How mental illness is attacking our immigrants

Loneliness, unemployment, the tough task of changing traditional ways—these obstacles are undermining the mental health of our million foreign-language immigrants. This searching study suggests some concrete remedies

SIDNEY KATZ January 4 1958

How mental illness is attacking our immigrants

Loneliness, unemployment, the tough task of changing traditional ways—these obstacles are undermining the mental health of our million foreign-language immigrants. This searching study suggests some concrete remedies

SIDNEY KATZ January 4 1958

Ever since man began traveling the world in large numbers there has been potential pain, anger, misunderstanding and frustration in sudden mass movements of people. With this in mind, Canadian government authorities and mental hygienists have constantly been asking identical questions about the almost one and a half million people who have come to Canada during the last eleven years. They are particularly concerned about two thirds of the immigrants—those from non-English-speaking countries who don’t know our language.

How are the New Canadians settling in? Are they being accepted by the Canadians who arrived earlier or were born here? Has an undue proportion of them succumbed to mental illness? Do they break the law more frequently than the rest of us?

In short, how well have the New Canadian families withstood the experience of being transplanted?

To find the answers to these questions, I recently spent several weeks talking to New Canadians and to people who have had a lot to do with them—immigration officials, welfare workers, employers, psychiatrists and clergymen.

The main conclusion will sound paradoxical to most people and startling to some. New Canadians have a lower crime rate than the national average. But their rate of mental illness is higher than the national average—perhaps alarmingly higher.

The vast majority of New Canadians are law-abiding, working at regular jobs and beginning to put down roots in Canada. Many of them, however, complain that this undramatic set of facts has been obscured by the widespread publicity given to individual acts of misbehaviour. Frank Glogowski, editor of a Toronto Polish weekly paper, says, "Every time one of our people gets into trouble the papers use the word ‘Pole.’ They don’t identify a native offender as a 'Canadian.’ All our people are not angels but this way the wrong impression is created." Glogowski also points out that any miscreant with a non-Anglo-Saxon name is automatically classified by the public as a New Canadian. Using this method of identification, in 1955 a high official in the attorney-general’s office in Ontario stated flatly that “ninety percent of the murders in this province in the last three years were committed by immigrants.” Later, he had to retract this statement because it was grossly inaccurate.

But there is little doubt about there being more mental illness among the foreign-born than among the native population. A national study by the Dominion Bureau of Statistics considered the mental health of New Canadians during 1948-55, by year of their arrival. In five of these eight yearly groups the first admission rate of immigrants to mental hospital was about ten percent higher than for the non-immigrant population. The report was prepared in 1956 and, significantly, the immigrants who had the best mental health records were those who arrived in 1954 and 1955. More of these may have experienced breakdowns since 1955. The Canadian Medical Journal explains that many immigrants arrive in this country emotionally weakened by hardship and punishment suffered in their former countries. “Studies in grief,” says a Journal editorial, "show that a lapse of time, measurable in years, may elapse between the initial distressing event and the overt, acute reaction to it.”

The emotional hazards of settling in a strange country are reflected in other studies as well. Dr. George C. Sisler of Winnipeg, after surveying first admissions to Manitoba's mental hospitals in 1952, found that the New Canadians had a twenty percent higher rate than the general population. James Wanklin, a research assistant in psychiatry at the University of Western Ontario, after studying the two thousand patients who had been admitted to two Ontario mental hospitals between 1950 and 1952, concluded that immigrant males between the ages of fifteen and forty-four who had been in the country five years or less had an admission rate about forty percent higher than nonimmigrants. Studies in the United States reveal that much the same situation exists there.

However, there’s an impression among many observers that the immigrant breakdown rate is higher than the statistics show. “Most New Canadians shy away from psychiatric clinics,” says Dr. Alastair MacLeod, a McGill University psychiatrist. Furthermore, a Toronto physician told me. “Many doctors don't report mental illness found in New Canadian patients. They don't want them deported." In the last eleven years the Department of Citizenship and Immigration has deported eight hundred immigrants for reasons of "physical and mental health.”

