Workplace Racism and Mental Health: A Literature Review Analysis

This literature review explores the impact of racism on mental health in the workplace, with a focus on immigrants in Australia. The review analyzes various literary articles, highlighting how racial discrimination increases psychological demands, reduces self-esteem, and elevates depression levels, ultimately hindering organizational productivity. Studies indicate that subtle forms of discrimination, such as micro-aggressions, significantly affect mental health, leading to depressive symptoms and increased employee turnover, especially among ethnic minorities. The review also reveals that racial discrimination in workplace settings causes higher psychological distress compared to other public places. Furthermore, the economic burden of racial discrimination in Australia is substantial, primarily affecting Aboriginals and immigrants, leading to increased anxiety, depression, and PTSD. The review identifies a gap in research concerning the specific impact of racial discrimination on immigrants in Australian hospital settings, suggesting a direction for future research.

Running head: LITERATURE REVIEW
How Racism impacts Mental Health in the Workplace
Name of the Student
Name of the University
Author Note

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LITERATURE REVIEW
Abstract
Discrimination means denying equal treatment to people. People from the poor socio-
economic background or people who are from minority classes become victims of racial
discrimination. Racial discrimination creates a sense of immense depression among the
victims. The paper conducted a systematic review based on the search of the literary articles
on the topic, "How racism impacts mental health in the workplace?". The analysis of the
literary articles highlighted that racial discrimination increases psychological demands along
with the generation of poor self-esteem and high sense of depression. This further hampers
the level of organisational productivity. However, the analysis of the review did not highlight
any significant studies conducted over the racial discrimination over the immigrants in
Australia under the hospital settings and how it impact their mental health. Hence the future
research scope will be directed towards this research gap.

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LITERATURE REVIEW
Table of Contents
Introduction................................................................................................................................3
Search Strategy...........................................................................................................................3
Databases................................................................................................................................4
Keywords and combination of keywords...............................................................................4
Inclusion and exclusion criteria.............................................................................................4
Flow chart...............................................................................................................................8
Critical analysis of literature......................................................................................................9
Summary table of literature......................................................................................................11
Summary of the review............................................................................................................14
Gaps in research.......................................................................................................................14
Further research proposal.........................................................................................................15
Conclusion................................................................................................................................15
References................................................................................................................................16

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LITERATURE REVIEW
Topic: How racism impacts mental health in the workplace?
Introduction
Discrimination is defined as an act of denying equal treatment to the people because
of their groups, skin colour or due to their ethnic background (Triana, Jayasinghe and Pieper
2015).Racial discrimination denies people from ethnic and racial minority backgrounds from
comprehensive access to basic rights like ability to take part equally and freely in social
activity and equitable service provision (Ferdinand, Paradies and Kelaher 2015). According
to Walker (2012), Australia has long considered as immigrant nation. Each year the total
number of Australians who are born overseas increases. These immigrants are first kept in the
detention centres is it’s a part of mandatory rule in Australia since 1992 (Australian Human
Rights Commission 2014.). According to Newman, Proctor and Dudley (2013) the
immigrants in the detention centre in Australia becomes a victim of the racial discrimination
and other kind of mental torture which decreases their overall health related quality of life.
According to the reports published by the ABC news Australia New Zealand and the South
Sudanese immigrants report highest level of discrimination in the healthcare centres which
force them to pass on to depression. The following paper aims to analyse the impacts of racial
discriminationon the mental health under the workplace settings with a special focus on the
immigrants’ workers and the immigrant service users in healthcare.
Search Strategy
The main search strategy that was used for the systematic review was electronic
search of articles through online databases.

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LITERATURE REVIEW
Databases
The main databases which were used for the search of articles include Google Scholar and
PubMed, CINHAL and MedLine.
Keywords and combination of keywords
Population Boolean
Operator
Intervention
/Interest
Boolean
Operator
Comparator
/Control
Boolean
Operator
Additional
Keyword
Immigrants
in Australia
AND Mental
Health
AND Workplace
settings
AND Racial
discrimination
OR OR OR OR
Immigrants Depression Workplace Racism
OR OR
Asylum
Seekers
Anxiety
OR OR
Australian
Immigrants
Self-esteem
Inclusion and exclusion criteria
Inclusion Criteria Exclusion Criteria
Articles published after 2010 Articles published before 2010
Articles centring Australian immigrants Articles centring immigrants from other parts of
the world
Primary and Secondary Research Case studies
Articles published on adults workforce Articles published on minors
Articles published in English Articles published other than English

