Reading Assignment-Albanian Help Seeking Behavior

Journal of Balkan Studies
Help-Seeking Behaviors and Mental

Well-Being of Albanian Immigrants
in Malaysia
Voltissa Thartori,
Nik A. Hisham Ismail,
Faizah Idrus,
Siti Kholijah Kassim
Abstract: The objective of this study is to explore the life experiences of 18 ethnic Albanian immigrants from
Albania and Kosovo currently living in Malaysia or who’d previously lived in Malaysia and currently live in
Australia. Specifically, the study explores (i) the obstacles and barriers immigrants face in Malaysia and (ii) the role
stigmatization has had regarding the immigrants’ help-seeking behaviors. The study uses the phenomenological
case study design and in-depth semi-structured interviews for collecting the data. The results show that narrations
regarding phenomena such as cultural shock, permanent residence status, stigmatization toward the immigrants,
and being labeled with terms such as Mat Salleh [Westerners] have adversely affected the immigrants’ mental
well-being. In addition, the Albanian immigrants, especially the females, felt safer confiding their burdens and
challenges with family members and close friends. Negative perceptions, stigmatization, and labeling are among the
psychological explanations the Albanian immigrants experienced. These inevitable shortfalls affect the immigrants’
mental well-being and correspond similarly to the experiences of many immigrants all over the world.
Keywords: ethnic Albanian, immigrants, mental well-being, phenomenological study, help-seeking behavior
Dr., UCSI, Kuala Lumpur Malaysia, voltisat@gmail.com

Prof. Dr., International Islamic University Malaysia, nikahmad@iium.edu.my
Assoc.Prof., International Islamic University Malaysia, ifaizah@iium.edu.my
Assis Prof., International Islamic University Malaysia, sitikholijahkassim@iium.edu.my
0000-0003-3482-4385
0000-0003-1944-3402
0000-0002-2340-429X
0000-0002-7043-0108
Balkan Studies Foundation Reiceved: 02.11.2022

