Mental Health: Global Challenges Journal

https://reference-global.com/journal/MHGCJ

ISSN 2612-2138

Rethinking Intersectionality in Immigrant Mental

Health Research Through Qualitative, Reflexive,

and Decolonial Frameworks

Supriya Middha 0009-0005-3375-0742

University of Lethbridge, Lethbridge, Canada

Abstract

Introduction:

Immigrant mental health research continues to rely heavily on Eurocentric

biomedical frameworks that inadequately capture the complex social, historical, and political

forces shaping immigrant wellbeing. These models often obscure how migration, racism,

gendered expectations, and colonial legacies intersect to structure mental health vulnerabilities

among diverse immigrant populations. Intersectionality theory offers a corrective, yet its application

remains limited by conceptual and methodological challenges.

Purpose: This paper critically examines the applicability of int

ersectionality in immigrant mental

health research, using South Asian immigrants in Canada as an illustrative example. The aim is to

evaluate both the strengths and limitations of intersectionality and propose ways to strengthen its

use in population health research.

Methodology: This is a conceptual and theoretical analysis grounded in Black feminist scholarship,

critical public health literature, and decolonial epistemologies. An interpretive approach is applied

to examine how intersectionality has been used in immigrant mental health research and where it

requires expansion.

Results:

Findings demonstrate that intersectionality illuminates layered forms of oppression but is

often hindered by theoretical overload, methodological ambiguity, essentialism, and Western

centric epistemic boundaries. These constraints risk flattening diversity within immigrant groups and

overlooking colonial histories that shape mental health outcomes.

Conclusions: An expanded intersectional framework, integrating qualitative inquiry, reflexivity, and

decolonial approaches can more effectively capture the lived realities of immigrants and support

culturally responsive mental health research. Strengthening intersectionality in this way advances

health equity and enriches global mental health scholarship.

Keywords

Mental health, Intersectionality, Immigrant Mental Health, South Asian Immigrants, Systemic

Oppression, Decolonial Theory, Qualitative Inquiry, Social Determinants of Health.

Address for correspondence:

Supriya Middha, PhD Candidate, Population Studies in Health

University of Lethbridge, Lethbridge, Canada

E-mail: supriya@uleth.ca

This work is licensed under a Creative Commons Attribution- 4.0

International License (CC BY 4.0).

©Copyright: Middha, 2026

Publisher: Paradigm (De Gruyter)

DOI: https://doi.org/10.56508/mhgcj.v9i1.330

Submitted for

publication: 22

November 2025

Revised: 22 December

2025

Accepted for

publication: 26 February

2026

Mental Health: Global Challenges Journal

https://reference-global.com/journal/MHGCJ

ISSN 2612-2138

Introduction

Despite growing attention to immigrant health

disparities (WHO, 2022), mental health research

often remains epistemologically constrained by

frameworks that inadequately account for the

complex, intersecting systems of oppression

shaping immigrant experiences (Braveman et al.,

2022; Viruell-Fuentes et al., 2012). Encounters with

mental health care are not shaped solely by

race, gender, or class in isolation, but through

their interconnections with immigration histories,

colonial legacies, and systemic inequities

embedded within health institutions (Kirmayer et

al., 2011; Millner et al., 2021). Standard models

rooted in Eurocentric biomedical traditions often

obscure these layered dynamics, resulting in

analyses that underestimate structural

determinants of immigrant mental health

(Fernando, 2020).

Intersectionality theory offers a promising

framework to address these limitations.

Originating from Black feminist thought,

intersectionality highlights how multiple

dimensions of identity and power interact to co-

produce lived experiences of advantage and

disadvantage (Crenshaw, 1991; Collins & Bilge,

2016). In public health research, intersectionality

enables a move beyond single-axis analyses

toward refined examinations of how structures of

oppression shape health outcomes (Bowleg,

2012; Hankivsky, 2014). However, despite its

growing use, the application of intersectionality in

immigrant mental health research remains

fraught with theoretical, methodological, and

epistemological challenges (Nash, 2020;

Bhambra, 2014).

Purpose

The purpose of this paper is to critically

examine the applicability of intersectionality

theory to immigrant mental health research in

Canada. Alongside theoretical critique engaging

broadly with immigrant health scholarship, in this

paper, South Asian immigrants are used as an

illustrative example to concretely explore the

strengths and limitations of an intersectional lens.