The mental-illness rate of immigrants may zoom upward because of the thirty five thousand Hungarians admitted in 1956. In their case, immigration authorities waived the usual rule that bars people with a history of mental illness. A psychiatrist who worked with a large group of Hungarians who arrived in Toronto told me. "I saw several psychotics among them. One man told me he came to Canada to escape his factory supervisor but he could still hear her voice, quite plainly, shouting at him. Two or three people showed the scars of brain operations. One had been operated on three times for a brain injury.”

"They're frightened strangers"

By symptoms, perhaps the greatest difference between the immigrant and nonimmigrant mental patient is the frequency with which the former experiences feelings of suspiciousness and persecution. “It's not surprising that they show paranoid trends." says Dr. Victor Szyrynski, a Polish psychiatrist now at the University of Ottawa. "They're frightened strangers in a new country who don't understand what's going on about them."

Dr. Libuse Tyhurst, after studying forty-eight New Canadian mental patients at Montreal's Royal Victoria Hospital discovered several male patients who believed that Canadian government authorities and employers had it in for them: that they were being spied on. A Toronto social agency told me about a client, a German woman over here for five years. She had gone to a lawyer, complaining that people on the street and on buses were laughing and talking about her. A TV performer, she claimed, insulted her during a program she was viewing. "I recognized him as a former RCAF pilot who bombed our city in Germany. He hates me and all Germans.” she said.

While the mental health of the foreign-born lags behind the national average, they surpass the native Canadian, according to a recent immigration department report, in their ability to live within the law. Surveying crime in Canada for the years 1951-54, the report concluded that the over-all crime rate of the foreign-born was only half that of the native Canadian. The report showed that immigrants born in the U. S. had the highest rate of conviction, followed by the Scandinavians and the British. The Italians were the least frequent offenders.

Differences in the “crime pattern” of the two groups are revealed by the study. In the foreign-born group, assault offenses and homicide rank second and eleventh respectively, in the list of thirteen crime categories. In the native group, they hold fourth and thirteenth place.

A closer examination of the study shows that certain groups of New Canadians—notably of Polish, German and Russian origin—when they do resort to violence, are provoked by anger in the heat of the moment. They are not likely to commit premeditated acts. The Hamilton and District Soccer League, in which the majority of players are New Canadians, is a case in point. In a recent match a disputed decision led to fierce fighting, involving players and fans. It was the third such incident in the season. Again, the ethnic press is constantly urging readers to restrain themselves at political and social gatherings of ethnic groups. Dr. Victor Kaye, a citizenship official who is an authority on ethnic groups, offers an explanation for these explosions. “The New Canadian’s social contacts are limited: he can’t speak the language: he's afraid to criticize anybody or anything. Feelings of frustration and anger build up inside him. Occasionally, he relieves himself by bursting out in violence."

It's possible that the 1956 influx of unscreened Hungarian immigrants will appreciably raise the crime rate of New Canadians in the near future. A number of newly arrived Hungarians told me that it's probable that a large number of prison inmates came over to Canada with them: during the revolt prison gates were thrown open. Only a few weeks ago a Toronto court sentenced a twenty six-year-old Hungarian for viciously beating up a lawyer. There was no provocation. After the trial Crown Counsel Bowman Galbraith observed that "quite a large number of criminals from Hungarian prisons have come to Toronto and are beating and extorting money from their fellow Hungarian immigrants." At about the same time, the Rev. Paul Piszai, spiritual director of the Hungarian community in Ottawa, complained that at least a dozen Hungarian girls had been beaten and tortured by a gang of fifty youths newly arrived from Hungary.

