The study results highlight the impacts of the COVID-19 pandemic on the daily lives of immigrants to Canada. Confusion, fear, and uncertainty about the future experienced by study participants impacted mental health and all other aspects of life as is extensively reported (4, 29–32). The death of 23 elderly post-vaccination in Norway further increased fear and concern about vaccine safety (33). Participants reported feeling bored, lonely, and sad. Negative impacts of restrictive interventions, quarantine, and social distancing, on mental health of all ages reported by study participants were observed in other studies (1, 19, 20, 32, 34, 35).
Quarantine and social distancing segregated the elderly from their extended family, their primary sources of social and daily support (21, 36). Elderly participants mentioned that the fear of infection, losing family and friends, and social isolation cumulatively created stress as reported in other studies (21, 34–36). For younger participants, relocation stress was further augmented by the fear of infections, death, loss of family members, and economic and social challenges as the pandemic unfolded (31, 32, 34). Study participants also reported being unable to form social connections with other immigrants who were cognizant of their life challenges or gain their support. Lack of social support during grief and loss experienced by a few participants was identified as an important source of stress in the literature (31, 34). Delayed language development, restlessness, difficulty in managing children, and overuse of technology were reported by participants as negative impacts of social isolation for children as reported in another study (37). As observed in the literature (38, 39), the study results highlight the importance of social networks and support from mature immigrant families for the smooth integration of new immigrants.
Consistent with the literature, participants used various social media platforms such as WhatsApp, WeChat, etc., to stay connected and maintain family cohesion (40–43) and YouTube to pursue hobbies, exercise, and new skills to stay productive and cope with stress. Technology overuse negatively impacted the physical and mental health of all age groups (44, 45). Participants relied on social media for COVID-19-related information. Studies cautioned against the spread of misinformation through social media (46–48). Disseminating misinformation publicly, especially among new immigrants can be risky due to language barriers and unfamiliarity with the host culture. Participants greatly appreciated the discussion sessions that provided tailored, credible, and current health information, enabling them to participate in the national pandemic response.
Coping strategies employed to address adverse situations varied with age groups and gender (49, 50). Elderly participants mentioned reflecting on the bigger picture, insights, lessons learned, having patience, and accepting the inevitable in situations beyond one's control. While young participants engaged in productive household activities, caring for family, reconnecting with estranged friends, revisiting hobbies and activities, etc. Younger male participants pursued skills development, hobbies, and technology. Increased technology use, video games, and television usage were reported among children. Participants reported complying with all public health directives and vaccine uptake was high among participants. Most participants mentioned having faith in a higher power supported them during difficult times.
As observed in other studies (25, 51–53) mental wellness emphasized through self-help strategies, gratitude, self-love, and self-care during the pandemic was well received. Facilitators and RIWC staff shared their perspectives, encouraging participants to focus on positive self-characteristic by maintaining a gratitude journal as proposed by Fishman (51). Consistent with the literature, participants mentioned engaging in positive activities, religious activities, prayers, and reflection on the profound meaning and lessons during the pandemic to cope with stress (4, 25, 50, 54). This offered hope, and enhanced mental strength and resilience during the pandemic (4). Encouraging participants to share such insights collectively allowed them to meaningfully learn from each others’ experiences and support each other and adopt a positive mindset (4, 54). The pandemic created unprecedented challenges for countries, governments, health systems, communities, families, and individuals, dismantling known and established ways of functioning and living (4, 55). Governments, health systems, families, and individuals were often forced to arrive at decisions under tight timelines. Historically the human race has shown great strength and unwavering resilience in responding to natural and or man-made disasters such as the destruction of the New York World Trade Centre, the Sumatran tsunami, Hurricane Katrina, and war and infectious diseases that continue to disturb global stability (4, 55). Consistent with the “3 Cs (control, coherence and connectedness)” models of resilience mentioned by Reise (55), this study documents unaverred resilience demonstrated by study participants in managing the crisis as the pandemic unfolded. The open discussion sessions were instrumental in promoting resilience and enhanced preparedness to deal with the ongoing crisis. First, by offering credible and current public health information the open discussion sessions enabled participants to engage in the national pandemic response. Participants collectively discussed new challenges and potential solutions as the pandemic progressed thereby installing a sense of control during uncertain times. The self-help strategies, gratitude, and positive self-talk presented in partnership with role models from the same ethnic groups equipped participants with useful tools to address mental distress and experience a sense of control during stressful times. Second, coherence was emphasized by encouraging participants to reflect and share their perspectives on the bigger picture, lessons learned, and insights. This allowed participants to collectively make sense of the public health directives and responses from governments, health systems, and communities. Finally, the discussion session offered opportunities to develop social connections with others in similar situations and the ability to collectively examine the challenges and find solutions. Participants mentioned finding kinship, and support during trying times (25).
As we focus on rebuilding our lives post-pandemic, it is important to reflect, curate lessons learned, and employ those to bolster our emergency preparedness. As previously observed, programs offered in collaboration with community organizations can support immigrants during the resettlement phase (23).The language-assisted discussion sessions offered through the study served dual purposes. First, they were effective in disseminating credible health information relevant to the local context. Second, the discussion session offered opportunities to develop social connections with others in similar situations and the ability to collectively examine the challenges and find solutions. Participants mentioned finding kinship, a sense of community, and solace that they were not alone and that help would be available when needed (25). Requests for more sessions by RIWC staff and participants indicate that these sessions can support immigrants during future health crises.
Lessons Learned:
Results indicate that a sense of community and belongingness is important for mental health. As observed in other studies cultural teachings and religious activities provide mental health support for immigrants. Partnerships with key stakeholders such as health researchers, clinicians at SHA, and RIWC helped enhance access to local credible public health directives for immigrants. The language interpreters assisted information sessions, providing easily comprehensive, locally relevant information can assist immigrants with language barriers in participating in the provincial and national response to public health emergencies. Mental wellness, resilience, and emergency preparedness can be enhanced among immigrants by supporting social connectedness, encouraging active problem-solving, and steering their focus on lessons learned and insights during health emergencies.
Limitations
Only RIWC participants attending virtual programming during the pandemic were included in the study, and the views might not represent those not accessing RIWC programming. Participants representing specific countries were small and the views might not represent those of new immigrants from specific countries. Although language translators were available, some aspects of participants’ views and perspectives might have been missed due to language barriers.