Albania and Kosovo-Albania Immigrants' Perceptions of Mental Well-Being and the Psychological Challenges Faced in Malaysia

Abstract

Background

Immigrants who relocate to a foreign country often face numerous stressors and challenges as they try to assimilate to a new culture. This transition can often have a significant impact on their mental well-being. In this qualitative study, we aim to explore and examine the life experiences of 16 Albanian and Kosovo-Albania immigrants who have settled in Malaysia, as well as those who previously resided in Malaysia but are now living in Australia and Albania.

Objectives

This study aimed to investigate two main objectives: (i) to explore immigrants’ psychological problems and how they perceive and approach mental well-being; and (ii) to identify the challenges and barriers that immigrants face in Malaysia.

Methods

The data was obtained using a qualitative phenomenological case study, using in-depth semi-structured interviews. The interviews were audio-recorded, transcribed, and thematically analysed.

Results

The study's findings indicate that immigrants' mental well-being is positively affected by inner peace, happiness, fulfilling family needs, a balanced life, and self-improvement. On the other hand, challenges related to visa and employment pass issues, difficulty in securing employment status, feeling like a foreigner, and lack of family support have a negative impact on their mental well-being.

Implications

The study's findings advocate for targeted support programmes to address the psychological challenges of Albanian immigrants. Prioritising inner peace and self-improvement benefits their mental well-being. Policymakers are encouraged to prioritise reducing employment pass difficulties and fostering an inclusive job market to improve employment opportunities for this community.

Introduction

Immigration is one of the oldest social phenomena, with people moving for various reasons such as economic, political, social, and cultural aspects (Lucas, 2005). The number of international migrants has significantly increased over the last 50 years, with approximately 272 million people living outside of their birth countries as of 2019 (World Migration Report, 2018). The proportion of immigrants has increased worldwide, including Albania, where it was reported that in 1990, one in four people from the Republic of Albania migrated globally (Kasimati et al., 2009). According to the 2021 census data released by INSTAT (INSTAT 2021), the most prevalent reasons for emigration among Albanians are attributed to limited career opportunities, access to education, and healthcare. As a result, approximately 21% of the Albanian population is estimated to be living outside the country's borders (Cattaneo, 2009). Moreover, in a recent survey evaluating potential migration rates, Albania ranked fourth globally, with 60% of its population expressing a desire to migrate. Additionally, the country ranked sixth in the world, with 9.1% of its citizens actively making plans to migrate (King and Gëdeshi, 2020).

The literature review suggests that the primary reason for emigration is often linked to political, demographic, socio-economic, and environmental conditions. These aspects play a crucial role in shaping and contributing to the process of migration. (Castelli, 2018). Migration is often associated with the hopes and dreams of a better life and the desire to achieve goals that were probably unattainable in their home country. While refugees commonly flee for their lives given short notice to unknown destinations, most immigrants have made preparations or a real choice to change their country of residence. In other words, immigrants plan-ahead practically, psychologically and systematically (Tribe, 2002). The process of immigration is not just a change of environment; it involves various other changes, such as social, ecological, cultural, and behavioral adjustments, which can result in distressing situations impacting immigrants' mental wellbeing (Al-Hawdrawi, 2017). Factors such as language barriers, cultural obstacles, a lack of social support, and unemployment can also contribute to elevated stress levels among immigrants, influencing their quality of life in the host country (Ku & Waidmann, 2003; Kasimati et al., 2009). Acculturation, or the process of adapting to a new culture, poses challenges for immigrants migrating to countries with different cultures and lifestyles from their countries of origin (Berry et al., 2002). This process can lead to culture shock and additional psychological adjustments due to stressors related to acculturation, employment search, adapting to a new environment, feelings of loss, and a sense of not belonging in the host country (Sarkar & Bera, 2015; Pantelidou & Craig, 2006; Torres & Rollock, 2004).

Furthermore, many other factors and indicators motivate individuals to migrate such as political and economic reasons among many others. According to the Push and pull theory, developed by Rack (1982), individuals may be "pulled" to other countries for better economic or educational opportunities. Conversely, some individuals can be "pushed" to leave their countries for economic, political and social reasons which is the case in Albania since the end of the communist period in 1990, and in Kosovo after the war in 1998.

A recent literature review conducted by Pantelidou et al. (2021) investigated mental health service utilization among Albanian migrants in the Cyclades region, comparing it to native Greek residents. The study revealed that fewer Albanian migrants sought mental health services, and those who did were more likely to consult psychiatrists, receive medication prescriptions, and experience higher dropout rates.

Another study by Mirelinda Shala et al. (2019) found that distress among Albanian migrants is often associated with post-migration challenges, such as social issues and life-changing events. Coping strategies like self-management and social support played a vital role in managing these difficulties. However, participants displayed hesitancy towards psychotherapy due to mental health stigma, despite trusting physical health care. The use of non-stigmatizing language in health communication is crucial in such cases. The results from a study by Henríquez et al. (2021), using structural equation modeling, indicate that collective self-esteem and ethnic identity are positively linked to almost all aspects of psychological well-being. Nevertheless, identity fusion with Colombia specifically relates to the dimension of positive relationships, while identity fusion with Chile is specifically correlated with the dimension of autonomy. Another study provide valuable insights into the diversity of mental health approaches across geographical and social contexts, shaped by cultural meanings, norms, and social dynamics. Emphasizing the impact of multiple exclusions on collective psychosocial well-being among immigrant populations, the findings also underscore the role of narratives in shaping knowledge about immigration and health, influencing public policy, social perspectives, and community well-being (Sangaramoorthy et al., 2021).

In the past three decades, a plethora of research has contributed to the body of knowledge in understanding the term "mental wellbeing." Mental wellbeing has been theorised as: positive feelings, such as feelings of happiness; as a personality trait inclusive of the psychological possessions of self-esteem and mastery; and as resilience, which is the ability to cope with adversity. People who face traumatic and shocking life events are able to persevere and function at an average rate because of a high level of resilience (Bonanno, 2004).

In summary, these studies suggest that the process of migration is subject to several challenges that can affect immigrants' mental wellbeing. To understand this phenomenon, it is essential to address these challenges effectively. However, little attention has been given to investigating the mental wellbeing status of immigrants living in Malaysia. Also, there is limited information on the mental wellbeing of the Albanian and Kosovo Albanian populations. This study aims to fill this gap by exploring the mental wellbeing experiences and psychological challenges faced by Albanian immigrants in Malaysia. The study also assessed how immigrants perceive mental well-being.