Specifically, the paper identifies how

intersectionality highlights layered vulnerabilities in

mental health experiences. It also interrogates

the risks of theoretical overload, essentialism, and

epistemological limitations. In this paper, I adopt

a critical and qualitative interpretation of

intersectionality that foregrounds lived

experiences, structural power, and epistemic

context. This differs from operationalized,

quantitative approaches that tend to treat

intersectionality as additive or rely on interaction

effects (McCall, 2005).

Building on these critiques, the paper

proposes extending intersectionality through

reflexive practices, qualitative inquiry, and

decolonial frameworks to advance culturally

responsive and equity-oriented approaches in

immigrant mental health research.

Methodology

This paper employs a conceptual, theoretical,

and interpretive design grounded in post colonial

scholarship, and decolonial epistemologies. The

paper synthesizes and analyzes peer reviewed

research across population health, immigration

studies, mental health, and intersectionality

theory to evaluate how intersectionality has been

operationalized within immigrant mental health

research.

A conceptual approach is appropriate

because the paper seeks to evaluate the

epistemological and methodological

foundations of immigrant mental health research

rather than assess individual-level experiences or

clinical outcomes. Intersectionality is inherently a

theoretical framework; therefore, evaluating its

application requires interpretive engagement with

conceptual, theoretical, and policy literature.

Ethical considerations

This is a theoretical and methodological

manuscript that does not involve human

participants or animals. As such, ethical board

approval was not required.

Declaration of Generative AI and AI-

Assisted Technologies in the Writing

Process

During the preparation of this work, the author

used Grammarly in order to proofread and edit.

After using this tool/service, the author reviewed

and edited the content as needed and takes full

responsibility for the content of the publication.

Review and Discussion

Intersectionality and Immigrant Mental

Health Research

Intersectionality, first introduced by Crenshaw

(1991), offers a critical framework for

understanding how multiple systems of

oppression interact to shape lived experiences.

Developed within Black feminist thought and

activist movements, intersectionality emerged as

a response to the erasure of Black women’s

experiences in both antiracist and feminist

Mental Health: Global Challenges Journal

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ISSN 2612-2138

discourses (Crenshaw, 1989; Collins, 1990).

Rather than treating social identities such as race,

gender, or class as discrete variables,

intersectionality emphasizes that these axes are

interdependent and co-constructed within

historically specific relations of power (Collins &

Bilge, 2016). It provides a means to capture the

complexity of marginalization, recognizing that

the experiences of those situated at multiple axes

of oppression cannot be understood through

additive models of discrimination alone (Abrams

et al., 2020; Harari & Lee, 2021).

In the field of population health,

intersectionality has been increasingly recognized

as a crucial framework for moving beyond

reductionist models of health disparities

(Hankivsky, 2014; Bowleg, 2021; Holman et al.,

2021). Traditional public health research often

isolates social determinants such as race,

gender, income, or education, as separate

predictors of health outcomes (Krieger, 2014;

Marmot, 2015). Intersectionality challenges this

fragmentation by insisting that these determinants

operate collectively (Tinner et al., 2023), and that

structural forces such as systemic racism,

capitalism, patriarchy, shape health experiences

in ways that are not reducible to any single axis.

The application of intersectionality to

immigrant health research is particularly critical.

Immigrants' experiences of health and

healthcare access are shaped not only by their

immigration status but also by the intersections of

racialization, gendered expectations, class

positioning, legal precarity, and colonial legacies

(Braveman et al., 2022; Liu et al., 2023; Tuyisenge

& Goldenberg, 2021; Koseoglu Ornek et al.,

2022). Within settler colonial states such as

Canada, immigrants’ experiences of

marginalization are also shaped by ongoing

structures of settler colonialism that privilege

certain groups while subordinating others (Allan &

Smylie, 2015; Wispelwey et al., 2023). As a result,

understanding immigrant mental health requires

moving beyond culturalist or individualist models.

Mental health research with immigrant

populations has historically been dominated by

Eurocentric biomedical frameworks that

pathologize distress while neglecting its socio-

political origins (Fernando, 2020; Beresford &

Rose, 2023; Antić et al., 2023). Such frameworks

tend to focus on diagnosing and treating

symptoms within individuals, often overlooking

how systemic racism, migration-related stressors,

labor market exclusions, and legal barriers shape

immigrants’ mental health (Bhakuni & Abimbola,

2021; Côté-Olijnyk et al., 2024). Intersectionality

offers a corrective by foregrounding the broader

structures that create and sustain health

inequities. Recent scholarship has highlighted the

promise of intersectionality for immigrant health

research particularly in linking legal precarity and

racialization to health inequities (Tuyisenge &

Goldenberg, 2021; Lin, 2023).

