Why Language and Cultural Values Matter in Immigrant Inclusion: Structural Factors Hindering Inclusive Access to Effective Mental Health Services for First Generation Korean-Canadian Immigrant Mothers

Carmen Kim
Apr 10 · 7 min read
My mother (center), sister (right), and myself (left) in a school family portrait from 2009.

My mother immigrated to Vancouver with her two daughters in 2009. We were a typical kirogi gajok (“wild geese” family), a cultural term that depicts the relatively recent transnational family structure in which the father works in Korea while the mother emigrates with her children. Particularly among first generation Korean immigrant mothers like my own, high levels of mental health issues are common (Choi et al., 2009). Yet, a U.S.-based study reveals that 88% of surveyed Asian immigrants with a serious mental illness have not received professional treatment (Jang et al., 2019).

This article will analyze multi-layered structures, spanning across sociocultural, economic, and political domains, that culminate to shape gendered burden and hinder access to effective mental health services for Korean first generation immigrant mothers in Metro Vancouver.

Engendering the Modern Korean Transnational Family Structure

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A peak in globalization policies in the late 20th century drastically opened up Korea’s diplomatic and sociocultural borders (Kim et al., 2012). English fluency and foreign credentials have since then become a mark of status and an essential skill for decent employment and upward socioeconomic mobility in Korea, thus sparking the transnational migration of these “wild geese” families (Lee & Johnstone, 2016).

Migrants are active, strategy-oriented agents rather than passive subjects under structural forces; however, the gendered division of migration strategies is shaped by hegemonic gender roles and institutional immigration systems. Kirogi gajok is the product of parents taking on this gendered family project in the pursuit of English education abroad, hence acting as agents of globalization while improving their children’s competitiveness in the global market (Lee & Johnstone, 2016). Through this structural process, split family dynamics have become a culturally accepted norm and model standard for Korean households in their strategic mobilization of capital across nations. In this way, the kirogi gajok structure promotes economic growth in both Canada and Korea while imposing gendered burden on the immigrant mother.

The Role of Cultural, Ideological, and Religious Subjectivities

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A Korean immigrant woman holds multiple identities and responsibilities. Confucian values have historically shaped patriarchal household dynamics and gender roles within South Korean families. Women are expected to fulfill gendered obligations of caregiving and prioritize family interests above self-interest. Seo and colleagues (2020) discuss the “wise mother and good wife” (WMGW) ideology that has evolved into an oppressive double burden for the transnational Korean woman.

Korean immigrant mothers spearhead the immigration process, as well as fulfill guardianship, social provisioning, and single parenting roles (Lee & Johnstone, 2016). Though these women carry significant emotional burden as a result of this amalgamation of commitments, outward expression of their struggles is discouraged in order to preserve household reputation and their own filial identity as a good wife and mother (Seo et al., 2020). The “self-sacrificing, soft-spoken, and submissive” feminine adage suppresses emotional vulnerability and transparency among Korean immigrant women (Seo et al., 2020).

Since expression of personal needs is culturally ingrained as a disruption to family harmony and emotional suppression is so normalized, these women may not perceive themselves as being in need of psychological and social assistance in the first place (Delara, 2016). Conforming to such ideology predisposes Korean immigrant women to poor mental health outcomes as they strive to complete the breadth of their household responsibilities while coping with various distressors, including acculturation and racism (Seo et al., 2020).

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Korean immigrant women tend to seek emotional support and health-related advice through kin relations rather than mental health professionals (Kim et al., 2015). This tendency is reflective of Korean familism and exclusive formations of trust within kinship structures. Such kinship-based emotional support is unavailable for Korean immigrant mothers within the kirogi gajok family structure. Thus, many Korean immigrant mothers perceive their Korean-Canadian church community as a second family, as the church often acts as a source of social support through language, child care, finances, and community inclusion (Choi et al., 2014). On the other hand, religious subjectivities can influence immigrant women’s decision to avoid biomedical or professional treatment (Delara, 2016). Immigrant women may underuse mental health services due to religious frames of thought and rely on ethnic spiritual group leaders and informal support systems to meet their emotional needs (Delara, 2016).

Access and Representation in Mental Health Services

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The federal government sends major transfers to provincial or territorial governments who then determine resource allocation in mental health services (Office of the Parliamentary Budget Officer, 2020). Settlement and integration services are provided by municipality-based non-profit agencies. A select few of these agencies (eg. S.U.C.C.E.S.S.), provide language-specific counselling services for Korean immigrant women. Some agencies (eg. MOSAIC) offer counselling services that are unavailable in Korean or require a third-party interpreter. As these services are generalized counseling services, they fail to meet the specific mental health needs of patients. Other agencies have Korean social workers on staff who refer clients to registered clinical counsellors.