Related Research

Dow and Woolley's (2011) study explored the shame and stigma associated with mental illness in Albanians living in California. The findings revealed that shame and stigma were deeply embedded in family pride and honor, affecting not only the individual with mental health issues but also the entire family. The Kanun code, emphasizing family reputation and honor, played a significant role in shaping attitudes towards mental illness. Dimitrova and Chasiotis (2013) conducted a study comparing the wellbeing and adjustments of Albanian and Serbian immigrant children and their parents with mainstream Italian children in Northeast Italy. The study highlighted the challenges faced by immigrant parents in adjusting to the Italian context, while the children experienced comparable levels of depression, but less social adjustment problems compared to their Italian peers. Balidemaj and Small (2018) examined the correlation between acculturation, ethnic identity, and psychological wellbeing among Albanian-American immigrants aged 21-35. The study found positive correlations between acculturation, ethnic identity, and psychological wellbeing, with gender and period of residency in the USA moderating this relationship.

Other studies explored the effects of demographic variables on acculturation among Albanian immigrants living in Greece (Papadopoulos et al., 2015) and the experiences of loneliness among older Albanian migrants in Italy (Cela & Fokkema, 2017). These studies revealed the influence of factors such as age, gender, and language proficiency on the acculturation process and highlighted the importance of social connections in mitigating loneliness among migrants. Furthermore, Turner et al.'s (2003) study investigated mental health problems among Kosovan Albanian immigrants, revealing the prevalence of post-traumatic stress disorder (PTSD) and major depressive disorder among the participants. Lastly, Zevulun et al. (2018) explored the wellbeing of migrant children who returned to Kosovo and Albania after living in a European country, finding that procedural characteristics and ethnicity predicted wellbeing and were mediated through the child-rearing atmosphere. Overall, these studies contribute to a deeper understanding of the mental wellbeing experiences of Albanian immigrants and provide essential insights for developing targeted interventions and support programs to address their specific needs and challenges.

Methodology

The primary aim of this phenomenological case study was to investigate the experiences of Albanian immigrants living in Malaysia. The study focused solely on Albanians and Kosovo Albanian immigrants, and data analysis was centred around two key research questions: 1) How do immigrants perceive mental wellbeing? and 2) What are psychological barriers immigrants face in a foreign country?

The research questions were developed based on the major themes identified in the existing literature. Data collection involved the use of demographic questionnaires and in-depth, semi-structured interviews. To explore a specific phenomenon from the perspectives of Albanian diaspora immigrants living in Malaysia, the researcher utilized a phenomenological case study approach. Several factors were considered in selecting this design, and it was deemed the most suitable method to capture and explain the participants' lived experiences. The phenomenological case study enabled the interpretation of the immigrants' experiences, while a case study approach was employed to gain a comprehensive understanding of Albanian immigrants and their experiences through an inductive procedure. The combination of these two qualitative research methodologies has been widely used in the social sciences.

Data Collection

The study utilized one-to-one in-depth semi-structured interviews to collect rich information from Albanian diaspora immigrants living in Malaysia. This approach was chosen to better understand the participants' mental well-being and the challenges they faced in a foreign country. The interviews allowed for a deeper exploration of the immigrants' experiences and perceptions. According to Ryan and his colleagues (2009), the one-to-one interview is a better method of understanding people's perceptions, believes, understandings their experiences of the phenomenon.

Additionally, in-depth interviews promote sympathy and compassion and give the researchers an empirical basis describing people perceptions although also logically reporting his/her feelings, views and insights as part of the data (Patton, 1990).For instance, during the interview process, the researcher understood the informants disappointments and setbacks in Malaysia and sympathized in the way by listening to their conversations about incidents of the immigrant's children being discriminated and called “Orang Putih” by school children or the immigrants are called “Foreigner” even though they have stayed here more than 20 years. That made the researcher understand that by using one-to-one interviews, the researcher can attain the objective of the study Patton (1990) as ' inner perspectives' and it enabled the researcher to explore " what is in and someone else's mind” (p. 278). Furthermore, by using one-to-one in-depth interview, the researcher gained more information compared to focus group discussion. One to one session could “be highly responsive to individual differences and situational change” (Patton, 1990). The purpose of using semi-structured interviews is to construct a thorough perspective of the immigrants’ psychological wellbeing, which is an aspect that is not studied enough, and the obstacles experienced by immigrants in a foreign country. It is essential to allow participants to “describe in their own words the internal and interpersonal processes by which they defined their identities” (Jones & Abes, 2013, p.64).

Phenomenological Case Study

A phenomenological perspective aids the comprehension of the essence of a person's experience with a focus on gaining a rich understanding of a specific encounter from the participant(s). The personal, first-hand information, of the participants provides descriptive data which the researcher can use to strengthen the understanding of the “lived experience for a specific event” (Patton, 2002, p. 104). This phenomenological approach, paired with the case study method, allows the researcher to comprehend or understand elaborate human experiences and “the essence and the underlying structure of a phenomenon” (Merriam, 2009, p. 23). Phenomenology is one of the many varieties of qualitative research that prospered during the philosophical development of the early 20th century. There are divisions within the field regarding the techniques and characteristics via which phenomenology defines itself. The two principal branches are: ‘descriptive phenomenology’, with the aim of finding and describing the meaning of people's stories and their experiences, and ‘interpretive phenomenology’ (or hermeneutics), which aims at deciphering the meaning of people's descriptions (Pringle et al. 2011). Husserl (2004) asserts that obtaining subjective qualitative comprehension is a precursor to the accomplishment of the objective quantitative skill. A phenomenological approach does not focus on the individuals themselves, but rather, their everyday lived experiences (Creswell, 2007).The research must interpret the participants’ point of view, from their own words, then describe their reports as authentically as possible (Van Manen 2014). Husserl is regarded as the forefather of phenomenology in the 20th century (as cited in Sadala & Adorno, 2002). A phenomenological approach suggests that a phenomenon is illustrated rather than being described or searching for its causal relations, and it focuses on things as they manifest themselves (p. 283).

Yin (2013) asserts that a case study design should comprise three components of qualitative study, namely described, provided and explained for an understanding of the phenomenon of the study. Moreover, Yin labelled three categories of case studies: explanatory, exploratory and descriptive. An explanatory case study is a combination of quantitative and qualitative approaches, with the purpose of not only describing the phenomenon being studied but also developing a theory describing the fundamental relationship (Yin, 2013). Additionally, an exploratory case study reveals if a phenomenon has been explained and clarified by existing theory (Yin, 2013), and is used as a basis for future research studies. Lastly, a descriptive case study describes a specific phenomenon in-depth, without making any predictions on relationships (Yin, 2013). Therefore, the researcher used a case study because the goal of the study is to determine the wellbeing of Albanian immigrants living in Malaysia, without making any predictions and identifying any relationships. A descriptive case study design is used to gain an in-depth understanding of the phenomenon, paired with a phenomenological qualitative study which will evaluate the aspects of wellbeing in Albanian immigrants living in Malaysia.