The greatest mental-health hazard to non-English-speaking New Canadians is the manner in which they are rejected by the vast majority of native Canadians. From New Canadians I heard the same story over and over again: “Canadians refuse to accept us. We are forced to live in isolation as a race apart.” A foreign-born member of the staff of Toronto’s International Institute, a private organization which encourages social activities between immigrants and native Canadians, told me. “Even liberal-minded Canadians who do volunteer work with ethnic groups . . . won't associate with us outside our club or invite us into their homes.” The editor of a Polish newspaper described how he lived in a "Canadian” neighborhood for six years. "Not a single door was opened to us. Once a father came to our house to inquire about the whereabouts of his child. That's the closest we've ever come to social contact.”

According to psychiatrist H. E. Lehmann, clinical director of the Verdun Protestant Hospital, professional people are often no better than laymen in accepting New Canadians. He says, "Psychiatrists are often hostile toward New Canadians, especially when they criticize our Canadian way of life." A supervisor of a large social agency told me. “Some of our social workers freeze up if a new client speaks in a foreign language.” This unfriendliness can have disastrous effects on the newcomers: they feel inferior, inadequate and their personalities disintegrate. "As soon as a person is isolated he develops a hunger for social contacts." says Alastair MacLeod of McGill. "If he is too long deprived he becomes unfit to accept social contacts. He may build his own world of paranoia."

Can the New Canadian's isolation be blamed on his own standoffishness? It's true that many immigrants refuse to take the initiative in making friends with Canadians. A Greek housewife told me, “We're strangers here and we're afraid to take the first step for fear of being refused.” The New Canadian is often criticized for setting up his own social and cultural groups. One doctor told me —and his views are shared by many native Canadians—"They should be scattered all over the city and thus forced to become Canadian.” Most authorities on immigrant problems disagree. Dr. Victor Szyrynski of the University of Ottawa, for example, says, "It's only natural for people in a strange land to want to live with their own group. Nor is it necessarily a bad thing.” It gives the newcomer a chance to learn something of the problems facing him from people who speak his language and have had a similar experience. Furthermore, the immigrant doesn't remain in his ghetto indefinitely. Many of them move out when they begin to feel secure.

According to Dr. Alexander Szatmari, a Toronto psychiatrist who comes in contact with many non-English-speaking immigrants, the extent to which an immigrant will withstand social rejection as well as the other rigours of his early life in Canada will depend mainly on three factors: his motives in coming here, the robustness of his personality and the amount of knowledge he has about conditions in Canada.

The worst risk is the immigrant who made a quick decision to come to Canada and who was chiefly motivated by the desire to run away from a personal problem. The Canadian Mental Health Association reports that the recent Hungarian immigrants included "an unusual number of people with broken marriages and personality problems." Says Richard Kolm of the International Institute: "The problem of adjusting to the new condition here is often only an added pressure.”

“What will happen to me?”

The first years are usually fraught with anxiety and insecurity. The chances are the immigrant came from a country where the state looked alter him when he became ill or unemployed. In Canada he soon realizes that the social-security system won't attend to all his needs. He lies awake nights, wrestling with the nightmarish question. "What will happen to me if I become sick or lose my job?” He dreads these eventualities because he knows they are sometimes valid grounds for deportation.

Whipped by these painful fears, he desperately tries to make as much money as possible, as quickly as possible. Money spells security. This early struggle is often damaging to his physical and mental health. A European army officer and his wife came to Canada and were forced to leave their two-year-old child behind. The father felt guilty about it. To provide a suitable home for the child as soon as possible, he worked in a store by day and as a bartender's assistant at night. Six months of this back-breaking routine, plus the burden of guilt that he carried, led to a psychotic breakdown. A twenty-eight-year-old German worked for six months and amassed enough money to send tor his wile and infant daughter in Frankfurt. No sooner had he mailed off the tickets than he lost his job and couldn't find another. When the woman and her child arrived in Canada, he wasn't at the station to meet them. Indeed, he seemed to have disappeared. Some days later he was found wandering the streets suffering from amnesia and too ill to eat or sleep. He is now in a mental hospital.