While intersectionality’s conceptual

contributions are widely recognized, its practical

operationalization within immigrant health

research remains underdeveloped (Collins &

Bilge, 2016; Harari & Lee, 2021; Ghasemi et al.,

2021). Most studies employing intersectionality

remain descriptive, identifying multiple

dimensions of identity without fully theorizing how

these dimensions interact within larger systems of

oppression (Bilge, 2013; Carbado et al., 2013;

Holman et al., 2021). Furthermore, many

applications of intersectionality in public health

have treated it as a static categorization tool,

rather than as a framework demanding reflexive,

structural, and decolonial analysis (Bauer, 2014;

Bowleg, 2021).

In the context of Canadian immigrant mental

health research, these gaps are particularly

salient (Lin, 2023). Although scholars increasingly

recognize that mental health outcomes among

immigrants are influenced by systemic inequities,

few studies systematically apply intersectionality

to interrogate it (Kirmayer & Jarvis, 2019; Liu et al.,

2023). Even when intersectionality is referenced,

there remains a tendency to treat immigrant

populations as internally homogenous, masking

critical differences along lines of caste, ethnicity,

religion, legal status, and migration pathway.

Thus, while intersectionality offers a powerful

framework for immigrant mental health research,

its potential has not yet been fully realized.

(Lentin, 2012). It demands methodological

innovation, including approaches that center

qualitative participant experiences, recognize

multiple epistemologies, and interrogate the

researcher’s own positionality in knowledge

production (Zhang et al., 2021; Montenegro et

al., 2024).

Strengths and Limitations of Intersectionality

Intersectionality has been widely proposed as

a framework for analyzing immigrant mental

health broadly (Rocha-Jiménez et al., 2025;

Viruell-Fuentes et al., 2012). The experiences of

South Asian immigrants in Canada offer a useful

case to explore its conceptual strengths and

practical limitations. By foregrounding how race,

gender, class, and immigration status interact,

intersectionality captures the layered

vulnerabilities that shape health outcomes

(Bowleg, 2012; Viruell-Fuentes et al., 2012). South

Asian immigrant women, for example, often

navigate compounded barriers arising from racial

discrimination in healthcare systems, gendered

expectations within both immigrant communities

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and Canadian society, and precarious

employment or legal status (Kipp & Busolo, 2025;

Shankar et al., 2024). Intersectionality thus moves

beyond simple categorical frameworks to reveal

how multiple axes of oppression produce specific

patterns of exclusion and disadvantage.

One of intersectionality’s major strengths lies in

its ability to frame mental health not as an

individual pathology, but as a product of broader

systemic inequalities (Hankivsky & Cormier, 2010;

Bowleg, 2021). Mental health struggles among

South Asian immigrants are often linked to cultural

stigma, economic marginalization, and historical

displacements tied to colonial legacies (Millner et

al., 2021). Intersectionality provides the

conceptual space to recognize these

connections, offering a more structural and

historically grounded understanding of mental

well-being than traditional models allow.

Furthermore, intersectionality enables a critical

shift from documenting disparities to interrogating

the systems that create and sustain them

(Bowleg, 2021; Viruell-Fuentes et al., 2012). It

directs attention to how health services,

immigration policies, labor markets, and societal

discourses work together to reinforce immigrant

precarity (Côté-Olijnyk et al., 2024). For South

Asian immigrants, whose experiences are shaped

by both pre-migration histories and post-migration

exclusions (Satia, 2019), intersectionality makes

visible the cumulative impact of systemic forces

on mental health access, quality of care, and

outcomes.

Despite these important contributions, the

application of intersectionality also presents

significant limitations that warrant critical

reflection. One persistent challenge is the risk of

theoretical overload. In attempting to account for

the multiplicity of identities and structures that

shape immigrant experiences, intersectional

analyses can become fragmented (Hancock,

2007). In studying South Asian immigrants, for

instance, dimensions such as caste, religion,

immigration pathway, linguistic affiliation, and

generation status plausibly intersect with gender,

race, and class. Without clear methodological

guidance, efforts to incorporate all these

intersections can overwhelm analysis and

obscure coherent findings (Bauer et al., 2021;

Christoffersen et al., 2025).

Methodological ambiguity further complicates

the operationalization of intersectionality.

