Exploring Experiences of Depression in Immigrant Women with the Cultural Formulation Interview (CFI)

Cultural factors can both trigger and mediate the severity of symptoms of psychological disorders. Culturally responsive therapeutic encounters increase the effectiveness of treatment. This qualitative study used the Cultural Formulation Interview (CFI), featured in the DSM-V, as a newly developed tool to explore the culturally grounded narratives of depressed migrant women’s identity, perceived causes of psychopathology, and help-seeking behaviors and barriers. Participants were nine (n = 9) outpatient immigrant women diagnosed with depression from Saint-Mary’s Hospital, in Montreal, Canada. Conventional content analysis was used to identify overarching themes across the women’s interviews. Results are concurrent with past qualitative research on the perception of social factors implicated in psychopathology onset, development, and barriers to treatment among female immigrants. Participant’s initial focus centered on somatic symptoms, and moved towards feelings of sadness and loneliness with time. The disorder was described in terms impeding on everyday activities, and worsened by environmental stressors, namely workplace and housing conditions. Further, depression onset was linked to major life events, such as the death of a family member. The most important obstacle to help-seeking was the language barrier between the patient, and primary or mental health care practitioner. Implications for this research include highlighting the CFI’s utility as a tool to elicit critical culturally grounded patient information, which may serve to strengthen the therapeutic alliance and provide culturally informed treatment. Further, it calls for the provision of more accessible and supportive social services to this population in the form of employment and housing opportunities, as this has the potential to drastically ameliorate mental health outcomes.