Like other parish priests ministering to New Canadians, Father Michael Smith, of Toronto's St. Casimir's Church, has seen such emotional damage. Most of his congregation are Poles who have come here since the end of World War II. "I'm often visited by couples who have been pushing themselves for maybe three, four or five years. Both husband and wife have worked long hours. They’ve taken no holidays. Now they've got some money, maybe a house. But they're nervous, high-strung and depressed. They don't have to work as hard any more but they don't know how to relax. I've had five suicides in my parish during the past five years."

Besides having to grapple with the problem of economic survival, many immigrants arrive in Canada handicapped by an unrealistic conception of their new land. An immigration official told me, "I have seen newcomers on the train rolling westward from Halifax terrified by the physical size of the country. They wonder, ‘What kind of endless wilderness am I getting into?' " Often, their ideas about our living standards are false. “Many of them feel that our streets are paved with gold" says John Eckertt, an immigration job-placement officer in Toronto. They are sure that they will soon have homes, cars, TV sets and other luxuries, unaware that many Canadians can't afford them even after years of hard work. Many laborers believe that hundred-dollar-a-week jobs are going begging.

For many New Canadians, the greatest struggle during the early days is for what sociologists call “vertical adjustment." In other words, they seek a place in society of comparable level to that which they enjoyed in their native land. The tragic figures in this struggle are some members of the professional and intellectual classes. They can't qualify in their former professions; they can't speak English; they're mostly in their forties and fifties, when it's difficult to start over again. Thus, the former editor-in-chief of a literary magazine wraps parcels; a former respected member of parliament runs an elevator; a well-known lawyer works as a hospital orderly; an army officer and a school inspector work on a factory production line. How many such people there are cannot be determined exactly. One study, by Miss C. L. Grant of the citizenship branch of the Department of Citizenship and Immigration, claims that twelve percent of a New Canadian group surveyed had “a greatly lowered occupational status" than in Europe. Frank Glogowski, editor of a Polish-language paper, estimates that about fifteen percent of the Poles who came here since War II are in this class. They feel useless and frustrated, and degraded because they must work with their hands and associate with people of lesser education.

One such unhappy figure comes from a distinguished old European family and graduated from university with honours. The best job he could get in Canada is as janitor in an office building. Ashamed, he has kept the nature of his work secret from everyone, including his wife. When asked about his job. he replies vaguely that he’s in “business administration.” In an attempt to put on a false front, he’s been living beyond his means and is now in financial difficulty. To make matters worse, his wife—who knows some English—started working six months ago and now holds a responsible office job. Formerly cheerful and charming, he is now bitter, irritable, taciturn and voluble in his criticism of Canada.

A European physician, now practicing in Montreal, told me, “I know a number of people of this sort. Some have been in the country as long as ten years. They have as little contact as possible with Canadians. Psychologically, they're still not in Canada. They probably never will be.”

In addition to occupational maladjustment, many new Canadians face possible dislocation within their own family circles. Family relationships in many European countries differ from those in Canada. The family tends to be “father dominated." The North American custom of the wife working at a separate job having her own bank account and pursuing her own interests with considerable freedom is one the husband finds it hard to get accustomed to.

However, conflicts between New Canadian parents and their children are even more frequent. The children mingle freely with Canadians of their own ages at school and on the street and soon acquire their language, values and interests. Brought up in a different culture, the parents sometimes resent this acceptance of what to them is strange. An American sociologist cites the case—and it could easily have happened in Canada—of the twelve-year-old boy who wanted to watch boxing on TV. The father was furious and ordered his son to bed. “Boxing is vulgar and barbaric,” he said. The boy went to his room but refused to go to sleep. From the living room the father could hear the son repeating, “Down with foreigners! Foreigners are anti-American!"

