British psychiatry has tended to hold itself aloof from social theory. Nonetheless, these ideas have influenced the development of mental health services. Alongside this, the biopsychosocial model cannot reconcile contradictions in the scientific evidence regarding mental illness. We need to develop a more constructive understanding of the implications of social theory.

An aging population and immigration-based population growth necessitate research, practice, and policy focusing on the mental health of older immigrants in Canada, especially, because their mental health appears to deteriorate over time. This review focuses on: What is known about the social determinants of mental health for older immigrants in Canada and what are the barriers they face in accessing mental health services? Findings reveal that: (1) the key social determinants of mental health are culture, health services and gender; (2) older immigrants use fewer mental health services than their Canadian-born counterparts due to cultural beliefs, lack of culturally and linguistically-appropriate services, financial difficulties, and ageism; and (3) regardless of the subcategories within this population, older immigrants experience mental health inequities. The research evidence provides a clear message that addressing mental health service gaps for older immigrants should be a policy and practice priority for Canada’s health care system.