DOI: http//doi.org/10.51331/A033 Revision: 20.12.2022
Journal of Balkan Studies, 3 (1), 2023 Accepted: 31.12.2022
balkanjournal.org
94 Journal of Balkan Studies
Introduction
Immigration has been and still is a global social phenomenon. Individuals who are un-
happy or dissatisfied with their own countries due to many economic, political, and
personal reasons choose to leave their homeland and migrate to other countries. This
movement is often associated with hopes and dreams for a better life and a desire to
achieve goals that were probably impossible to attain in their homeland. Some immi-
grants commonly leave for a better life without having given much thoughtkamariah@
unisza.edu.my about a particular destination, and might even have chosen unknown
destination. Thus, some immigrants might not have made preparations or did not plan
to migrate strategically, practically, systematically, or psychologically.
As a result, the exodus of immigrants to other countries can be stressful and may result
in adjustment and situational difficulties and challenges. Hence, many immigrants
are unfortunately found to suffer and be vulnerable to mental and psychological prob-
lems. In addition, barriers in the new environment such as language, cultural, religious,
social, economic, and political differences impact the immigrants’ well-being. Indeed,
living in a new environment that is unlike one’s own country may be highly challeng-
ing and stressful. Immigrants residing in a new country are exposed to life stressors
and challenges while assimilating, adjusting, adapting, integrating, and harmonizing
within a new environment and new community, and even with new friends. This phe-
nomenon may affect immigrants’ psychological and mental well-being. The experience
of migration can be a stressful decision for immigrants due to the psychological and
physical challenges. Numerous narrations in the literature have highlighted mental
stress among immigrants moving to a new country, namely in terms of language, cul-
tural barriers, social support, employment prospects, and financial and educational op-
portunities (Sainula et al., 2020; Voltissa & Ismail, 2021). Due to the complications of
shifting to a new environment, immigrants undoubtedly will have difficulty adjusting
to new way of life. Maladjustment causes stress, which has been proven to negatively
affect immigrants psychological and mental well-being. Furthermore, stress has the po-
tential to harm personal development, interpersonal relationships, and physical health
and can lead to loneliness, depression, and alienation.
Voltissa Thartori, Nik A. Hisham Ismail, Faizah Idrus, Siti Kholijah Kassim
Help-Seeking Behaviors and Mental Well-Being of Albanian Immigrants in Malaysia 95
Nevertheless, mental health issues among immigrants are among the social and psy-
chological problems that are often overlooked and not discussed openly. In many cases,
immigrants are afraid to reveal and disclose their mental health challenges and difficul-
ties due to the fear of being stigmatized. In addition, De Vylder et al. (2020) stated the
stigmatization of mental illnesses and other issues to implicate labeling and a devalu-
ing of individual worth. Thus, revealing how one is suffering from mental issues and
difficulties is a choice that could trap one into being discriminated, labeled, prejudiced,
and stigmatized by others. In other words, revealing or disclosing mental health chal-
lenges and difficulties may lead to negative perceptions from others who are confront-
ed with individuals with mental health issues. Consequently, people tend not to seek
the necessary treatments to avoid being labeled as crazy or as a lunatic. Moreover, de
Andino & de Manami (2022) also stated perceived discrimination by mental health
sufferers to also be associated with help-seeking attitudes. Discrimination can be gen-
eral in terms of ethnicity, race, skin color, language, and religion; however, many have
found the practice of discrimination to also be associated with mental and psychologi-
cal well-being. Chiang et al. (2022) referenced young adults and find adolescents to be
less likely to confide in anyone and more likely to have no one to confide with, as well
as their help-seeking behaviors to be connected to their concerns regarding the impacts
of being stigmatized, labeled, or experiencing prejudice. Furthermore, al-Maglash et al.
(2022) stated such factors as validity, accessibility, cost, easiness, approach ability, and
user-friendliness of intervention programs to affect individuals’ choices when seeking
help for their mental health.
In addition, immigrants do not seek help for their psychological problems for numer-
ous reasons. For instance, the stigma of being labeled as a crazy person is deeply rooted
in many societies’ social and cultural norms and may lead to individuals not seeking
help. As a result, worries, sadness, and sometimes madness remain untreated and dif-
ficult to diagnose and treat. Attitudes and perceptions toward seeking psychological
help are greatly influenced by an individual’s cultural norms and beliefs. Every culture
perceives mental health problems and help-seeking behaviors differently. The fewer de-
monological explanations a society has for mental illnesses and disorders, the better
individuals respond toward professional help. Lua et al. (2022) stated help-seeking be-
haviors to be related to life satisfaction, with different affects for different societies
based on how well individuals adapt to the sensitive perspective of the community to
which they’ve migrated. Bryant et al. (2021) posited individuals’ mental health to be
related to living arrangement, sexuality, age, sense of belonging, and ethnicity. Thus, in
order to avoid all the negative perceptions from society, an individual would normally
first seek help and informal support from family members, friends, and peers. Marti-
nez et al. (2022) stated mental health to be viewed as a stigmatized condition and many
people to opt to approach help-seeking behaviors first through their network of family
members and friends, followed by a community-based organization, and finally by pro-
fessional help. This statement is also supported by Seon et al. (2022), who expressed
help-seeking behaviors among young adults to be categorizable under informal and
formal approaches, depending on the type of help they are seeking. Another study from
Alviar and del Prado (2022) described help-seeking behaviors to generally be support-
ed by family, friends, peers, and religious institutions. For example, many would turn
to religion to find solace in prayer and meditation, as well as other religious practices
that deal with mental health issues. However, some would feel shameful and guilty in
seeking help from religious institutions due to it having practices and teachings that
are considered to typify strictness and rigidity.
Help seeking behaviors may also be gender-based issues or issues universal to both gen-
ders. However, females in reality perceive seeking help for mental health issues as some-
thing positive and acceptable. Research has shown female victims of mental health to
be better than their male counterparts at seeking help for mental health problems and
difficulties. Ratnayake and Hyde (2019) explained how individuals with high levels of
mental health literacy, especially female sufferers, will engage more in help-seeking be-
haviors compared to those with lower levels of mental health literacy, especially males.
Brown et al. (2022) claimed individuals’ perceived need to be a key barrier to help-seek-
ing behavior, with many males perceiving themselves to be less likely to need to seek
help for mental health issues. Sifat et al. (2022) stated individuals’ positive views, per-
ceived needs, and mental health literacy to be the motivating factors behind help-seek-
ing behaviors among female. Another study (Burke et al., 2022) addressed the ability of
factors such as socio-cognitivism, systemic risk, individual perceived need, and societal
structural to influence young men’s attitudes toward help-seeking behaviors regard-
ing mental health issues. Lipson et al. (2022) posited that the significance of inequal-
ities experienced by young adults is related to the identification of help-seeking be-
haviors between males and females. Furthermore, greater internalized mental health
stigmatization is positively related in both genders to help-seeking attitudes. Norwali