Language is often the subject of conflict. Many New Canadian parents make a rule—and it’s usually an unpopular one —that their children speak their native tongue at home. A Polish parent explained why. “The main reason is emotional. We think children should speak the language of their parents and grandparents. Second, how can our children inherit our culture if they don’t know the mother tongue?” Another reason is that without a common family language parental control is weakened.

In time, as the cultural gulf between parents and children widens, the children may become increasingly defiant. They may become ashamed of their parents and refuse to invite their friends home to meet them. “The child torn between two cultures may grow up to be hypersensitive, anxious and hostile,” says Victor Kaye, of the Department of Citizenship and Immigration.

If the non-English-speaking New Canadian happens to be a single male he has his own special problems to face. His prospects of enjoying female company or finding a woman he can marry are dim. If he hopes to marry a New Canadian girl, he finds they’re in short supply. For example, 1956 immigration statistics show that only half as many females as males between the ages of twenty and thirty arrived in this country. They are usually besieged by offers of marriage as soon as they're off the boat. But some New Canadian girls are reluctant to marry other immigrants. “We don’t want to be dominated," they say. “Canadian men are easier to live with.”

The New Canadian who aspires to court a Canadian girl runs the risk of being cold-shouldered. A young Pole said, “Canadian girls talk and dance with us at an affair sponsored by an organization or a club, but they won’t date with us privately.” A blond Italian, with a fairly good command of English, said, “I’ve gone out with girls who didn’t know I was Italian. When they found out, they dropped me. Women here tend to regard you as a ‘dirty immigrant.’ ”

How does the New Canadian resolve his problem? He can attempt to ignore it —but deprivation can lead to severe and troubling frustrations and serious sex conflicts. He may, as many do, resort to prostitutes. On the other hand, he may, as some do, become more aggressive in his search for women and this sometimes involves him with the law.

Some of the New Canadian’s difficulty is the result of the difference in Canadian and European wooing habits. In some European countries the “pick-up" is a socially acceptable way for people of the opposite sexes to meet. A man who tries the same thing in Canada may be hauled in by the police. Again, in certain European countries, certain remarks and expressions are regarded as invitations to the man to greater intimacy. Here they are without meaning and hence misinterpreted.

Social scientists have made an attempt to chart the psychological ups-and-downs of the immigrant from the moment of his arrival. During the first few weeks, according to Libuse Tyhurst, of Montreal’s Royal Victoria Hospital, the immigrant feels exerted and on top of the world. He has arrived in body, but not in mind. The next period — roughly up to about six months—is the period of “psychological arrival.” He has now come face-to-face with the practical problems of living. During this period New Canadians are apt to be anxious, depressed and critical.

From the point of view of the native Canadian, the most irritating symptom displayed by the immigrant during his early months here is his habit of criticizing life in Canada. No facet is immune— our women, food, housing, weather and culture. Most Canadians react to this criticism and argue back. They feel hurt because the New Canadian is so ungrateful. “This is the wrong approach,” says H. E. Lehmann, of the Verdun Protestant Hospital. “Even though it may be difficult, we must accept the immigrant’s criticism. It’s inevitable. It’s like adopting a child who’s been mistreated—you can’t expect him to be reasonable in all the things he says.”

The stress and strain of the early months frequently results in symptoms of physical illness in the immigrant. Victor Kaye, of the citizenship department, has been impressed by the large number of cases of psychosomatic illnesses found among New Canadians—chronic fatigue, insomnia, asthma, palpitations and stomach troubles. “Sickness can be used as an escape mechanism,” says Dr. Alex Szatmari, a Toronto Hungarian psychiatrist. “It’s also an effective way to obtain love and attention—two things that many new settlers desperately lack.”

After about two years, with average luck, most immigrants are handling their problems and beginning to feel at home. For many who are not, the end of the road may be a mental breakdown. Clergymen, social workers and psychiatrists face at least two serious difficulties when they try to help. One is that the New Canadian often refuses psychiatric help. Dr. Anthony Meszaros, a Montreal psychiatrist, told me, “I've found it difficult to explain to New Canadians what psychiatry is. They fear it. Everything connected with mental illness and mental hospitals terrifies them. During my years in clinic in Montreal I rarely had an immigrant patient who came on his own.” Dr. R. O. Jones, professor of psychiatry at Dalhousie University, comments, “One of the reasons they keep away is that they live in constant fear of being deported.”

