Abstract

The percentage of the Canadian population that reports being or having been an immigrant has been steadily increasing for the past 50 years, such that more than 20% of Canada’s population identifies as foreign-born. As a result, a large proportion of the users of healthcare find themselves in language discordant situations in a healthcare system that they might not be comfortable navigating. The problems associated with using one’s second language (L2) in a healthcare setting might be especially salient in the mental healthcare context, where the quality of diagnosis, treatment, and overall services is highly dependent on language. How does the anticipation of having to use one’s second language affect immigrants’ experience of the seeking and obtaining mental healthcare services? Are there factors in immigrants’ social environment that might influence this experience? This thesis investigates the role of second language communication anxiety in the context Russian-speaking immigrants’ use of mental healthcare services in their L2 (HCA2m). First, the link between HCA2m and immigrants’ willingness to use L2 mental healthcare services is investigated. Second, predictive certainty, or immigrants’ confidence in their ability to predict how interactions and treatment in an L2 context will unfold, and their actual predicted outcome are investigated as potential components of the mechanism that underlies the association between HCA2m and willingness. Finally, the role of immigrants’ social networks is investigated in order to understand how social variables might play a role in the hypothesized mediation model. Results indicated that HCA2m was negatively associated with the willingness to use L2 mental healthcare services and that this relationship was entirely mediated by immigrants’ predictive certainty, such that higher HCA2m was associated with lower predictive certainty, which was associated with reduced willingness to use L2 mental healthcare. Finally, the results of this project failed to support the hypothesis that certain characteristics of immigrants social network are associated with predictive certainty, suggesting that perhaps the nature of one's L2 social network does not play a role in modulating the mechanism by which HCA2m affects the willingness to use L2 mental healthcare services.