et al. (2022) maintained that male respondents believe help-seeking behaviors could
be seen as weak and a breach of a male’s masculinity. This attitude is very much related
to interpersonal dilemmas (e.g., communication, information accessibility, misconcep-
tions, religious beliefs, stigmatization, and professionals’ practices regarding ethical
standards) that could hinder men’s help-seeking behaviors.
Method
This qualitative study employs the phenomenological case study as its method. The
phenomenological case study approach is designed to explore specific phenomena as
described from the experiences of ethnic Albanian diaspora immigrants who are resid-
ing in Malaysia or had for a while and have since migrated to Australia as their perma-
nent residence. The phenomenological is design used to interpret these immigrants’
lived experiences, and a case study was conducted to gain an in-depth understanding
of Albanian immigrants and their experiences using an inductive procedure. The quali-
tative design of the study has been an excellent way for it to obtain rich and thick data.
Sampling
The study uses purposive and snowball sampling methods to recruit participants. Ilker
et al. (2016) asserted purposive sampling to be a non-probability sampling technique
that researchers can use to choose a sample in a population. The technique is useful due
to the study having limited resources, time, and manpower. Furthermore, the tech-
nique is suitable as the researchers do not aim to generalize the results for an entire
population. According to Cooper and Schindler (2003), purposive sampling allows re-
searchers to select individuals based on their unique features, experiences, attitudes,
or perceptions. Snowball sampling, also referred to as chain referral sampling, is also
a non-probability method for selecting a survey sample and is typically used to locate
populations. Parker et al. (2019) proposed snowball sampling to be one of the most
popular sampling methods in qualitative research. This technique usually starts with
initial contacts (i.e., seeds) who fit the criteria for becoming a participant in the re-
search. The participant is then asked to recommend other potential participants for
the research. The search for participants goes on until the researcher finds the target
sample size has been achieved and the saturation point has been established. Snowball
sampling is also a commonly used method in qualitative studies for identifying and
estimating hidden people. Another factor that makes snowball sampling important is
that it is a low-cost and effective way of locating individuals that are difficult to find.
Snowball techniques can also be used in many settings to collect data very quickly and
is undoubtedly an effective method for the primary exploration of phenomena and
populations. The use of snowball sampling has been essential in the current research
for finding participants through other participants due to the Albanian embassy no
longer being present in Malaysia nor any authority representing the Albanian people
there. Thus, snowball sampling has allowed the researcher to effectively locate the hard-
to-find population (Biernacki & Waldorf, 1981). These two techniques of purposive and
snowball sampling have been used to select Albanian immigrants living in Malaysia as
well as those residing in Australia. A qualitative case study by its nature entails a rela-
tively small sample size. Therefore, this study has recruited and interviewed 18 female
Albanian immigrants, with two female participants taking part in the pilot study.
Data Analysis
According to Creswell (2013), data analysis in the case study approach includes steps
similar to those found for other qualitative methods, such as data management, read-
ing, describing, classifying and interpreting. After collecting the data from interviews,
the researchers organized the material by creating folders for each data collection
method. All the interviews were recorded, transcribed into narrative texts, and numer-
ically coded alongside the first names of the participants. The researchers carefully read
the transcripts, listened to the recordings, and identified the significant statements
that reflect the participants’ understanding of their experiences and other issues relat-
ed to the mental well-being of ethnic Albanian immigrants.
The researchers analyzed the data by organizing them according to the main ideas and
then generated the themes. Themes are the conceptual elements that summarize the
aspects of the data (Merriam, 2009). Firstly, the researchers read all the transcriptions
repeatedly in order to familiarize themselves with the transcribed data and be more
comfortable for analyzing them. Secondly, the researchers developed the coding tem-
plate table to generate the main ideas.
To ensure inter-rater reliability, two experts also expressed agreement or disagree-