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LITERATURE REVIEW
Figure: Screen shot of Google Scholar Search
Keywords used "Australia" AND "immigrants" AND "Racial Discrimination" AND
"Healthcare"
Filters used Articles published after 2010
No of hits 2,240
Figure: Screenshot of Google Scholar Search

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LITERATURE REVIEW
Keywords used "Australia" AND "immigrants" AND "Racial Discrimination" AND
"workplace" AND "Mental health"
Filters used Articles published after 2013, no patents and citations included
No of hits 853
Figure: Screenshot in PubMed
Keywords used "Racial Discrimination" AND "Mental Health" AND "workplace" AND
"Australia"
Filters used Articles published after 2010, Full-Text
No of hits 38

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LITERATURE REVIEW
Figure: Screenshot of PubMed
Keywords used "Racial Discrimination" AND "Mental Health" OR "Depression" AND
"Australian Immigrants" AND "Australia" AND "Hospital"
Filters used Articles published after 2010, Full-Text
No of hits 4

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LITERATURE REVIEW
Flow chart
PRISMA 2009 Flow Diagram(Moheret al. 2009)
Records identified through database
searching
(n = 38 )
Additional records identified
through other sources
(n = 2 )
Identification
Full-text articles assessed
for eligibility
(n = 15)
Studies included in
qualitative synthesis
(n = 8 )
Full-text articles excluded,
with reasons
(n = 7 )
Records excluded
(n = 5 )Records screened
(n = 20 )
Records after duplicates removed
(n = 20 )
Included Eligibility Screening

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LITERATURE REVIEW
Critical analysis of literature
In order to analyse racial discrimination in workplace, Van Laer and Janssens (2011)
conducted a qualitative study over the ethnic minority professionals. They mainly included
26 ethnic minority people (Turkish or Maghrebu descent in Flanders) and conducted an
interview. The analysis of the interview highlighted that the subtle discrimination occurring
in the workplace is characterized by three different elements. The first element is ambiguous
and mainly deals with disempowerment through apparent empowering behaviour. The second
subtle discrimination is based on process of power like the normalization like legitimization
and normalization. The third subtle discrimination is the workplace is associated with societal
structures and discourses which permeat the workplace. In the domain of racial
discrimination, Nadalet al. (2014) conducted a study in order to study the impact of racial
micro-aggressions on the mental health. The analysis of the results highlighted that the subtle
and unintentional form of racial discrimination and mostly prevalent among the ethnic
minority group under the workplace settings. This racial mirco-aggression negatively affects
the mental health of the individual leading to the generation of depressive symptoms which in
turn decrease the productivity of the employee and increase in the rate of the employee
turnover. Moreover, increase in the employee turnover signifies especially among the ethnic
minority group leads to decrease in the workplace diversity which again hampers the
organisation's productivity. In relation to the impact of the mental health on racial
discrimination in workplace, Ferdinand, Paradies and Kelaher (2015) conducted a cross-
sectional survey among the Australian culturally and linguistically diverse communities.
They collected data from 1,130 Australians in relation to the kind of racial discrimination
they experienced under the workplace settings which lead to an increase in the psychological
distress. The analysis of the results via the psychological distress scale highlighted that the

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LITERATURE REVIEW
age, religion, education, visibility and gender, all are significantly associated with the
differences in the frequency of getting victim of the racial discrimination in workplace.
However, the impacts of mental health were not associated with the type of discriminatory
experience but all promoted an overall increase in psychological distress. The discrimination
occurring under workplace settings promoted higher level of psychological distress in
comparison to other racial discrimination occurring in shops or in other public places. The
study conducted by Elias and Paradies (2016)was based on the mental health disease burden
due to the exposure of the racial discrimination under the workplace settings. In order to
achieve their aims, Elias and Paradies (2016) conducted a survey and performed meta-
analysis of the data obtained from the racial discrimination with health-related outcomes. The
analysis of the data highlighted that the racial discrimination increases the mental health
pressure over the victims and this in turn increases overall cost in order to improve their
health related quality of life. The meta-analysis conducted by Elias and Paradies (2016)
highlighted that in Australia, the main victims of the racial discrimination are the Aboriginals
and the immigrants and it has cost to the Australian economy 235,452 in disability adjusted
life years lost. This is again equivalent to annual gross domestic product (GDP) and this
indicates sizeable loss for the economy. The analysis of the survey also highlighted the
impact of racial discrimination mainly caused negative mental health related outcomes like
increase in the sense of anxiety, depression, anxiety and post-traumatic stress disorder
(PTSD).Font, Moncada and Benavides (2012) conducted a study over immigrants in
Australia who are working as labour force. Font, Moncada and Benavides (2012)mainly
conducted multistage cluster sampling in order to evaluate the effect of mental health arising
out of workplace discrimination. The analysis of the results highlighted that immigrants’
worker experienced high level of quantitative demands and high level of emotional demands
in order to hide their emotions while they are exposed to mental health complications under