Another difficulty in helping maladjusted immigrants is that there are not enough therapists who speak their native languages. “The use of interpreters in psychotherapy doesn’t work very well," says Dr. John Dewan, director of the Toronto Psychiatric Hospital Outpatients’ Clinic. “Patients hold back in the presence of a third person.” A psychiatrist in a Quebec hospital told me, “We’re so handicapped by language that sometimes we don't know whether we’re dealing with a patient who’s mildly or seriously ill. At times we’ve been forced to put the patient on the phone with a doctor in another hospital who speaks his language.”

What can be done to help the New Canadian to adjust with a minimum of emotional wear and tear? Perhaps the best way to answer this question is to summarize the suggestions I received from dozens of people I interviewed:

First, they advised caution. Integration must be a free process. “Any pressure to integrate us will have the opposite effect,” a New Canadian told me. Like his fellow countrymen, he still remembers foreign conquerors who attempted to assimilate them by threat lash and prison. A woman entered the study of a Catholic priest, whose parishioners were mostly Polish, and gave him a tongue lashing for preaching in Polish. “It's absolutely disgraceful!” she scolded. “You must switch over to English at once!” Later, the priest told me, “Had this woman been a little calmer, I might have explained to her that recently I've started to give one sermon a week in English. I'll increase that number just as soon as more of my parishioners learn the language. It's foolish to try to make my people accept an entirely new way of life completely. They would rebel. Leave them alone, and they will accept Canadian life in small doses of their own free will.”

It would be helpful if the public were prepared for the settlement of large numbers of immigrants by a vigorous program of education. “Too many people think that adjustment is easy,” says Dr. Charles Roberts, a psychiatrist with the Department of Health and Welfare, Ottawa. The press, radio, television, film and speakers should be used to spread information. Churches and private organizations could assume a more active interest in New Canadian problems. A Canadian program of education should include a sober and scientific explanation of the fact that many Canadians will dislike and fear the New Canadians. It’s not unnatural to hate strangers. “We should be told that we must accept criticism from them without striking back," says Dr. Lehman. “It’s not being disloyal —it’s being therapeutic. Striking back at these people at this time only makes matters worse. We should feel big enough and secure enough to realize that our country is not in danger.”

Our program of teaching New Canadians English should be stepped up. Language is important: it helps immigrants get jobs; encourages them to mix socially; gives them an insight into Canadian attitudes; tends to diminish their feelings of persecution. “We’ve only made a beginning at tackling this problem," says an immigration official, who points out that most of the classes are in large cities. “Any town with ten immigrants should organize a class. If there’re fewer, individuals should undertake to instruct them.”

Something should be done to make the New Canadians feel that they are not a race apart. At a community level they should be invited to take part in Community Chest drives, blood-donor campaigns; churches, schools, libraries, organizations should design their programs to include New Canadians. Social events should be held where the immigrants can meet with Canadians and talk about living in Canada. Perhaps such group activities will help New Canadians make friends and lead to invitations to Canadian homes. Acceptance by Canadian families, on an equal level, is the cherished goal of most New Canadians.

Finally, psychiatric clinics and social agencies should expand their services to take care of New Canadians with serious problems in adjustment. They should include staff members who speak foreign languages. They should advertise their services. One of the largest social agencies in Canada doesn't have a single sign in a foreign language explaining how they can help the newcomer.

Perhaps if such measures were adopted, we could more effectively communicate to the New Canadian that we care about him. He would be spared the emotionally corroding feeling that results from rejection. And, in this atmosphere of friendliness and acceptance, he could soon achieve his goal of being a healthy and useful member of our society.