This study investigated whether self-perceived workplace discrimination has any role in the mental health status of immigrants living and working in Italy, taking into consideration other personal experiences like self-perceived loneliness, level of life satisfaction, and perceived physical health.
We hypothesized that S-PWD may affect MCS directly as well as through the influences of some psychophysical factors, personal experiences (e.g. S-PL and LS), and self-reported physical status. Our results underline and quantify the relationship between S-PWD and mental health outcomes, directly as well as through S-PL, LS, and PCS as mediators.
In our study S-PWD seemed to act on MCS both through a direct relationship, which we estimated as 68.9% of the total effect, and through an indirect relationship mediated by S-PL (13.6%), LS (13.6%), and PCS (3.9%). In particular, we observed a negative effect of S-PWD on MCS when it was mediated by S-PL and low level of LS, while the indirect effect mediated by PCS was positive, as the product of two negative effects (S-PWD on PCS and PCS on MCS).
Our findings appear to support previous research that underlined the relationship between workplace discrimination and mental health in a large, heterogeneous immigrant sample [17]. It would seem that self-perceived discrimination – whether suffered during a current or past job – can act as a predictor of alterations in self-perceived mental health, as already demonstrated by a number of other studies. In particular, perceived discrimination has been associated with mental health conditions such as anxiety, depression, fear, frustration, helplessness, hopelessness, paranoia, resentment, and low self-esteem [17,20,36,37,45,46].
Psychosocial risk factors, such as anxiety, insecurity, low self-esteem, social isolation, and the lack of control over work and home life increase the risk of poor mental and physical health. The lower people are in the social hierarchy of industrialized countries, the more common these problems become. In the case of immigrant workers self-reporting discrimination, for whom we can hypothesize long-term stress, these individuals become more vulnerable to a wide range of poor health conditions, acting as an accelerator of mental distress [18,37,47,48].
An explanation of this process can be found in the construction vs. deconstruction of professional and personal life projects of migrants [49]. In fact, the process of immigration itself constitutes a pool of life projects and expectations of those people who decide to change their life. The status of these projects can thus greatly influence overall life satisfaction. Among migrants, these projects are usually work-oriented, devised and implemented to guarantee economic survival, obtain personal and professional satisfaction, obtain rights connected with having a residence permit, and improve social inclusion by becoming part of the host country [50,51].
Discrimination in the workplace can be extremely harmful, especially for immigrant populations, given that work (and its implications) is one of their priority objectives [17,25,52,53].
Overall, the literature shows that perceived discrimination in the workplace is a significant stressor for all population groups because one’s job represents a strong link with society; it is an important way to feel part of this new world [36,48]. Experiences of unfair treatment and daily difficulties for any reason can therefore have an impact on mental and physical health [12,23,25].
The workplace is a social context where discrimination is experienced due to limited access to certain types of jobs, bad relationships between workers and management, or to the characteristics of the job itself [46]. Not being valued and respected in the workplace, imbalanced job design, and occupational uncertainty may negatively affect mental health, as can interacting with individual personality characteristics, attitudes, and coping [20].
Experiences of perceived discrimination may vary in relation to many contextual factors as well as to other personal and economic resources. Immigrants who experienced discrimination were most likely to report worsening self-reported mental health, with a higher risk of feelings of sadness, depression, and loneliness [3,6,7,11].
Our findings suggest that the low life satisfaction and perception of loneliness self-reported by immigrants in Italy could have a negative effect on their mental health status. Indeed, our results seem to support the hypothesis that discriminatory experiences may affect mental health through stress responses, which explain part of the effect on MCS of exposure to S-PWD, as suggested by the indirect negative effect of loneliness and low life satisfaction on MCS.
In our study, immigrants in almost all cases reported ethnic/cultural-related factors as the cause of their experience of discrimination in the workplace: being a foreigner, not speaking Italian well, skin colour, religion. It is interesting to underline that, unlike some other European countries, for example France or the United Kingdom, Italy has not experienced immigration from former colonies, with immigrants speaking the same language as in the host country, which means that integration may be even more difficult. In different countries, empirical evidence indicates a negative relationship between perceived ethnic discrimination and life satisfaction or sense of loneliness [54].
Immigrants face the integration process with an inner sense of inferiority with regard to the host country and the dominant culture. Losing one’s job or perceiving discrimination could generate a deep sense of self-isolation, perceived social exclusion, and low sense of self-efficacy. Inevitably, this could affect the well-being or mental health status of these persons [7,52].
Our findings of worse perceived mental health in people who had been in Italy longer than 10 years was similar to the findings of previous Canadian studies, which showed poorer mental health status among long-term immigrants than among recent immigrants [55,56]. It is interesting to note that in a previous study conducted in Italy, psychotic disorders were more frequently diagnosed in immigrants who had had a residence permit for a long time, i.e. those who had been living in the country longer, than in those who had been living in the country for a shorter amount of time [57].
We also found that having lost one’s job (and therefore being unemployed at the time of the interview) may have negatively affected good mental health status among immigrants. In general, immigrants in a host country have invested considerably in personal projects [52]. Achieving medium- or long-term personal goals is an important factor in their improved life-satisfaction [54]. The literature shows that immigrants expect to be recognised as people who contribute to the receiving society in terms of experience and resources as well as in social and cultural wealth. They also expect their rights as citizens to be recognised at least to the degree that they were in their native country [58]. A collapse of these expectations, such as job loss, could negatively affect their life satisfaction in the host country [52,54].
Strengths and limitations
The strength of this study is that it was conducted in a large sample of Italian immigrants, where the first generation still makes up most of the foreign population, which has been strongly affected by the economic crisis and which has been subjected to a concerning increase in xenophobic episodes. Further, because its geographical position makes it the most common port of entry to Europe and thus migration here has very specific and unique characteristics, Italy is the ideal setting to study immigrants in terms of their mental health as well. Moreover, to the best of our knowledge, there have been few studies in Southern Europe that have investigated the implications of perceived discrimination in the workplace [35,36,37,59].
Our study also extends existing research by examining the independent effects of mental health on other factors strictly related to the perception of one’s life condition. In particular, we considered the potential role of some personal experiences (loneliness, level of life satisfaction) and self-perceived physical health in the association between discrimination and self-perceived mental health.
One possible limitation of this study is that cross-sectional data can make it difficult to discern causality in the association observed. However, theoretical perspectives support the idea that perceived discrimination adversely affects mental health outcomes [27].
Furthermore, this study relies exclusively on self-reporting. However, many of the current studies in this area involve perceptions of discriminatory treatment based on self-reporting of life events and personal experiences rather than on objectively observed discrimination [27]. Moreover, it has been demonstrated that self-perceived health is a reliable predictor of mortality [60], reason for which it has frequently been used as an outcome measure in numerous studies on immigrant health [61].
Another limitation is that we did not have any information about the time frame, the regularity of discrimination experience, whether or not the immigrants had experienced discrimination in other areas of life, or information about income, a factor that leaves immigrants vulnerable to discrimination and is also associated with factors such as life satisfaction and physical health.
Finally, our decision to dichotomize some variables (education level, age, and length of stay) to obtain more robust estimates and to make the interpretation easier, may have produced an information loss about collected data, albeit modest, at least for categorical variables.