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The mental health needs of immigrants often center on immigration, and it’s not hard to see why. Immigration is often a stressful, long, and traumatic experience. But immigrants’ mental health experiences and challenges shouldn’t be limited to their migration status – they can be wide-ranging and complex.
Immigrants face many challenges when seeking and accessing support for their mental health. Even those who do have access to support may be afraid to for fear of arrest or deportation.
In today’s blog, I wanted to explore these challenges in more detail and provide an overview of how we can help immigrant clients on their overall mental health journey.
What are Some of the Mental Health Risk Factors for Immigrants?
To understand the common mental health challenges of immigrants, I thought it might be a good idea to first look at some common mental health risk factors.
You might already be aware of most of these if you have already worked with immigrants. If you’re new to supporting this client group, this will hopefully be a good starting point to begin developing your understanding further:
Discrimination & Acculturative Stress
Undocumented immigrants are more likely to have multiple psychosocial problems, including unemployment, low employment or risky employment, limited access to healthcare, and difficulties accessing or navigating the legal system when needed (for example, if they are being mistreated or discriminated against at work).
Acculturative stress is a form of psychological and social stress immigrants experience when there is an incongruence of beliefs, values, and other cultural norms between their home country and the one they find themselves now participating in.
Research has pointed to the ways that limited ability to speak the dominant language in a new country for immigrants can lead to poor health outcomes.
Not being able to discuss their health concerns appropriately, being misunderstood or misinterpreted, and misinterpreting health advice and guidance can all lead to low or no management of health issues, including mental health.
Undocumented immigrants exposed to violent trauma are at high risk for depressive disorders, post-traumatic stress disorder (PTSD), and substance use disorders.
Unaccompanied minors have more traumatic exposures on average than minors who migrate accompanied by family, which increases their risk for mental health problems like PTSD.
Fear of Deportation
Immigrants often fear and doubt the U.S. legal system, causing decreased use of these systems, even when they are victims of crimes. This fear can also extend to the healthcare system and create additional barriers to accessing support.
Being Separated from Family & Community
Separation from core family members and their wider community can be traumatic, especially for children.
Immigrants also face varying family conditions and mixed-status families once they migrate, creating tense situations, including different desires for assimilation among family members. These shifting priorities can create increased intergenerational conflicts.
Supporting Immigrants: Advice & Guidance
Without a doubt, the mental health risk factors and challenges faced by immigrants cannot be understated, and their unique needs require dedicated attention and curiosity from the clinicians that seek to support them.
There has been a fair amount of psychological research on this and how clinicians can boost their professional knowledge and skillset to best support immigrants.
The American Psychiatric Association (APA) has collated some of these, and I encourage you to review their site with the complete list of actionable ways we can support immigrants. Below I’ve provided a simple overview:
- Minimize Language Barriers: Offer resources and forms in various languages, where possible, and work with local, trusted translators that match the needs of the bilingual clients who live and work in your community.
- Stay Curious: Work to eliminate explicit and implicit bias and focus on supporting the unique individual in front of you in the ways they need.
- Practice Trauma-Informed Care: Trauma-informed care is a way of working with clients that understands and acknowledges how trauma can show up and impact how someone behaves and engages with you. Following this framework can improve patient engagement, treatment adherence, and health outcomes.
- Be Consistent: Immigrants, especially undocumented immigrants or those awaiting visa outcomes, can distrust professional service systems, including healthcare. Being consistent with following up, reaching out, and demonstrating care, helps to build trust.
Working in Immigration Evaluations
Even though within immigration evaluations, we may only work with clients for a shorter amount of time with a clear, focused outcome, it doesn’t mean these practices for supporting immigrants should go unregistered.
We learn about a complete individual’s mental health journey when we conduct our evaluations. We have a strong role to play in showing them what a positive, engaging, and trusted experience it can be to seek support from someone like us.
This is an experience they will likely take forward into the rest of their lives, and if it is a positive one, it could make a significant difference in how they seek further support for their mental health.
Dedicating our time to understanding the full complexity of the immigrant experience can help us better connect with our clients – not only for evaluation – but to set them up for lifelong success by seeking help when they need it.
I’m Cecilia Racine, and I teach therapists how to help immigrants through my online courses. As a bilingual immigrant myself, I know the unique perspective that these clients are experiencing. I’ve conducted over 500 evaluations and work with dozens of lawyers in various states. Immigrants are my passion, I believe they add to the fabric of our country.
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