Researchers may find a phenomenological study design optimal for exploring the lived experiences of participants, taking into consideration the nature of their research subjects (Marshall & Rossman, 2016). On the other hand, some researchers may prefer a case study design to identify operational links between events over time. (Yin, 2014)

Therefore, the researcher used a blended design in this research to obtain rich and thick data and to attain one of the aspects of triangulation. 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 researcher expanded the sampling size and interviewed people who had lived in Malaysia to fulfil the space and time aspect on the mental wellbeing of Albanian immigrants living in Malaysia as well as those who had previously lived in Malaysia. Reaching the purpose of saturating the data is far more achievable with the case study design than with phenomenology.

Saturation is the point in data collection and analysis when new data no longer yield new insights. Data saturation occurs when sampling additional participants or collecting additional data does not lead to the emergence of new themes, concepts, or categories" (Creswell, 2013, p. 186). In this study, the researchers initially reached the saturation point during the interviews with the 8th participants, where no new themes or insights were emerging. However, to ensure the findings were comprehensive and reliable, the researchers decided to interview an additional 8 participants. By doing so, the researchers wanted to confirm that the themes, concepts, and categories identified earlier were stable and redundant. This decision was made to confirm the stability and redundancy of the identified themes, concepts, and categories, aligning with the notion of data saturation as described by Creswell (2013)

Study Setting

Malaysia has been, and still is, the leading target country for immigrants, and the economy of the country is highly reliant on foreign workers (Yeoh, 2006). Foreign workers from neighbouring countries such as Indonesia, Bangladesh, Nepal, Myanmar and India were the main supply of foreign workers in Malaysia. Indonesia is among the world's primary sources of unskilled labour. Many Indonesian emigrant workers look to Malaysia as the leading destination for resettlement since the 1990s. In 2015, the Ministry of Home Affairs – Malaysia, reported that there were 835,965 registered Indonesian workers, which was 39.2% of the total number of foreign labourers in Malaysia (Abd Rahim, Rostika, & Petrus Boroh, 2017). Furthermore, a study done by Jordaan (2018) suggested in Malaysia 90% migrant workers compromises low-skilled migrant workers that foreign workers generate positive productivity and efficiency impacts in Malaysia economy. Comparing low and high skilled foreign workers highlights the fact that migrant workers create positive productivity effects.

This study was conducted among Albanian and Kosovar Albanian immigrants living in Malaysia or who'd previously lived in Malaysia and currently live in Australia. The Albanian populace is estimated to be 3,659,616 occupants, with a yearly development rate of 0.56% (Mane & Waldorf, 2010). Ethnically, the Albanian population is composed of: Albanians (98.1%), Greeks (0.9%), and others (1%). Kosovo is situated in South-East Europe. Demographically, about 88% of Kosovo's population is Albanian, while other minorities, such as Serbian, Roma, and Turkish, make up 12% of the population. Kosovo has the youngest population in Europe, with an approximation of one citizen in every two who are under 25 years of age; about 30% of the population in Kosovo is below the age of 15 (Kosovo Census Results, 2012). Albania and Kosovo have one of the highest emigration rates in Eastern Europe. Consistent with the Migration Survey of 2009 (World Bank 2010), 1 in 4 households have a minimum of one family member living outside of Albania and Kosovo.

Data Analysis

After collecting field data, all audio recordings were transcribed into text. The data was then analysed using thematic analysis. According to Braun and Clarke (2006), thematic analysis is an essential approach to qualitative data analysis. This method involves identifying, analysing, organizing, describing, and reporting themes that arise from the data. In the process of quality data analysis, the first step involves the researchers familiarizing themselves with the transcripts. The second step involves organizing and reviewing the raw data set to generate the main ideas. Finally, the researchers develop themes and sub-themes during the third step of the analysis. To ensure the inter-reliability of the data, the researchers selected two specialists in the relevant field of study. This approach can improve the credibility of developing and approving themes for a specific phenomenon.

Analysing The Transcribed Data To Generate The Main Idea

According to Ahmad Sheikh (2017), there are several methods to analyze transcribed data. The analysis process begins with the researcher reading all the transcriptions multiple times to become familiar with the data and facilitate a more effective analysis. Subsequently, the researcher develops a coding template table to derive the main ideas.

The coding template table comprises seven columns. In the first column, the researcher lists the standardized interview questions, not the transcribed responses. Each interview question has a dedicated coding template. Moving on, the second column, known as the Superordinate column, captures the essence of the interview questions. The third column, the Subordinate column, highlights the main ideas elicited from the participants' responses to each question. It is important to note that this column should not merely summarize the ideas, but instead emphasize their core content. The fourth column allows for elaboration, where participants provide further explanations related to the main ideas. To gauge the significance of each category of meaning, the researcher uses the fifth and sixth columns to record the occurrence and frequency of the main ideas. The frequency count helps identify the level of emphasis placed on certain interview questions. For instance, if a particular idea, like the difficulty of obtaining permanent residency, appears more than three times as shown in Table 1. its frequency of occurrence in column 6 would be noted as three.

Table 1.

Coding Template for Generating Main Ideas

CODING TEMPLATE FOR GENERATING MAIN IDEAS 1	2	3	4	5	6	7
INTERVIEW QUESTIONS	SUPER-ORDINATE	SUB-ORDINATE	ELABORATION	OCCURRENCE	FREQUENCY OF OCCURRENCE	ORDERING OF DISCOURSE UNIT
1. a) what is wellbeing to you? b) What helps to maintain a balanced mental wellbeing? c) What is your definition of happiness?	a)Meaning of wellbeing b)Balancing wellbeing c)Definition of happiness	a- Hmm, okay. aaa Wellbeing to me is being happy with whatever you have, being comfortable with life and the things that surround you. b) Hmmm Well, to have a balanced wellbeing, you have to have a balanced life in all aspects such as social and family life as well as working life c- hmm well, Happiness is very broad as well as complex concepts in in a way that people nowadays try to find happiness in different	a-Wellbeing means being well in all of our life aspects such as health, mental health, and physical health. And to me leads to me, aaa this leads to life satisfaction. Moreover, wellbeing is to see my family happy. If my family is happy, and have all they need, I am happy. In personal level wellbeing means to achieve my goals and success in life. In life, we have goals and purpose. We all do. I believe goals are the main factor to have a happy life because our mind and energy is focusing until we reach there. So, in short, I will say, wellbeing is self-satisfaction and happiness. I would like to add that wellbeing is how resilient you are in life, how strong enough you are to deal with difficulties in life because there are times that we fall during the journey. But the most crucial aspect is to get up and move	a)-Being happy with what you have -Being well Mentally and physically healthy -Family Happiness -Achieving Goals Self-satisfaction and Happiness -Resilient b) Social and family Life c-) Providing for Family	1 1 2 3 1 3 3	16 18 22

