Contextual factors influencing Thai immigrant women`s mental health, and their strategies to cope with mental health problems - A qualitative study of Thai immigrant women in Norway

With a growing immigrant population, Norwegian society faces new challenges in provision of health care. Multicultural challenges are particularly visible in mental health care and immigrant women seem to be underrepresented in health care services for mental health problems. Thai migration to Europe has increased in the recent years, and Thai women are among the largest groups of immigrant women in Norway, with almost five times as many immigrant women as there are men. Identifying barriers to health care is an important step in addressing access to care for immigrant women. Knowing more about the factors that influence immigrant women`s mental health and their coping strategies can help aid health care delivery and policy planning. The purpose of the study is to explore the contextual factors that influence Thai immigrant women`s mental health and how they feel about consulting their GP for mental health problems. Fifteen semi- structured interviews of Thai women living in Norway (31-55 years old), conducted by Melanie Straiton, were analysed in this qualitative study. The analysis was informed by the postcolonial feminism perspective, in order to address the view of Thai immigrant women in light of their gender specific reasons for migration. The analysis revealed that gender, ethnicity, culture and socioeconomic status affects Thai immigrant in Norway`s mental health. Power imbalances between them and their husband potentially maintain some of the women in subordinated positions. These factors may contribute to stress as well as influence their coping strategies. The women try to live up to expectations of them being a wife/partner, daughter, mother and/or a breadwinner, but face many challenges in Norway. Few of the women had consulted their GP for mental health problems, even though all the informants experienced some level of stress or distress. Many feel that their GP will not understand them and try to deal with stresses in life with alternative coping strategies, like religion and friends. The study findings indicated that many Thai immigrant women live transnational lives and try to fulfil different roles and expectations. Health care providers should gain cultural competence in order to understand their challenges and their needs. Even though the women showed a great deal of awareness of how to cope with difficulties in life, all reported some level of stress and stress, which indicates that their coping strategies may not be sufficient. Improving ways of help seeking is suggested as beneficial