Upon running a filtered search for Korean-speaking registered psychologists, two results show on CounsellingBC and one result shows on the BC Psychological Association Directory. Such lack of Korean or Korean-speaking therapists may be due to the Confucian ideological structure of family honour that prescribes prestige to professions other than psychology. On the federal and provincial level, the Government of Canada and HealthLink BC do not offer any mental health resources, directories, or search engines that are reliably translated in Korean.

Lack of appropriate linguistic communication prevents the establishment of rapport with the service provider and casts a significant barrier to understanding bureaucratic structures, procedures, and functions of Canadian mental health services (Delara, 2016). Korean immigrant women do not often seek professional support services due to their lack of English language proficiency and the ethnic, cultural, and linguistic mismatch with their service provider (Seo et al., 2020). In addition, the presence of a third party interpreter can invoke fear for immigrant women who worry that their confidential matters may be shared with the greater community (Delara, 2016).

Such lack of representation of and community connections to Korean-speaking service providers and Korean-translated resources means that Korean immigrant mothers are expected to become fluent in English as a precondition to accessing adequate mental health services. Many Korean immigrant mothers carry multiple commitments that leave little room for self-care or accessing a language learning program (Choi et al., 2014). Ironically, while there is a lack of linguistically and culturally accessible mental health services, there is a multitude of English learning programs provided by non-profit organizations that seek to assimilate Korean immigrant women upon arrival.

Immigrant mental health is often measured by an immigrant’s level of success in acculturation or assimilation, thus supporting Canada’s neoliberal political attitude in leaving immigrant well-being in the hands of individual responsibility. Canada’s history of racial alienation and marginalization has not stopped since its branding as a multicultural nation and continues to form its national agenda for immigrant integration — one based on assimilation to the hegemonic culture rather than multicultural inclusivity.

Mapped analysis of the structures that interact to form access to language- and culture-specific mental health care for first generation Korean-Canadian immigrant mothers. (agents: bold text, structures rooted in Korea: navy box, structures rooted in Canada: yellow box)

Now What? A Call to Action.

The marginalization of Korean immigrant mothers in accessing quality mental health care is a product of economic, cultural, ideological, and political structures interacting in local, national, and global scales. There is an established community of more than twenty thousand first generation Korean immigrant women residing in Metro Vancouver (Statistics Canada, 2016).

In order to meet the needs of this growing population, immigrant mental health must be perceived by Canadian governments as a public responsibility. Governments and meso-level agencies must collaborate on double-pronged approaches that address both 1) cultural, ideological, and religious obstacles to accessing mental health care, and 2) the systemic lack of language- and culture-specific mental health services.

Read this article for further analysis on the political formations of gendered burden and language injustice faced by Korean-Canadian immigrant mothers.

References

Choi, J., Kushner, K. E., Mill, J., & Lai, D. W. (2014). The experience of Korean immigrant women adjusting to Canadian society. Journal of Cross-Cultural Gerontology, 29(3), 277–297. doi:10.1007/s10823–014–9235–8

Choi, J., Miller, A., & Wilbur, J. (2009). Acculturation and depressive symptoms in Korean immigrant women. Journal of Immigrant and Minority Health, 11, 13–19.

Delara, M. (2016). Social Determinants of Immigrant Women’s Mental Health. Advances in Public Health, 2016. doi: 10.1155/2016/9730162

Kim, W., Kreps, G. L., & Shin, C. (2015). The role of social support and social networks in health information-seeking behavior among Korean Americans: A qualitative study. International Journal for Equity in Health, 14, 1–10.

Lee, E., & Johnstone, M. (2016). A production of Education migrants: A case study of South Korean transnational families in Canada. International Social Work, 60(2), 307–320. doi:10.1177/0020872814539987

Kim, A., Noh, M. & Noh, S. (2018). 1. Introduction: Historical Context and Contemporary Research. In Korean Immigrants in Canada (pp. 1–18). Toronto: University of Toronto Press. doi:10.3138/9781442690387–004

Seo, Y. J., Cheah, C. S., & Cho, H. S. (2020). The gender ideology of ‘Wise mother and Good wife’ and Korean immigrant women’s adjustment in the United States. Nursing Inquiry, 27(4). doi:10.1111/nin.12357

Jang Y., Yoon, H., Park, N.S., Rhee, M., & Chiriboga, D.A. (2019). Mental Health Service Use and Perceived Unmet Needs for Mental Health Care in Asian Americans. Community Mental Health Journal, 55(2): 241–248. doi:10.1007/s10597–018–0348–3.

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