The seventh column, known as the discourse unit (DU), serves as a reference for locating and elaborating upon each main idea. This facilitates the researcher's ability to navigate the transcriptions and aids examiners in comprehending the conversation and the themes expressed in the written report. Importantly, the main ideas are not limited to a single DU; instead, they may involve multiple DUs. For example, DUs 25-28 indicate that a particular conversation recurs between the 20th and 28th instances in the transcriptions. By employing these steps and adhering to a systematic approach, the data analysis process becomes more comprehensive and insightful, contributing to a more rigorous and well-founded research study.

Combining Main Ideas to Develop Themes in Qualitative Research

In qualitative research, the primary objective is to address the research question. To achieve this, a critical approach is employed to analyze the data and distill it into a set of key main ideas. These main ideas then serve as the foundation for generating themes that elucidate the central phenomenon under investigation. Table 2. is utilized in this process to merge all the main ideas and create coherent themes.

Table 2.

Generating Themes

Research Questions 1: How Immigrants Perceive Mental Wellbeing
Interview Question 1: a) What does mental wellbeing mean to you? b) what helps to maintain wellbeing? c) What is your definitions of your wellbeing?
Info 1	Info 2	Info 3	Info 4	Info 5	Info 6	Info 7	Info 8	Info 9	Info 10	Info 11	Info 12	Info 13	Info 14	Info 15	Info 16	Sub-theme	Themes
a) Self-satisfaction Happiness Harmony with self and others b)-Understanding happiness understanding the purpose that causes happiness c) Inner peace Satisfactions with what you have Appreciations of the belongings	a)-Balanced life Harmony with thoughts and feelings b)-State of being and positive feeling c)Purpose in life	Maintaining balance within personal life, family life friends and relative's life. Inner peace	a) Balancing psychological wellbeing and physical wellbeing b) Forming a good habit and don't overthink	Healthy physically mentally Early to bed early to rise makes the man wealthy, healthy and wise - I am happy with what I have and what god has given	Mentally psychological and physically healthy Motivated and engaged b) -Family support c) -Proper daily management Providing for family Life progression and achievements	a)-Life achievement b) Life objective Goal setting Accomplishment	a) Good mental health conditions Purpose in life a)-Achieving goals b)-physical activities b) Achieving goals	Fulling needs of family Progressing academically Balancing the needs of family and academic career Doing well by myself and others in life	Things that make me happy	Being happy Stability in your life b)-Having a good mindset b)-Satisfaction with everything you do	Relationship with family Relationship with yourself b)-Balancing daily life c) Happy with what you have Happiness is getting closer to God	Physical, emotional and mental health -Focusing in priorities -Peace of mind Being grateful living life on a conscious level.	State of being very well in terms of mental in terms of spiritual in terms of physical situations inner happiness Being happy with what you have	Healthy mind body and spirituality Being happy with what you have	Being happy with what you have Being well mentally and physically healthy Family happiness Achieving goals Self-satisfaction and happiness Resilient Finding a purpose	Happiness is getting closer to God Harmony	a) Self and life improvement Inner peace Mentally psychically and spiritually healthy b) Happiness Contentedness c)Accomplishment and Purpose in life Having and fulling family needs Balanced life Resilient

To accommodate the 16 informants who participated in this research, Table 2. comprises 16 columns, representing each participant from the 1st informant to the 16th informant. The main ideas extracted from each participant are based on the coding templates (see table 1) designed to facilitate the identification of main ideas, which are listed in column five.

Interpreting the main ideas is essential for the subsequent development and endorsement of the themes. Some ideas may align with a single theme, while others may correspond to multiple themes. To simplify the systematic endorsement of themes, similar ideas are assigned a specific color. Additionally, column 7 is dedicated to sub-themes, as some themes may include several sub-themes that further illustrate specific aspects of the research. By employing this methodological approach, the process of generating and organizing themes becomes more structured and facilitates a thorough exploration of the data to address the research question effectively. (Ahmad Sheikh, 2017)

Sampling

Purposive sampling and snowball sampling were used in this study to recruit participants. Snowball sampling is also a commonly used method in qualitative studies to identify and estimate hidden people. The use of snowball sampling was essential for the research in finding participants through other participants since there is no longer an Albanian embassy in Malaysia. Thus, snowball sampling allowed the researcher to effectively locate the hard-to-find population (Johnson, 2003). Semi-structured interviews were taken individually, mostly in cafes and participants' homes and offices. To determine how many interviews to conduct, data saturation was used (Fusch et al., 2015) The participants chosen for this study need to meet these requirements: (a) they must be from Albania or Kosovo, (b) they must currently live in Malaysia or Australia, (c) they must have lived in Malaysia or Australia for at least five years, and (d) they must be at least 18 years old. For more details on the participants' background, see Table 3.

Table 3.