ment with themes the researchers had generated. Five themes were generated from
18 female participants. Next, the researchers assessed the inter-rater reliability for the
themes, calculating it by finding the percentage of agreement between the researchers
and the two experts.
Triangulation
In qualitative research, the validity of a study is related to whether the research find-
ings are valid and certain. Accuracy is a term that explains whether the research find-
ings precisely mirror the situation, and if sufficient proof is found to uphold the re-
search findings. Triangulation is a strategy qualitative researchers utilize to establish
validity in their investigations by breaking down a research question from numerous
points of views. Guion (2002), stated triangulation to involve multiple methods of ex-
ternal analysis that are able to enhance the utilization of multiple external data collec-
tion methods concerning an equivalent event. Triangulation is a technique in which
the researcher analyzes data, then presents the results to an audience to understand
the experience of a standard phenomenon. Cohen et al. (2002) described triangulation
as an attempt that help explore and explain complex human behaviors using a variety
of methods to offer a more balanced explanation to readers. A blended design combines
qualitative designs and is an excellent way to obtain rich and thick data. Therefore, the
researcher used a blended design in this research to attain one of the aspects of trian-
gulation. A phenomenological case study design is often seen from two perspectives:
a case study design with phenomenological interviews or a phenomenological study
that’s bounded in time and space by a case study design. Therefore, the researchers ex-
panded the sampling size and interviewed people who had lived in Malaysia in order
to fulfil the space and time aspect regarding the mental well-being of Albanian immi-
grants living in Malaysia as well as those who had previously lived in Malaysia. Reach-
ing a point of data saturation is far more achievable with the case study design than
with phenomenology. One further point to add is that a particular phenomenology can
be better understood with a good sampling method.
Findings
This study’s findings are grouped under five themes. The themes generated from this
study were aimed at answering the research objectives. Therefore, each theme is dis-
cussed in the findings with illustrated quotes from the participants.
Research Question 1: What are the psychological barriers faced by ethnic Albanians in
Malaysia and Australia?
Three themes emerged for this question: a) cultural shock, b) permanent residence
status and c) the Mat Salleh [Westerner] phenomenon.
Cultural Shock
Several informants claimed cultural shock to have been a major obstacle for them. Cul-
tural shock is inevitable, and anyone who travels abroad may experience some form
of cultural shock such as language, food, culture, or tradition. For example, the infor-
mants reported challenges in getting acquainted with the new culture and language in
Malaysia and Australia. They claimed that they had a hard time understanding local
people, as they did spoke neither English nor Malay. Some informants also reported
having problems and difficulty adjusting to local cuisines. For example, the Participant
12 explained how she had been devastated and sick during her first two years staying
in Malaysia. The food was different from Albania, and thus adjusting was difficult in
the beginning.
It [the food] was very overwhelming for me. Thus, I was sick for about two years,
so it was a bad experience for me when I moved to Malaysia; and I was young, the
food was not good. Everything that we used to eat there had sugar….it was so
strange to me why they had sugar in everything. Even the chicken had sugar. So, I
got sick. You know I was really ill for about two years. (Participant 12)
As for the participants, many opted for fast food such as McDonald’s, Burger King, and
Kentucky Fried Chicken due to being unable to access the cuisine from their homeland.
Meanwhile, cultural shock signifies the feelings of fear and confusion that a person
experiences due to their inability to adjust and feel comfortable in a new cultural envi-
ronment that is starkly different from their country of origin. Similarly, the Albanian
immigrants also reported facing many other barriers, including feeling homesick, anx-
ious, and nervous while adapting to the new culture, traditions, norms, severe lan-
guage barrier, and hot weather. The cultural shock was a challenge to the immigrants’
psychological and mental well-being. Furthermore, many of the respondents reported
being very unhappy there in Malaysia because they missed their families back home
dearly.
Permanent Residency Status
Another theme emerged was permanent residency (PR) status, particularly with regard
to the adversity ethnic Albanian immigrants faced in getting PR status in Malaysia. Ac-
cording to the respondents, getting PR status in Malaysia is full of challenges. Despite
even having resided for more than 20 years in Malaysia, they specified attaining PR
status in Malaysia to entail many challenges. Therefore, many who had applied were
known to commonly be found to have been rejected. For example, one of the respon-
dents narrated how her application for PR status was rejected more than two times, so
she decided to migrate to Australia. Meanwhile, another respondent stated how failing
to get PR status despite being married to a Malaysian had been a great disappointment
for her. She had spent more than 20 years in Malaysia, was married to a local, and had a
Malaysian son yet was ineligible for attaining PR status. Regretfully, the locals still con-
sidered her as a foreigner. Another respondent added how her biggest disappointment
in Malaysia had been her family’s application for PR status being rejected. Her father
had filed for PR status five times, and each application had been rejected. She highlight-
ed that she could speak the local language, adhere to Malay customs and went to a na-
tional school, yet she could not be considered eligible for PR status.
We said that maybe Malaysia is our home you know; we wanted to stay there, not
just for a while, but a long-term stay there… forever… We applied three times…
for this PR, but it didn’t come through. (Participant 12)
I consider myself to be half Malaysian because my son is Malaysian… I’m still
a foreigner…that’s what makes me feel unhappy. You can live here for 20 years
[and] marry a local…but you will never be eligible for a PR. (Participant 10).
Meanwhile, two informants who had left Malaysia after 10-18 years of residing there
stated that they had been given Australian PR status after being there for only two
years.
In Australia…I actually don’t have any disappointments here…the government