Although intersectionality calls for the

simultaneous examination of multiple social

locations, it offers limited practical direction on

how researchers should select which intersections

are most salient for a given study population (Cho

et al., 2013). This ambiguity becomes especially

salient when working with diverse South Asian

communities, whose mental health experiences

vary across region, language, religious

background, immigration histories, and socio-

economic status. Researchers must exercise

careful reflexivity in selecting and prioritizing

intersections, ideally informed by participants’

lived experiences rather than imposed

frameworks (Esposito, 2024).

A related limitation is the risk of essentialism.

Despite intersectionality’s goal of capturing

complexity and diversity, if applied carelessly, it

can inadvertently homogenize groups (Nash,

2020; Davis, 2008). Treating "South Asian

immigrants" as a unified or monolithic category

risks flattening important internal differences, such

as those between Hindu, Muslim, Sikh, and

Christian communities, or between economic

immigrants and refugees. Recognizing intra-

group diversity is crucial to avoiding the

reproduction of reductive categorizations that

intersectionality itself seeks to challenge (Bauer et

al., 2021).

Finally, intersectionality’s theoretical origins in

Western feminist and critical race traditions raise

epistemological tensions when applied to

postcolonial immigrant populations (Thomas,

2020; Savaş & Dutt, 2023). While intersectionality

offers important insights into structural inequality, it

may insufficiently capture the historical and

geopolitical specificities that shape immigrant

experiences, particularly those tied to colonialism,

empire, and global migration flows (Bhambra,

2014). For South Asian immigrants, whose

experiences are deeply intertwined with the

histories of British colonialism, partition, and

forced displacement (Satia, 2019), a solely

intersectional analysis may risk overlooking the

broader structures of colonial violence that

continue to shape contemporary realities.

Thus, while intersectionality provides a vital

foundation for understanding the mental health

experiences of South Asian immigrants, its

application must be expanded and refined.

Addressing issues of theoretical overload,

methodological ambiguity, intra-group diversity,

and colonial epistemologies is necessary to

strengthen intersectionality’s critical potential. To

move toward more inclusive immigrant mental

health research, intersectionality must be

integrated with reflexive practices, qualitative

methodologies, and decolonial frameworks

(Christoffersen et al., 2025; Savaş & Dutt, 2023).

Expanding Intersectionality

While intersectionality offers a critical

framework for examining multiple systems of

oppression, its potential can be strengthened by

integrating reflexive, qualitative, and decolonial

approaches. These extensions allow for a more

Mental Health: Global Challenges Journal

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ISSN 2612-2138

situated and ethically grounded analysis of

immigrant mental health, particularly when

working with racialized and postcolonial

populations such as South Asian immigrants in

Canada.

Qualitative inquiry provides one pathway to

operationalize intersectionality without

fragmenting analysis (Abrams et al., 2020; Bauer

et al., 2021). Rather than predefining which

identities are most salient, qualitative methods

allow participants to articulate how their

experiences of race, gender, migration, and

class intersect in their own terms (Clandinin &

Connelly, 2000; Abrams et al., 2020). In

immigrant mental health research, qualitative

data highlights the ways individuals make sense

of mental health within broader cultural and

historical contexts, offering insights that may be

obscured by category driven frameworks. By

privileging participant experiences, researchers

can avoid imposing static identity labels and

better capture the fluid nature of intersecting

oppressions (Riessman, 2008; Bauer et al., 2021).

Reflexivity is also essential in expanding

intersectional analyses. Researchers must

continually interrogate their own positionalities,

epistemological assumptions, and

methodological choices throughout the research

process (Braun & Clarke, 2022; Pillow, 2003). In

immigrant health research, reflexivity requires

acknowledging the colonial histories that structure

researcher-participant relationships and the ways

academic knowledge production can reproduce

marginalization (Bhakuni & Abimbola, 2021;

Abimbola et al., 2024). Explicit attention to

reflexivity enhances analytical transparency and

mitigates the risks of speaking for or over

marginalized communities (Fine et al., 2004).

Further, decolonial and pluriverse frameworks

can deepen intersectional analyses by

challenging the Eurocentric assumptions

embedded within mental health discourses (De

Sousa Santos, 2015; Beresford & Rose, 2023;

Savaş & Dutt, 2023). Decolonial theory insists on

recognizing multiple ways of knowing and being,

rather than subordinating non-Western

epistemologies to Western standards of validity

(Mignolo, 2007; Smith, 2012; Santos, 2014). For

South Asian immigrants, this means valuing

indigenous understandings of mental health,

such as collective healing practices,

intergenerational resilience, and the spiritual

dimensions of well-being, that are often

marginalized within western systems (Fernando,

2020).