Respondents Biographic Profile

Participants Profile	Age	Gender	Employment Status	Place of stay	Length of interview	Years in Malaysia
Pilot Study Participant 1	45	Female	Self-employed	Malaysia	45 minutes	22
Pilot Study Participant 2	20	Male	Football coach	Australia	1 hour	Born in Malaysia and stayed in for 16 years.
Participant 1	35	Male	Global account manager	Malaysia	56 minutes.	14
Participant 2	30	Female	Accountant	Malaysia	56 minutes. and 38 seconds	8
Participant 3	39	Female	Housewife	Malaysia	59 minutes. And 59 seconds	21
Participant 4	40	Female	Researcher	Malaysia	56 minutes. and 15 seconds	22
Participant 5	47	Male	Business owner	Malaysia	27 minutes. and 38 seconds)	22
Participant 6	36	Male	Financial advisor	Malaysia	53 minutes and seconds 56)	14
Participant 7	32	Male	Administrative manager	Malaysia	56 minutes and seconds 56)	11
Participant 8	30	Male	Cloud solutions architect	Malaysia	34 minutes. and 37 seconds	10
Participant 9		Male	University Professor	Malaysia	53 minutes. and 8 seconds	5
Participant 10	47	Male	Self-employed	Malaysia	34 minutes. And 10 seconds	27
Participant 11	19	Female	Student	Malaysia	37 minutes.	Born in Malaysia
Participant 12	41	Female	Business owner	Australia	55 minutes. and 39 seconds	18
Participant 13	22	Female	Student/ English Tutor	Malaysia	56 minutes. and 35 seconds	5
Participant 14	30	Female	Architect	Albania	54 minutes and 41seconds	10
Participant 15	33	Female	Professional secretary	Albania	44 minutes and 42	8
Participant 16	47	Male	Business owner	Australia	56 minutes. and 38 seconds	18

Results

First Objective and Themes

• 1. The primary objective of this study was to investigate the psychological well-being of immigrants and their attitudes towards mental health. From the data analysis emerged four themes: (1) Inner peace, (2) Fulfilling family needs, (3) Maintaining a balanced life, and (4) Self-improvement and personal growth.

Inner peace

All participants provided their own interpretation of mental well-being. Some described mental well-being as having inner peace, which emerged as the first theme in this investigation. Inner peace is generally identified as a state of freedom, including the mind, thoughts, and social connections, indicating a harmonious life. Furthermore, inner peace is identified as a state of tranquillity and harmony, free from worries, anxieties, and fears. Participants also highlighted that happiness is a key factor in inner peace. One informant stated that happiness is achieved by being at peace with your thoughts and mind and by having people around you who understand your happiness. Participants highlighted that happiness is an inner state of mind that can be found within oneself rather than in external factors. The following quotes from participants illustrate this concept:

“Happiness to me is being at peace with yourself first of all ones you are at peace or peaceful with your thoughts and mind.” (Respondent 3)

“Okay, wellbeing I believe is a state of self-satisfaction happiness and have inner peace and harmony with yourself and all surrounding around you.” (Respondent 1)

“It's about your inner happiness, I guess more than everything else. Sometimes We try to find wellbeing in these external factors, but we forget that the main, important thing is your inner sight how you feel about.” (Respondent 4)

Fulling family Needs

All the participants were able to give their understanding of how they perceive mental wellbeing. Some informants emphasized mental wellbeing as "fulfilling family needs".

According to the respondents the head of the family, is accountable to provide the family with basic needs. For instance, the father is responsible to fulfil the basic needs such as food and housing while the mother must nature and educate the children. Around 40% of respondents emphasised the need of meeting family needs noting that it contributes to a well-managed life.

Participants mentioned that fulfilling the family's needs brings a sense of fulfilment and satisfaction in life. The following responses from the informants reflect these concepts:

“Yeah, happy family. You're able to support to the daily troubles, the routine things you manage properly. At the end of the day, you are at ease that everyone you have provided for the family... (Respondent 6)

“Having sufficient resources to fulfil the needs of my family.” (Respondent 9)

Balanced Life

When asking about how immigrants perceive mental wellbeing most of the participants reported having a “Balanced Life”. A balanced life, according to the participants is having balance in every aspect of life such as in finances, relationships, self-development, and health. In addition, many participants expressed that achieving balance requires harmony between a person's beliefs and feelings. Participants also suggested that mental wellbeing involves finding balance between psychological and physical aspects of life, which can be achieved through healthy lifestyle habits and avoiding overthinking. Furthermore, some participants highlighted the importance of creating balance between personal and family life for overall wellbeing. Overall, the informants suggest that a balanced life is a key component of mental wellbeing, achieved through creating harmony and equilibrium in various aspects of life. The following responses from the informants reflect the concepts.

“Well, you know wellbeing to me means having a balanced life. I think this is the first thing which makes people to be in harmony with their thoughts and feelings.” (Respondent 2)

“Wellbeing is the balance between the psychological wellbeing between the physical wellbeing, having a good a habit in daily lifestyle stops overthinking.” (Respondent 4)

“Well wellbeing to me is creating and maintaining balance in life that balanced can be personal life, family life friends and relative's life.” (Respondent 3)

Self and Life Improvement

The study participants also shared their views on self and life improvement. Many respondents expressed a strong desire to continually improve their lives and strive towards reaching their full potential. They believe that there is always room for growth and development, and they maintain an optimistic outlook on the future, with a focus on integrating into society.

“There is more to do and more to improve about myself, that's beauty because if tomorrow I am waking up and, and I am assuming that I am going to be better than yesterday...I feel good about myself, and I know there is more to do and more to improve about myself.” (Respondent 1)

“I am positive I look forward to improving myself to integrate myself more into society.” (Respondent 2)

Second Objective and Themes

• 1. The second objective of this study was to examine the challenges immigrants encounter in Malaysia. Four themes were generated: 1. Visa and employment pass issues 2. Difficulty securing employment status; 3. Foreigner; and 4. Lack of family support.

Employment Pass and Visa Issue

Participants commonly reported that in Malaysia attaining a working permit is an arduous and complex process. They also reported that there are several procedures and policies to go through to obtain a working permit. In addition, there are restrictions on companies hiring foreign workers. Companies must demonstrate to the government that the foreign employee possesses higher skills and cannot be replaced by a local individual. These findings are consistent with information found on the website "Wonderful Malaysia", which notes that companies in Malaysia are only permitted to employ foreigners when they can demonstrate that locals are not qualified or skilled enough to carry out the job. Essentially, companies are only allowed to hire foreign staff if there is a shortage of qualified and skilled local citizens.

It is important to highlight that Malaysians nowadays are highly educated individual, which means that expatriates looking to work in Malaysia must possess very high qualifications to secure employment and obtain a working permit. In addition, many of the study participants reported that they decided to create their own companies in Malaysia, and they were able to apply for the two-year work permit under their own companies. Nevertheless, some participants reported disappointment that, even after residing in Malaysia for more than twenty years, they are still on a two-year visa with no citizenship or permanent residency. The participants expressed that living in a foreign country is not an easy task, and they often felt that they were treated as second-class citizens. For instance, one informant shared that although she is married to a local citizen and holds a spousal visa, she is not permitted to work in Malaysia. When asked about the setbacks they have faced here in Malaysia, many participants cited the difficulty in obtaining a work permit as the primary challenge. One informant, who owns a business, still encountered obstacles in obtaining a work permit.