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LITERATURE REVIEW
the workplace settings. This leads to an increase in the overall state of mental depression,
poor self-esteem and lack of productive inputs in work. The analysis of the results also
highlighted that native workers are more exposed to this kind of discrimination factors in
comparison to the non-natives. Thus their perceived mental health loss is also high.
Limpangog (2012)is of the opinion that the immigrants in Australia mainly experiences racial
discrimination while seeking healthcare due to their cultural and language barrier in
Australia. Moreover, Mahmoud and Hou (2012) are also highlighted that immigrants due to
lack of proper knowledge mainly uses emergency department as a medium of primary care
and this increases the overall burden over the healthcare workers leading to increases in the
tendency of racially discriminating the health service users, immigrants in Australia. The
aftermath of this racial discrimination increases the overall mental health burden leading to
depression and poor self-esteem. The review of the immigrants’ utilization of the emergency
departments in Australia highlighted that language barrier leads to improper utilization of
hospital units and thus they become victim of the unfair treatments of the hospital staffs
(Mahmoud and Hou2012).
Summary table of literature
Name of the
author and year
of publication
Aims of the
research
Study design Research findings
Van Laer, K. and
Janssens, M.,
2011
To analyse the
nature of racial
discrimination in
workplace
Qualitative study
based on interview
conducted over ethnic
minority group from
Turkish or Maghrebu
descent in Flanders
The results highlighted that there
is subtle discrimination in the
workplace over the ethnic
minority group

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LITERATURE REVIEW
Nadal, K.L.,
Griffin, K.E.,
Wong, Y., Hamit,
S. and Rasmus,
M., 2014
To analyse the
effect of racial
mirco-aggression
on the ethnic
minority group in
the workplace
Systematic review Mirco-aggression negatively
affects the mental health of the
victims and thereby increasing the
sense of depression which again
decreases the productivity of the
employee
Ferdinand, A.S.,
Paradies, Y. and
Kelaher, M., 2015
To analyse the
impact of racial
discrimination on
mental health
Cross-sectional survey
among 1130
Australians who
belong to culturally
and linguistically
diverse (CALD)
communities
Racial discrimination occurring
under workplace settings be it
context of gender, ethnic
background, language, skin
colour or the spiritual thoughts,
hold prominent significance in
casting mental health impacts
among the CALD communities of
Australia. The mental health
impact lead to an increase in
psychological distress
Elias, A. and
Paradies, Y., 2016
To estimate the
burden of the
disease arising out
of exposure
towards racial
discrimination
and measuring the
cost of this
exposure.
Meta-analysis of the
survey conducted over
the CALD
communities in
Australia
Racial discrimination in the
workplace results in negative
mental health outcomes which
increased the depression, anxiety
and post-traumatic stress disorder
Font, A., To analyse the The authors mainly Workplace discrimination

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LITERATURE REVIEW
Moncada, S. and
Benavides, F.G.,
2012
relationship
between the
immigration and
the mental health
via taking into
consideration of
the psychosocial
factors under the
workplace
settings
conducted multistage
cluster sampling over
7612 workers who are
immigrants and are
working as labour
force
hampered the mental health and
well-being of the immigrants
workers causing high emotional
demands
Mahmoud, I. and
Hou, X.Y., 2012
The aim of the
study was to
review if
immigrants use
emergency
departments
differently in
comparison to the
host populations
the also aimed to
review the
satisfaction level
of immigrants in
emergency care
Review of the studies
published about the
utilization of
emergency
departments by the
immigrants in
Australia
Immigrants tend to use
emergency department differently
due to lack and cultural barrier.
This make their overall
experience negative as they
become victim of racial
discrimination and thus suffer
from poor mental health

