Muslim

youth mental health in Peel Region,

Toronto, Canada

Farah Islam, Kashmala Qasim, Amal Qutub, Saamiyah Ali-Mohammed, Munira Abdulwasi,

Yogendra Shakya, Michaela Hynie and Kwame McKenzie

Abstract

Purpose –The purpose of this study was to understand the unique mental health concerns and access

barriers experienced by South Asian Muslim youth populations living in the Peel Region of Toronto, Canada.

Design/methodology/approach –For this qualitative exploratory study, interviews (n ¼15) were

conductedwith mental health professionals, educatorsand spiritual leaders (n ¼11) who work with South

Asian Muslim youth living in PeelRegion, as well as with South Asian Muslim youth themselves (n¼4,

aged 20–23).Interview transcripts were analyzedusing reflexive thematic analysis.

Findings –Four primary themes emergedfrom the data: challenges and stressors, barriers, facilitators

and hope and recovery. SouthAsian Muslim youth navigate a number of unique stressorsrelated to the

domainsof culture, religion and family dynamics, as well as the impactof migration.

Practical implications –The findings stress the necessity of creating culturally safe, multilevel

strategiesto meet the nuanced challenges and diverseneeds of South Asian Muslim youth communities.

Originality/value –This is one of the few papers to the knowledge that addresses the mental health

needs and service access barriers of youth populations at the intersections of South Asian diasporic

communitybelonging and Muslim faith in Canada.

Keywords Canada, Mental health, Youth, South Asian, Muslim, Mental health service access

Paper type Research paper

Introduction

Racialized populations in Canada doubled from 13.4% in 2001 to 26.5 % (9.6 million) in 2021,

with South Asian populations experiencing one of the largest in creases (Hou et al.,2023). In

many peri-urban regions surrounding major metropolis es in Canada, such as the Peel Region

(comprising Brampton, Mississauga and Caledon) located in the Gre ater Toronto Area,

racialized groups have recently seen substantial growth and oft en constitute the majority.

According to 2021 census data, the racialized population accou nted for over two-thirds

(68.8%) of the total population of the Peel Region. The Pe el Region is now home to one of the

largest South Asian populations (just over half a million), representing o ver one-third (37.4%) of

the total population and over half (54.3%) of the racialized population in the r egion (Region of

Peel, 2016). Islam is the third most widely practiced faith in Peel Region (5% in Peel Region:

4% in Brampton and 7% in Mississauga) (Region of Peel,2013a, 2013b).

Youth populations make up about a quarter of the population of Peel Region (Region of

Peel,2013a, 2013b). By the age of 25, one in five Canadians report a mental illness, and

(Informationabout the

authorscan be found at the

end of this article.)

Received 29 April 2024

Revised 15 July 2024

Accepted 10 September 2024

Funding: The research was

supported by a strategic

training grant from the

Canadian Institutes of Health

Research –Strategic Training

Initiative in Health Research

(CIHR-STIHR) provided for the

Social Aetiology of Mental

Illness (SAMI) Training Program

at the Centre for Addiction and

Mental Health (CAMH) and the

University of Toronto.

DOI 10.1108/IJMHSC-04-2024-0046 VOL. 20 NO. 4 2024, pp. 613-633, ©Emerald Publishing Limited, ISSN 1747-9894 jINTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE jPAGE 613

70% report that symptoms first began in childhood (Mental Health Commission of Canada,

2012). About one-third of youth in Canada aged 15 or older expressed that their mental

health needs were not met (Coulaud et al., 2023;Gorfinkelet al., 2023). Young people face

the greatest barriers to access to mental health care across the lifespan: delays in receiving

appropriate care, poor engagement with mental health programming, lack of continuity of

care as they transition out of children’s services to adult services, lack of involvement in

mental health planning and lack of evidence-based treatments and supports (Fusar-Poli,

2019;McGorry and Mei, 2018).

Studies indicate that newcomer, immigrant and refugee youth may be exposed to unique

risk factors, such as linguistic barriers within the education system and labor market and

challenges like income insecurity, unemployment and precarious employment (Shakya

et al.,2010

). Settlement stressors can also lead to mental health concerns such as difficulty

establishing friendships, bullying and susceptibility to stress, anxiety and low self-esteem

(Shakya et al.,2010;Smith et al., 2022). However, immigrant and refugee youth have some

of the lowest rates of mental health service utilization (Saunders et al., 2018) and are more

likely to present with their first mental health crisis in the emergency department compared

to nonimmigrants. This is associated with poorer outcomes and can lead to gaps in

continuity of mental health care (Saunders,2018).

South Asian individuals experiencing a major depressive episode reported the highest

proportion (48%) of unmet mental health care need and highest proportion (33%) of

perception of barriers to the availability of mental health care compared to eight otherethnic

groups in Canada (Gadalla, 2010). This may be even more challenging for South Asian

Muslim youth, as they inhabit a unique social position that impacts their mental health and

requires an intersectional investigation of racialization, culture, religion, immigration status,

age, gender and many others (Crenshaw, 1991).

For South Asian Muslim youth populations living in the diaspora, the stressors of migration

and resettlement have been found to play a major role in a young person’s mental health,

such as challenges in finding a cohesive cultural and religious identity in line with their

family’s expectations while juggling the expectations of their peers and the dominant host

culture (Islam et al.,2017;Sundar, 2008). In addition, South Asian Muslim youth may

experience racism from the external community in terms of religious and ethnic

discrimination (Maira, 2014) and, at the same time, experience discrimination internally

within South Asian communities based on class and skin color (Sadika, 2021;Shankar,

2008). External racism such as Islamophobia, discrimination against brown and black

bodies and internal discrimination such as colorism and classism have been associated

with serious mental health impacts such as higher levels of psychological distress

(Abdulrahim et al., 2012;Assari and Lankarani, 2017) and depressive symptomatology

(Ikram et al., 2016), higher levels of internalizing behaviors (Montgomery, 2008;

Montgomery and Foldspang, 2008), posttraumatic stress disorder, lower levels of

psychological well-being(Sadika, 2021) and self-harm (Chew-Graham et al., 2002).

Faith, cultural roots and connection to family, friends and the greater Mu slim community have

been found to be important resources for South Asian Muslim adult populations (Akram, 20 12;

Ahmad et al.,2013). Holistic practice of Islam, which encompasses personal worship, beliefs

and attitudes toward God, sense of belonging to the Muslim co mmunity and charitable

engagement in addition to ritual worship, has been found to be one of the strongest predi ctors

of Muslim mental well-being, life satisfaction and life purpose (Umarji and Islam, 2022). Islam

also intersects with mental health in complex ways when it comes to r eligious

conceptualizations of mental illness that can impact stigma as well as help- seeking behavior,

where Muslims may opt for spiritual care from a religious leader or scholar rathe r than seek

mainstream mental health services to deal with mental health challenges to prote ct the family

from negative consequences and shame (Al-Krenawi and Graham, 2000;Ali et al., 2005).

PAGE 614 jINTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE jVOL. 20 NO. 4 2024