“Yeah, it's not easy for a foreigner we are always treat as secondary…A foreigner you have a lot of restrictions…in my passports is stated that strictly prohibited any form of employment. I have been married to him 15 years. I have three kids…So, why I must go to all of these troubles.” (Respondent 3)

“The first time applying for working permit that was my, my worse setbacks…even though you have your own company even though you are the boss of the company very hard giving to you I don't know why. You have contributed in any way to this country, and then you have paid your own taxes you are contributing you are not taking the money to this country.” (Respondent 5)

Generally, the participants noted that obtaining a work permit in Malaysia is challenging. Companies tend to prefer hiring locals over foreigners due to the additional paperwork and effort required to secure a work visa. The participants believed that getting PR would give them a sense of security and ease their worries about the future. Immigrants who had children stated that they did not want their children to have to constantly apply for visa renewals, like themselves. It is undeniable that having permanent residency gives a sense of peace of mind and security as well as other numerous benefits. The Malaysian PR status gives an individual the ability to seek employment, similar to a Malaysian citizen’s right, and does not require a working visa. (Thartori et al., 2023) Citizenship is seen as a significant factor to the 112 immigrants that he/she is regarded as a member of the host society, and ‘on equal footing with the native population.’ (Simonsen, 2017).

Difficulty in Finding Jobs

When asked about setbacks in Malaysia, many participants reported difficulty finding jobs because priority was given to local citizens and permanent residents. The first group of immigrants who arrived in Malaysia before 1993 have gradually rebuilt their lives here, in contrast to the second group of immigrants who arrived after 2000 they struggled to find jobs due to being fresh graduates without prior working experience.

“In term of getting employed here in Malaysia is really hard So, that has been one of the measures seatbacks.” (Respondent 2)

“If you try to apply for any job, in general, the priorities, of course, it would be given to the locals then of course to the PR holders.” (Respondent 8)

“I applied a lot of places all the places rejected me, so I felt if they gone rejected me what's the point of me staying” (Respondent 11)

On the other hand, the 16th interviewee, who currently resides in Australia, shared that he initially faced challenges in finding employment there. However, he noted that once he secured a job and started paying taxes, the government appreciated his tax contributions. He went on to explain that.

“In Australia, we also have setbacks everywhere we go. But in Australia, they were temporarily. In the beginning when I moved to Australia, and it was difficult to find the job. But the moment I found the job, everything opened up. So, the moment you find a job, you start paying taxes. Everything goes through. The government appreciates when you pay the taxes there. At least they appreciate that you are a contributor to the economy”. (Respondent 16)

Foreigner

Immigrants are often viewed as foreigners by their host country, and this appears to be a common problem among Albanian and Kosovo Albanians immigrants in Malaysia. The immigrants expressed that they felt they were foreigners and did not have a sense of belonging in Malaysia. Despite having lived here for a considerable amount of time. The 10th and 16th interviewees both expressed that even though they knew and spoke the local language, they were still perceived as outsiders, The 16th participant stated, “once a foreigner, always a foreigner”. The findings suggest that regardless of how long an immigrant has settled in a new country, they may still feel a sense of self-awareness that they do not belong and that the country is not their own.

“Even though you enjoy, you get embraced by people and accepted. And then comes this guy and they'll say, this is my country. You feel you're not home, you're that reminded you that you are in a foreign country.” (Respondent 1)

“Well as a saying goes once the foreigner you always a foreigner meaning to say that life as a foreigner is not easy Because you are alone here, and the family is not here to help you when facing difficulties” (Respondent 16)

“Even you are here for a long time you know the culture you know the language you're still a foreigner.” (Respondent 10)

The 12th interviewee shared that she had encounter some forms of discrimination in Malaysia. where some Malaysians judge people based on the colour of their skin and consider them to be foreigners rather than Malaysians. On the other hand, the 13th interviewee noted that when she spends time with a group of local friends, she sometimes feels like a foreigner when they switch to speaking their local language and inadvertently exclude her from the conversation.

“In Malaysia, there is discrimination as we are from Europe, we have different skin colours. So, which means we are not Malaysians, even though our kids are born there, they don't have that title because we are not Malaysian, we are considered like foreigners.” (Respondent 12)

“I'm a foreigner here and I'm trying to hang out with my new friends from other countries. But if you don't speak English, I feel more of a foreigner.” (Respondent13)

Additionally, the 12th and 16th interviewees who had left Malaysia and moved to Australia stated that in Australia they had difficulties adjusting and feeling comfortable at first but never felt like a foreigner, unlike they did in Malaysia. The 12th interviewee stated that she felt like she belonged in Australia from the moment she arrived and considered it her country. Similarly, the 16th informant mentioned that he obtained permanent residency in Australia after living there for two years and never felt like a foreigner.

“Whereas here in Australia, the moment you move here. They don't ask you whether you're from here or from there. You know, I'm talking about when you go to the offices; this is how I'm talking, but people might judge you. You know, they straightaway take it as if you're Australian. Although there is no discrimination towards our kids as well. So, those are the differences we have come to.” (Respondent 12)

“When I moved in Australia. Only first, first two years I was feeling that just after the two years, I was awarded with a with a permanent residency. And I was same as Australians. I never feel that I'm a foreigner in Australia anymore.” (Respondent16)

Lack of Family Support

The decision to migrate to an unfamiliar environment and leave behind family and community is no doubt an arduous process to embark on. Immigrants start their journey with the hope of improving their lives and the lives of their loved ones. Along the way, they encounter numerous obstacles, including a lack of family support. They must resolve every issue they face, such as visa problems, unemployment, financial struggles, and psychological health concerns, on their own. The study participants emphasized that the challenges they faced in Malaysia were different from those they would have faced in their home country because there they have their own family and community to rely on for guidance and assistance. Furthermore, the informants reported that it is difficult dealing with problems in foreigner country because of lack of family support. The following responses from the informants illustrate these concepts:

“The challenges that I faced here I don't think I would had faced in my country because there is no visa issue. You are a citizen and is your own country. You have own people there that can give a hand or help you.” (Respondent 2)

“In your country if you have difficulties, you have your one- relatives or friends who may help you but here you are alone.” (Respondent 5)

“When you are, to your country you have other people who can help you, you have friends you have relatives But in Malaysia you're alone and all you have here yourself.” (Respondent 14)

“I am living alone here, so the only support that I have is myself. Yeah, I should say lack of support…back home you have the support of the family.” (Respondent 8)

Furthermore, the 15th interviewee, who returned to Albania, shared a similar experience as other participants, stating that living in Malaysia with only her husband was challenging compared to being back in Albania, where she has her family to rely on for help and support. She expressed that having family nearby makes a significant difference in coping with the difficulties.