granted me PR status after two years, then my family was given not just PR status
but also citizenship… We are all Australian citizens. (Participant 16)
We might get PR status here in Australia… Once you enter this country… they
show you a pathway for getting PR status and then citizenship. (Participant 8)
According to the respondents who now reside in Australia, they had been stressed and
felt like foreigners in Malaysia after a series of attempts to get PR status. Now, however,
they felt elated and shared a sense of belonging after being accepted as citizens in Aus-
tralia. They believe that Australia is a nation of immigrants. Thus, gaining Australian
PR status and citizenship is relatively easy, especially for ethnic Albanian immigrants
from Europe. However, because of Malaysia’s federal constitution, it places more con-
ditions on immigrants who wish to obtain PR status and citizenship.
Still, the informants also shared that attaining PR status would give them a sense of se-
curity and ease their worries about the future. Immigrants with children indicated not
wanting their children to repeatedly apply for visa renewals to reside long term in the
country, as the process is so tedious and sometimes upset their feelings as well as their
sense of self-esteem and humanity. Having permanent residency gives a person peace
of mind and security, as well as other numerous benefits. Having PR status in Malaysia
may allow one to seek employment and other social benefits such as medical and social
support, while many who’d migrated to Australia felt happy and welcomed in Australia.
Mat Salleh Labeling
The ethnic Albanian immigrants faced significant challenges as they tried to engage
and send their children to Malaysian national schools. Some of the immigrant chil-
dren reported being bullied and discriminated against due to being labeled as different.
Their struggles to adjust and conform with the norms and values of the local schools
appeared to have been undetectable by their peers, teachers, and schools. Several re-
spondents stated how local children had verbally bullied their children with name call-
ing. Somehow, the phrase Mat Salleh [Westerner] has a somewhat skewed connotation
with a negative meaning and is labeled toward the Albanian children. The ethnic Alba-
nian immigrants claimed that their children were still seen as European in school, even
though the children tried to fit in and conform to the national school culture just like
other Malaysian students. They also claimed how some of their children had been inten-
tionally discriminated against in school by their peers, such as how the local students
had perceived and assumed that all Mat Salleh are from England and non-Muslim. For
example, an Albanian mother who considered herself to be happy and liked her life
in Malaysia meanwhile reported being disappointed with how her children had been
labeled, discriminated against, and verbally abused in school. Those bad experiences
had made her question her sense of belonging and rejection by the local Malaysians.
Another participant said that her peers had always called her a Mat Salleh and that she
couldn’t accept it; she felt bad because the local people perceived her to have the same
mentality as Europeans.
They [the children] were always bullied…, being called names [negative narra-
tions] by their school peers, such as Orang Puteh [white person] or Mat Salleh…
What was disturbing for my children is that they wanted to fit in with the Malay-
sian children because they had been born in Malaysia. They kind of felt like Malay-
sian kids, but the authorities treated them as if they were foreigners all the time,
even though they were very much a part of the Malaysian culture. (Participant
16)
I speak their language, I was born here, they never [accepted me], they always
called me a foreigner, they always call me Mat Salleh [with negative connota-
tions]. (Participant 1)
Research Question 2: How does self-stigmatization prevent the help-seeking behaviors of