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LITERATURE REVIEW
Summary of the review
The analysis of the research articles highlighted that minority groups become victims
of the racial discrimination in the workplace. This racial discrimination is manifested in the
form of micro-aggression which negatively affects the overall mental health and well-being
of the victims and thereby increasing the sense of depression and decreasing the
organisational productivity. The racial discrimination varies with the skin colour, gender and
with the cultural background of the people. People who are immigrants and belong to CLAD
group are more vulnerable in getting victims of racial discrimination. Becoming victims of
racial discrimination leads to psychological distress, anxiety and post-traumatic stress
disorder along with high emotional demands. The Australian immigrants also become victims
of racial discrimination mainly in the detention centre and under the healthcare settings.
Gaps in research
The main gaps in the literature is, there are direct evidence of the type of racial
discrimination experienced by the immigrants in Australia under the healthcare settings of a
multi-ethnic hospital and how this kind of racial discrimination force them to pass on to
depression which affects their overall health and well-being further. The articles which are
published online mainly highlights the mental health consequences as a result of racial
discrimination under workplace settings but there are direct study about immigrants mental
health in hospital settings under the topic of racial discrimination.

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LITERATURE REVIEW
Further research proposal
The future research proposal will be directed towards the research question, How does
racial discrimination within immigrants in multi-Ethnic hospital employees lead to
depression on immigrants?.
The research design will mainly be qualitative based in open-ended interview
conducted over the immigrants in Australia who have visited multi-ethnic hospital. The
questioner will be drafted in such a way that it will help to capture their mental health
consequences and the state of depression upon getting victims of racial discrimination and
how they treated bythe multi-ethnic hospital employee.
Conclusion
Thus from the above discussion, it can be concluded that the racial discrimination
under the workplace settings affect the mental health status of an individual leading to
increase in the psychological imbalance along with an increase in the sense of depression.
The Australian immigrants also becomes victims of the negative mental health during their
stay in the detention centre, the future research proposal will mainly be directed towards
analysis of the mental health and the level of depression of the immigrants in Australia who
have become victims of the racial discrimination under hospital settings.

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LITERATURE REVIEW
References
ABC News. 2016. New Zealand, South Sudanese migrants to Australia 'report highest levels
of discrimination. Access date: 22nd September 2018. Retrieved from:
http://www.abc.net.au/news/2016-08-24/new-zealanders-report-higher-levels-of-
discrimination/7778520
Australian Human Rights Commission.2014.Immigration detention and human rights. Access
date: 22nd September 2018. Retrieved from:
https://www.humanrights.gov.au/our-work/asylum-seekers-and-refugees/projects/
immigration-detention-and-human-rights
Elias, A. and Paradies, Y., 2016. Estimating the mental health costs of racial
discrimination. BMC public health, 16(1), p.1205.
Ferdinand, A.S., Paradies, Y. and Kelaher, M., 2015. Mental health impacts of racial
discrimination in Australian culturally and linguistically diverse communities: a cross-
sectional survey. BMC public health, 15(1), p.401.
Font, A., Moncada, S. and Benavides, F.G., 2012. The relationship between immigration and
mental health: what is the role of workplace psychosocial factors. International archives of
occupational and environmental health, 85(7), pp.801-806.
Limpangog, C.P., 2012. Racialised and Gendered Workplace Discrimination: The Case of
Skilled Filipina Immigrants in Melbourne, Australia.”. Journal of Workplace Rights, 17(2),
pp.191-218.
Mahmoud, I. and Hou, X.Y., 2012. Immigrants and the utilization of hospital emergency
departments. World journal of emergency medicine, 3(4), p.245.

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LITERATURE REVIEW
Moher, D., Liberati, A., Tetzlaff, J. and Altman, D.G., 2009. Preferred reporting items for
systematic reviews and meta-analyses: the PRISMA statement. Annals of internal
medicine, 151(4), pp.264-269.
Nadal, K.L., Griffin, K.E., Wong, Y., Hamit, S. and Rasmus, M., 2014. The impact of racial
microaggressions on mental health: Counseling implications for clients of color. Journal of
Counseling & Development, 92(1), pp.57-66.
Newman, L., Proctor, N. and Dudley, M., 2013.Seeking asylum in Australia: immigration
detention, human rights and mental health care. Australasian Psychiatry, 21(4), pp.315-320.
Triana, M.D.C., Jayasinghe, M. and Pieper, J.R., 2015. Perceived workplace racial
discrimination and its correlates: A meta‐analysis. Journal of Organizational
Behavior, 36(4), pp.491-513.
Van Laer, K. and Janssens, M., 2011.Ethnic minority professionals’ experiences with subtle
discrimination in the workplace. Human Relations, 64(9), pp.1203-1227.
Walker, D., 2012. Anxious nation: Australia and the rise of Asia 1850-1939. Anxious Nation:
Australia and the rise of Asia 1850-1939, p.xv.