“Not to the same because there I don't had my family to interfere or to ask her to go. So, I was forced to face by myself or only with my husband. But here they can say I have a door where to go”. (Respondent 15)

In addition, the 16th interviewee, who had relocated to Australia, when asked about his experience living in a foreign country. He mentioned that his time in Malaysia had given him valuable life experiences and had made him more resilient in facing challenges. He further commented,

“Now, when I went to Australia, I had the life experience. So, everything I pass in Malaysia, it could have it. It made me tougher to face the problem. So basically, I could solve the problem easier.” (Respondent 16)

Discussion

This study examines the mental wellbeing experiences and psychological challenges faced by Albanian immigrants in a foreign country. The findings suggest that Albanian immigrants possess a significant understanding of mental wellbeing and provided insightful information on the topic. Remarkably, the study identified Albanian and Kosovo Albanian immigrants as hardworking individuals with a strong drive to improve their lives and achieve their goals. Their purpose in life revolves around providing their family's needs, and they display gratefulness for what God has given to them.

Understanding of Mental Well-being consistent with previous research, our findings reveal that Albanian immigrants demonstrate a profound understanding of mental well-being. They view well-being as achieving "inner peace," a state of tranquillity resulting from having inner peace. This aligns with Rajkumar and Christian's proposition that individuals can find inner peace and consciousness through self-awareness and choosing to be kind and non-judgmental (Rajkumar & Christian, 2012, p. 4). Therefore, inner peace leads to tranquillity in the mind, body, and soul. In his book "The Power of Now," Eckhart Tolle (2012) advises to focus on the power of now and not on the past or the future, because the past has already happened, and the future is not yet here. What individuals have is the present moment. "When you become conscious of ‘being’, the ‘being’ becomes conscious of itself. When being becomes conscious of itself, that is presence" (Eckhart Tolle 2012, p. 98). It was mentioned by the study participants that they perceive mental wellbeing as self- and life-improvement. Like the perspectives put forth by Maslow (1943) and Rogers (1961), our participants emphasize self-improvement and self-growth as crucial aspects of well-being. Albanian immigrants in this study strive to become the best version of themselves, consistently seeking personal development and actualization (Maslow, 1943; Rogers, 1961).

The participants emphasized that family holds a primary and often exclusive role in providing help for Albanian immigrants. One reason for turning to family and close individuals for support is their reluctance to share difficulties with others, given the judgmental nature of Albanian society towards those facing problems, leading them to safeguard their image and reputation. Notably, fulfilling their family's needs emerges as a critical criterion for their happiness, underscoring the significant role of the family in Albanian culture. The heads of families constantly strive for the best outcomes for their loved ones, ensuring their needs are consistently met. Within the family unit, each member has specific roles and responsibilities, and their social interactions revolve around mutual collaboration and respect, as seen in the parent-child relationship. Over a person's lifetime, roles evolve, such as transitioning from a child to a spouse, parent, or grandparent, impacting their character development based on age and family dynamics (Peterson, 2009). These familial roles constitute common behavior patterns that fulfill family functions and needs (Epstein, Bishop, Ryan, Miller & Keitner, 1993).

The significance of the family's role in Albanian immigrants' lives is evident even when it comes to coping with psychological problems. Research on immigrant families highlights the vital presence of family, regardless of its level of support, during the process of adaptation and settlement (Aroian & Spitzer, 1996). The lack of family support emerges as a significant factor affecting immigrants, as nearly 65% of informants reported that dealing with difficulties in a foreign country differs from handling them in their country of origin. Back home, immigrants have their families to turn to for help, whereas in a foreign country, they must navigate challenges on their own without anyone to seek assistance from. Family support serves as a protective factor, influencing psychological and economic aspects, and is consistently associated with higher levels of life satisfaction and an improved quality of life (Nguyen et al., 2016). Conversely, the absence of family support can lead to numerous life stressors, especially for those living abroad. Moreover, studies report that a lack of social support and cultural dissonance can contribute to psychological problems, particularly for parents who leave their children behind and migrate, as they face difficulties in adapting to new environmental conditions (Suárez-Orozco, 2015).

The findings of this research revealed that immigrants faced different kinds of challenges, such as visa and employment pass difficulties; difficulty in finding a job was another challenge that immigrants faced because they must have very high qualifications and prove that no locals can replace them; only then are companies able to hire them. Study participants reported that individuals who had immigrated after the year 2000 experienced more employment challenges. This distressful reality increases the distress of people who are already competing for highly skilled and professional jobs with local citizens. It is not surprising that immigrants face challenges to finding jobs in their host countries. As a result, they attempted to open their own companies and run their own businesses. Simon (1990) suggested that immigrants increased the standard of living in the country. Even though immigrants do take jobs, they are also able to develop jobs, as exemplified by the immigrants here in Malaysia. The immigrants that came in 1993 had created their own companies and businesses and eventually created new jobs for themselves and locals.

According to the informants, finding a job related to their educational background was very difficult. In 2013, in EU and OECD countries, more than 30% of immigrants with a higher education held lower positions in their profession compared to local citizens. The percentages are as high as 50% for countries like Spain, Italy, and Greece. In those countries, the percentage of higher qualifications amongst immigrants is much higher when compared to the local citizens. There are twice as many foreigners—local citizen workers—as there are in the Nordic countries. Until now, among a few exceptions are Switzerland, New Zealand, and the United States (OECD, 2015). Indeed, the effective economic integration of immigrants is the foundation of their social success. Nevertheless, barriers to occupational integration are experienced to some degree, and cultural detachment could be a significant obstacle. Immigrants lag behind the local population in terms of economic, educational, social, and political aspects. They tend to have higher unemployment rates and lower occupational and professional attainments. Even worse, mobility remains slow or non-existent across generations (Constant, Kahanec, & Zimmermann, 2009).

Albanian immigrants in Malaysia are legal immigrants and highly skilled professionals. Most of the participants were students in Malaysia, but after they had finished their studies, they did not return to Albania. They decided to stay and settle here in Malaysia. Even if the students had intended to return to their country of origin, the insecurity, and uncertainties of their future in their home country caused them to decide on settling down and working in Malaysia to receive better job opportunities and job security. If they went back to Albania, they would face a weaker economy and meagre salaries. Due to these factors, the students decided to stay in Malaysia and settle down; this phenomenon is called the brain drain factor'. It is when a country loses most of its educated and highly skilled citizens to other nations, generally developed countries, through migration (Yuan, 2012). This phenomenon is present across the globe; Albania and Malaysia are among the countries affected by this phenomenon and are losing many highly skilled people.