immigrants in Malaysia and Australia?
The two themes that emerged for this question are a) perceptions toward mental
well-being and b) help-seeking behaviors.
Perceptions Toward Mental Health
The study reported many ethnic Albanians immigrants to have felt ashamed to share
information about their mental well-being. They were reluctant to share information
about their mental being and related issues with others, instead choosing to be discreet
about their apprehensions. Some immigrants thought they would be able to protect
their self-image and family dignity by doing so. Other immigrants believed that being
labeled as having an unsound mental well-being was absurd and shameful in reality.
For example, one respondent stated that she would be embarrassed to admit if sha had
any psychological or mental instabilities, even to family members. People tend to pre-
judge and label those who suffer from psychological/mental instability. Thus, prejudic-
es and discrimination are quite common for these unfortunate sufferers. Another re-
spondent pointed out how she had also been prejudiced in Albania and had had adverse
perceptions toward people suffering from psychological/mental illnesses. She honestly
believed that those who suffered from mental illnesses were weak and helpless individ-
uals. She could not confide in anyone when she was in Albania. In Malaysia, however,
the openness and abundance of information portrayed mental instability positively.
Sometimes people are judgmental, or they will think you are crazy. (Participant 2)
I would be embarrassed because… I am concerned about others’ opinions. I don’t
know, maybe the upbringing or the culture in which we were raised, because we
were always judged… They [the locals] are judgmental… No matter what you do,
good or bad, you will still be judged… So, for me, it matters. (Participant 3)
Help Seeking Behaviors
Family members and close friends are the individuals to whom ethnic Albanians would
turn to get help and share their grievances. Many immigrants stated family members
are the first individuals in whom they would confide their problems before turning to
friends. Still, they were selective and careful in choosing family members and friends
who are trustworthy, honest, and non-judgmental.
First, I will discuss with my family… and… they will be the first people to know…
And maybe my friends, because of course they are close. (Participant 7)
So, I guess family comes first… and then, of course, I don’t mind sharing with my
close friends, but of course I feel more satisfied discussing with my parent’s family
in general. (Participant 8)
The participants in the study reported seeking help from family and close friends when
they had any emotional pain or concern. Family support is undeniably vital to every-
one, especially those who live abroad and far away from their country. Thus, confiding
one’s problems and worries with others, especially with family members, makes the
family unit stronger. The Albanian immigrants felt safe and secure sharing their issues
with family and close friends in order to find solutions to their problems. The ethnic
Albanian immigrants found it difficult to open up to everyone due to fear that peo-
ple’s perceptions would be closely related to stigmatization. Stigmatization is visible in
various forms such as fear, bias, shame, embarrassment, rejection, and avoidance. For
most individuals, stigmatization is one of the barriers to seeking help for mental health
issues among sufferers in the community.
Discussion and Conclusion

