When I first arrived in Canada, I brought the same things most South Asian immigrants do: a degree, ambition, a family counting on me, and a quiet certainty that I would figure it out.
What I did not expect was how disorienting it would be to feel unwell and have nowhere to turn to.
I was not in a crisis. I was not collapsing; I was just carrying the particular weight of displacement, the kind that arrives when you are building a new life in a country that does not know you yet. When I looked for support, I ran into something I could not name at the time. The therapists I found were kind, but the framework they worked from was not built for me.
There was no room in the conversation for the pressure of being a first-generation immigrant holding up a family’s expectations, for the guilt of struggling when you are supposed to be succeeding, or for the fact that in many South Asian households, talking about mental health is not just uncomfortable; it can feel like a betrayal.
I want to be precise about what I am describing because it is easy to dismiss this as a cultural sensitivity problem, a matter of finding the right fit. It is not. It is a structural one.
Statistics show unmet healthcare needs
South Asians are the largest racialized group in Canada, representing more than a quarter of what Statistics Canada classifies as the visible minority population. And yet research published in the Canadian Journal of Mental Health found that South Asians with major depression reported the highest rate of unmet mental healthcare needs of any group studied, at 48 per cent, and the highest perceived barriers to care, at 33 per cent, compared to every other minority group in the data.
These are not the numbers of a population that does not need help. These are the numbers of a population that the system is not reaching.
This matters in the context of immigration because the experience of arriving in Canada is itself a risk factor. South Asian immigrants report higher rates of anxiety disorders and significantly greater life stress than their Canadian-born counterparts. The immigration process brings financial pressure, credential uncertainty, family separation, and the slow erosion of social networks built over a lifetime.
Newcomers have unique problems
For many newcomers, it is their first extended exposure to loneliness in a language that is not their own.
And then they try to access help. For most, that begins with a family physician, the system’s primary entry point. Nearly 80 per cent of Canadians rely on them for mental health care, even though only 23 per cent feel adequately prepared to provide it.
According to data from the Ontario College of Family Physicians, 2.3 million Ontarians do not currently have a family doctor. Without a family doctor, you cannot get a referral. Without a referral, you cannot access publicly-funded mental health services. And even when a referral is made, patients can expect to wait six months to a year for a first mental health appointment. In the meantime, the median community mental health counselling wait sat at 29 days nationally in 2023-24, with one in 10 people waiting more than 143 days. That is for Canadians who already know how to navigate the system. For newcomers, it is longer.
But setting the wait times aside, there is a more fundamental problem. Most publicly-funded mental health care in Canada is built on a Western therapeutic model. Cognitive behavioural therapy (CBT), the backbone of publicly available treatment, was developed within a Western value system, one that centres individual autonomy, self-disclosure, and the separation of self from family and community.
Need for culturally-adapted therapy
For many South Asian patients, that framework does not map onto lived reality. Research from The Centre for Addiction and Mental Health (CAMH) and the University of Toronto has confirmed that culturally adapted CBT is more effective for South Asian populations than the standard model, and reduces dropout rates from therapy significantly. Despite this, culturally adapted services remain rare, underfunded, and largely inaccessible outside major urban centres.
Some progress is being made. CAMH, in partnership with the Mental Health Commission of Canada and community organizations in Toronto, Vancouver, and Ottawa, has developed a CaCBT training program and published guidelines for clinicians working with South Asian patients. But the initial training reached only 20 to 30 therapists nationally. In a country where South Asians number in the millions, that is a starting point, not a solution. Outside the three cities where this work was piloted, culturally adapted care remains largely out of reach.
What gets lost in these gaps is not abstract. It is the Punjabi-speaking mother who cannot find a therapist who understands what it means to be the primary emotional support for an entire extended family. It is the young professional who has been told by well-meaning relatives that what he is feeling is weakness, not illness. It is the grandmother who explains away her depression as chronic pain because there is no vocabulary in her family for what she is experiencing, and no clinician who would care to ask.
Building new systems
The argument I want to make to anyone reading this is not that the system is staffed by bad people. It is not. The argument is that a system designed without accounting for differences in the population will fail that group no matter how well-intentioned its providers are.
This is a design problem, not a compassion problem.
When I started building Sukoon Cares, it was partly because I had lived this gap myself, and partly because the research made it impossible to look away. We work with registered therapists who are specifically trained in culturally adapted care for South Asian communities: herapists who do not ask a client to explain why they cannot “just set boundaries” with their parents, or why leaving a bad situation is never as simple as it sounds when your visa status, your family’s finances, and your sense of identity are all entangled in it. Therapy, when it works, meets you where you are. For South Asians in Canada, that meeting point has been missing for too long.
Mental Health Awareness Month arrives every May with calls to reduce stigma and open conversations. That work is real, and it matters. But it is incomplete if the conversation happens and there is nowhere safe to go afterward. What South Asian newcomers need is not awareness campaigns aimed at them. They need services designed for them, funded for them, and available to them in the communities where they actually live.
The system was not built with them in mind. That is not a reason to accept it. It is a reason to change it.
Fahad Zahid
Fahad Zahid is the founder of Sukoon Cares, a virtual mental health platform with licensed Canadian psychotherapists providing culturally adapted care for the South Asian diaspora. www.sukooncares.com. South Asia covers India, Pakistan, Bangladesh, Sri Lanka and Nepal.