A pluriverse approach, as outlined by Escobar

(2018) also resists the homogenization of

immigrant experiences. Instead of seeking a

single, universal narrative of immigrant mental

health, it supports the coexistence of diverse

experiences shaped by distinct historical, cultural,

and socio-political contexts (García-Ramírez et

al., 2022; Escobar, 2018). For example, the

mental health experiences of Tamil refugees from

Sri Lanka may differ substantially from those of

Punjabi economic immigrants from India, despite

both groups being categorized under "South

Asian immigrants." Recognizing these differences

requires moving beyond intersectionality's

tendency to cluster identities and embracing

more flexible, participant driven models of

analysis.

Together, qualitative inquiry, reflexivity, and

decolonial methodologies enhance

intersectionality’s capacity to analyze immigrant

mental health critically and ethically. They move

research beyond mapping multiple oppressions,

toward centering marginalized knowledge,

amplifying agency, and advocating for systemic

transformation. For population health scholarship,

this expanded intersectional approach offers a

pathway toward more equitable and culturally

responsive mental health systems that better

serve diverse immigrant communities.

Strengths and Limitations

This study offers several conceptual strengths.

By synthesizing literature across intersectionality,

immigrant mental health, and decolonial theory,

the paper advances a multidimensional

understanding of how structural forces shape

mental health outcomes among racialized and

immigrant populations. Its analytical integration of

qualitative inquiry, reflexivity, and decolonial

epistemologies provides a theoretically robust

and methodological extension of

intersectionality. The paper also contributes a

nuanced critique of Western biomedical

dominance and demonstrates how expanded

frameworks can better capture the lived realities

of South Asian and other immigrant communities.

The study also has limitations. As a theoretical

and conceptual paper, it does not present

empirical data, which restricts the ability to

illustrate expanded intersectional methods

through primary participant experiences. The

focus on South Asian immigrants as an illustrative

example, while analytically useful, may limit the

generalizability of some arguments to other

immigrant groups shaped by different

geopolitical, historical, or cultural trajectories.

Additionally, the reliance on existing peer-

reviewed literature means the analysis is

constrained by the epistemic boundaries,

omissions, and biases present in the current

research landscape. Despite these limitations,

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ISSN 2612-2138

the study lays important groundwork for future

empirical applications.

Practical and social value

This study holds practical and social relevance

for global mental health research, policy, and

practice. By interrogating how intersectionality is

currently operationalized, and where it falls short,

the paper offers guidance for researchers seeking

to apply the framework with greater

methodological rigor and cultural sensitivity. For

practitioners and service providers, the expanded

intersectional model highlights the need to move

beyond individualizing or culturally reductionist

interpretations of immigrant mental health,

advocating instead for relational, community

rooted approaches.

At the policy level, the study underscores how

mental health disparities among immigrants

cannot be addressed without confronting

systemic racism, exclusionary immigration

regimes, and colonial legacies embedded within

health systems. The incorporation of qualitative,

reflexive, and decolonial tools provides a

pathway toward designing more equitable and

materially grounded mental health interventions

that recognize the complexity of immigrant

experiences.

Conclusion

This paper evaluated the applicability of

intersectionality within immigrant mental health

research and demonstrated how its strengths are

accompanied by conceptual and

methodological tensions. While intersectionality

remains essential for understanding the

overlapping systems that shape immigrant

mental health, its potential is limited when

applied through narrow, additive, or Western

centric frameworks. By integrating qualitative

inquiry, reflexivity, and decolonial approaches,

the paper proposes an expanded intersectional

model capable of capturing plural ways of

knowing, honoring lived experiences, and

addressing structural inequities.

Future research may empirically apply this

expanded framework across diverse immigrant

populations, examine how experiences reflect

geopolitical histories, and explore how decolonial

and pluriversal methodologies can be

operationalized within mental health studies.

Acknowledgements

The author wishes to thank their doctoral

supervisor- Dr. Toupey Luft for her continued

support and intellectual guidance.

Funding statement

The author declares that this research did not

receive any specific grant from funding agencies

in the public, commercial, or not-for-profit

sectors.

Conflict of interest

The author declares no conflicts of interest.

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