Lindner et al. (2022) stated that self-actualization might not only concern its benefits
but may also include all facilities and infrastructures that promote well-being, such
as housing, student loans, health insurance, and aptitude toward living. This was ob-
served among the ethnic Albanian immigrants, who either stayed in Malaysia or mi-
grated to other countries such as Australia when they perceived the challenges that
they had previously encountered again after migrating to Malaysia as students as well
as after graduation. The other aspect of self-actualization is the immigrants’ feeling of
inclusiveness within the new society to which they had migrated despite having differ-
ent objectives for migrating. This could be seen among the ethnic Albanian immigrants’
apprehension and satisfaction in Malaysia and Australia with regard to how well they
were accepted by the host countries. Even though most of them had migrated to Ma-
laysia because of the public unrest and war in their countries, many had also come to
Malaysia to continue their education. At the beginning of their migration, they had
great challenges acculturating in the Malaysian society. Madi et al. (2021) viewed immi-
grants to maybe feel that the host country might be better for them by observing how
well they are treated and welcomed by the local community. As a result, perceptions
of discrimination and a lack of positive responses from the local community toward
ethnic Albanian immigrants was a normal finding. While the experience of discrimi-
nation can be equally hard and painful for different immigrant groups, the immigrants
commonly observed and generally accepted incidences of discrimination, stereotyping,
labeling, and prejudices. This study has identified some of the cases ethnic Albanian im-
migrants have experienced, and the difficulty they encountered was in regard to obtain-
ing PR status, which is essential for enhancing a sense of belonging due to the ethnic
Albanian immigrants expectation of belonging to a community.
The foreigner stereotype was another barrier ethnic Albanian immigrants had to deal
with: By referring to the immigrants as Mat Salleh [Westerners], the locals perceived
the ethnic Albanians immigrants as foreigners. In this study, the participants expressed
their dissatisfaction due to local perceptions and the rejection their children experi-
enced in the local schools. Somehow, the participants tolerated this quandary their
children experienced; in reality, however, children stating what they see without fil-
tering their words is part of their natural development, regardless of their differences.
Bernal et al. (2022) realized language competency to be another aspect of individual