The sample in this study included Albanians and Kosovo Albanians. Both groups come from areas characterised by different socio-economic conditions and backgrounds in the last few decades. However, both two groups are the same people. They share the same language, cultural norms, and traditions, but they have been situated differently in history. The histories of both of these countries show that the Serbian government wanted the Kosovo Albanians out. While the government in Albania wanted to keep its people inside the country, the Kosovo Albanians, with their persistence and perseverance, tried to resist the Serbians' rules and stay in their land at any cost. Furthermore, Albanians were isolated and prohibited from being in touch with anything foreign during the communist period. Therefore, both immigrants from Albania and Kosovo looked forward to their neighbouring countries with expectations and opportunities to build a better-off and more rewarding life for themselves and their families. In addition to this study, both groups of Albanians and Kosovo Albanians did not show any significant differences because the findings were the same as what both countries faced here in Malaysia.

This study incorporates Maslow's hierarchy of needs, which outlines various levels leading to the fulfilment of higher needs. This series of needs, people want to have a home in a safe neighbourhood, a secure job, a lot of money, love, and a sense of belonging. Consequently, both Albanians and Kosovar Albanians seek permanent residency in Malaysia, aiming to feel safe and integrated within the Malaysian community, and not worry about what will happen next or depend always on a visa. Having a sense of belonging to the country is the most significant factor. This study's findings are consistent with (Simonsen, 2017), which asserted that the elementary problem for immigrants and the host country is immigrants' lack of a sense of belonging; they do not feel like they are members of society, and this affects their behaviour in all aspects.However, the findings indicate that some Albanians have already left or are considering leaving Malaysia. The driving factor behind this decision lies in their perception that Malaysia may not fully meet their requirements for safety and a sense of belonging. Consequently, many immigrants are drawn towards western countries, seeking greater levels of safety, security, and a stronger sense of community belonging, despite their genuine fondness and affection for Malaysia and its people.

In Conclusion

In conclusion, this study explored the mental wellbeing experiences and psychological challenges faced by Albanian immigrants in a foreign country. The findings revealed that Albanian and Kosovo Albanian immigrants displayed a strong determination to improve their lives and achieve their goals, driven by the purpose of providing for their families. The emphasis on the importance of inner peace as a key component of wellbeing. In additional, self-improvement was viewed as a crucial aspect of mental wellbeing, as immigrants aimed to become the best versions of themselves each day. Additionally, the study shed light on the various challenges faced by immigrants, including visa and employment pass difficulties, as well as barriers in finding jobs that align with their educational backgrounds. Family support emerged as a significant factor in coping with these challenges, while the lack of it contributed to stress and psychological struggles. The research has highlighted the similarities between Albanian immigrants from both Albania and Kosovo, as they faced comparable experiences and challenges in Malaysia. The decision to settle in Malaysia was influenced by the country's potential for better job opportunities and job security, in contrast to the economic challenges and brain drain phenomena observed in their home countries.

Policymakers and support organizations can use the findings to develop targeted support programs that address the specific psychological challenges faced by Albanian immigrants. These programs can focus on promoting inner peace and self-improvement as integral components of mental wellbeing. Providing resources and services that cater to the unique needs of the immigrant community can enhance their overall wellbeing and integration. Recognizing the importance of family support in coping with challenges, interventions can be designed to strengthen familial connections and social networks for immigrants. Creating platforms for families to share experiences, seek guidance, and provide emotional support can contribute to the overall mental health of immigrants. Understanding the barriers faced by immigrants in finding jobs aligned with their educational backgrounds can inform efforts to enhance employment opportunities for this community. Policymakers can work towards reducing employment pass difficulties and fostering an inclusive job market that values the skills and qualifications of Albanian immigrants.

Future research could explore interventions and support mechanisms to address the psychological challenges faced by Albanian immigrants, ensuring their successful adaptation and integration in the host country. Furthermore, investigating the long-term effects of mental wellbeing experiences on immigrants' overall quality of life could provide valuable insights for policymakers and support organizations.

Recommendations for Malaysia Government

Malaysia may not be a nation of immigrants, but indeed it is the most influenced country by international migration. Therefore, it is recommended that the Malaysian government be aware of the following reasons: First, it will be useful for the government to launch a campaign to enlighten the Malaysian community, especially schools, about accepting and welcoming immigrants from across the world. Second, the immigrants voiced out that having permanent residency will give them assurances and a sense of belonging in Malaysia; it is recommended for the Malaysian government to consider this matter. Immigrants just need guarantees that tomorrow will be safe and stable, not to live in constant fear concerning their visa status. Thus, they will be able to continue their lives here and invest in Malaysia. Third, it is recommended for the Malaysian government to develop effective outreach programmes targeted at immigrants who are less likely to use help resources for psychological problems, and online services that are accessible and give the right help regardless of race and nationality. Fourth, it is recommended for the Malaysian government to provide educational training programmes for psychologists and social workers who have direct working relationships with immigrants on how to recognise signs and symptoms of mental health issues and where and how to access help resources in the country.

Recommendations for Immigrants

It is fundamental for immigrants to do research and get enough information before deciding in which country they want to reside, as suggested by the participants. Immigrants are also advised to be open to new experiences in a foreign country so that issues such as new cultures, new people, and new food will be a significant stressor for them. Being a minority group is associated with a plethora of challenges, regardless of their nationalities and where they are located. Therefore, it is important for them to have effective coping strategies that will help them deal with and overcome any difficulties they may face in the host country. They also must interact and integrate not only with their countrymates but even with locals for them to assimilate and adjust quickly in a foreign country. Immigrants should seek help no matter what difficulties they face. Voicing out the problem is better than suffocating and suffering in silence, as their wellbeing will deteriorate, and they may be more likely to experience some forms of psychological distress.

Limitation of the Study

There are a few limitations to this study encountered by the researchers, specifically in generalisations and research biases. First, for example, quantitative studies employ numerical data to be more generalised to the entire population. The generalizability of a qualitative study is too specific to the case studied and therefore cannot be generalised to the whole population. The sixteen participants in this study were not representative of the entire community of Albanian immigrants in Malaysia.

Funding

The authors have no funding to disclose.

Informed Consent

Informed consent was obtained from all individual adult participants involved in the study.

Declaration of competing interest

The authors have no conflicts of interest to declare.