self-actualization and a good indicator for acculturation. A high level of language com-
petency, especially with some competency in the host nation’s language, has been as-
sociated with lower levels of acculturation stress. Murphy et al. (2000) found positive
feelings such as hopefulness, joy, happiness, and peace to assist in overcoming this
stress, compared to negative feelings such as nervousness, anxiety, sadness, and guilt
which they associated more with acculturation stress and lower levels of psychologi-
cal functioning and well-being. The challenges ethnic Albanian immigrants face were
greatly related to their ability to master the local language and to communicate with
the local community. Despite English being the second language in Malaysia, most
people, especially those in rural areas with lower education levels, are still unable to
communicate well in English. Janely et al. (2022) examined the cultural shock of stu-
dents who communicate in English in foreign lands based on the perspective of dis-
tinctive cultural backgrounds and lifestyles. In their study, ethnic Albanian immigrants
mentioned ways locals differ from them such as how they greet, talk, interact, social-
ize, behave, eat, think, maintain eye contact, and manage their time. From another
perspective, Hesty & Nur (2022) noticed cultural differences such as communication,
language, food, dress, individualism, food, family structure, perceptions, religion, time
orientation, tradition, and weather to cause students to experience cultural shock
abroad. Also, in regard to well-being, Swerdlick et al. (2018) noted that immigrants’
well-being may also involve their economic and financial struggle to survive and to
maintain a living, their social life and family responsibilities in the host country as well
as in their homeland. Some ethnic Albanian immigrants had to find part-time jobs to
meet their financial needs as well as those of their parents in their home countries. his
study was able to see how the experiences and challenges that the immigrants went
through had strengthened their self-esteem, self-actualization and resilience toward
challenges as immigrants.
The second part of the study examined the effects of survival and help-seeking behav-
iors among ethnic Albanian immigrants. Guarneri et al. (2018) stated negative aspects
of well-being such as stigmatization to always be a common denominator in mental
health issues, as well as other constructs such as race, ethnicity, and gender. In general,
perceived stigmatization and self-stigmatization negatively affect individuals’ well-be-
ing and willingness to seek help, and men are more commonly found to find experience
this negative aspect of well-being than women. This result shows similarities to the
greater willingness female ethnic Albanian immigrants have to seek psychological help
as a method of early intervention with regard to their mental health issues compared
to their male counterparts. Goncalves, M., & et al. (2022) stated men’s help-seeking
behaviors to depend on their perceptions toward the male gender; to be unique to indi-
vidual, interpersonal, and sociocultural factors; and to impact their life based on tradi-
tional gender stereotypes. In general, the respondents mentioned that they would seek
help from individuals who were close to them, such as their family and friends. Among
the reasons mentioned as to why the Albanian immigrants turned to their families,
and close friends for help was that they didn’t want other people to know about their
problems and concerns. According to the respondents, Albanian people are quite prej-
udiced towards people with problems and, as a result, hide their issues from their com-
munities to maintain their image. In summary, ethnic Albanian immigrants have trou-
ble opening up to people because they do not know what people might think of them.
This fear of people’s perceptions and opinions is closely associated with the stigmati-
zation they have toward people’s perceptions. Therefore, to prevent their name from
being tarnished in public, they feel they have to hide any weaknesses, such as their
emotional pain and psychological/mental health issues. Shu et al. (2022) posited fear
of losing reputation to be related to stigmatizations toward mental illnesses; however,
the nature of this relationship seems to be bidirectional. Participants argued that fear
of losing reputation was either the cause of their mental health difficulties or the con-
sequence of having mental health difficulties and being stigmatized for them. In both
cases, a loss of reputation directly added stress, whether by tarnishing their reputation
or by tarnishing their family’s reputation. Yongbin Kim et al. (2022) stated emotion-
al self-control to be significantly associated with unfavorable help-seeking attitudes.
This could be seen in the current study with the ethnic Albanian immigrants’ positive
responses in regard to dealing with the difficulties and problems they face, both for
those living in Malaysia and those living in Australia. Moreover, this study also showed
self-compassion to be a significant aspect of resilience for many ethnic Albanian immi-
grants’ ability to maintain and sustain their relationships in their family and the soci-
ety where they currently live.
In conclusion, many ethnic Albanian immigrants’ experiences with regard to settling

down in their host countries (i.e., Malaysia and Australia) are similar to those of many
other immigrants all over the world. The most significant lesson would be the impor-
tance mental/psychological health and well-being have in maintaining sanity and help-
ing one charter new episodes in life.
Funding: The authors have no funding to disclose.
Conflicts of Interest: The authors have no conflicts of interest to declare.
Informed Consent: Informed consent was obtained from all individual adult
participants
involved in the study.
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Journal of Balkan Studies

Help-Seeking Behaviors and Mental

Dr., UCSI, Kuala Lumpur Malaysia, voltisat@gmail.com

Balkan Studies Foundation Reiceved: 02.11.2022

stigmatization is positively related in both genders to help-seeking attitudes. Norwali

To ensure inter-rater reliability, two experts also expressed agreement or disagree-

Permanent Residency Status

In Australia…I actually don’t have any disappointments here…the government

Mat Salleh Labeling

Research Question 2: How does self-stigmatization prevent the help-seeking behaviors of

Perceptions Toward Mental Health

Help Seeking Behaviors

Discussion and Conclusion

Bernal et al. (2022) realized language competency to be another aspect of individual

In conclusion, many ethnic Albanian immigrants’ experiences with regard to settling

Funding: The authors have no funding to disclose.

Conflicts of Interest: The authors have no conflicts of interest to declare.

involved in the study.

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