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The mental health needs of immigrants often center on immigration, a stressful and sometimes long traumatic experience. In addition, many immigrants come from cultures where stigma around mental health makes them reluctant to talk about the emotional difficulties they face.
The COVID-19 pandemic has only aggravated an already difficult situation. While some are working on the front lines of the crisis, others may have lost their sources of income or find themselves having to tay at home to care for their children who are learning virtually.
Without support networks and often far from their families, many may face difficulties accessing mental health care and related services available to them.
And those who can access mental health services may be afraid to seek help to treat their symptoms for fear of arrest or deportation.
Some Immigrants’ Mental Health Risk Factors
Here are some of the migration-related factors that influence mental health.
Discrimination and acculturative stress
Latinos who are undocumented immigrants are more likely to have multiple psychosocial problems, including employment, access to health care, and the legal system.
Acculturative stress consists of psychological and social stress. Immigrants experience it due to an incongruence of beliefs, values, and other cultural norms between their country of origin and reception.
Limited English Proficiency
Limited English proficiency is usually associated with poor health outcomes.
On a practical level, not speaking English proficiently and needing interpretation services are two significant barriers to accessing and remaining in healthcare, including mental health care.
Undocumented immigrants who have had exposure to violent trauma are at high risk for depressive disorders, post-traumatic stress disorder (PTSD), and substance use disorders.
Unaccompanied minors have a higher number of traumatic exposures on average than minors who migrate accompanied by family, which increases their risk for mental health problems like PTSD.
Distrust of the legal system and fear of deportation
Immigrants fear and doubt the U.S. legal system, causing decreased participation in civic life, including advocacy efforts, even when they are victims of crimes. This disbelief can extend to the health care system and act as a barrier to care.
Given the political climate from the Trump administration, undocumented immigrants live in widespread fear of deportation, which limits their use of health care and social services and prevents social integration.
Intergenerational conflicts and family separation
Immigrants may have varying family conditions and mixed-status families, creating tense situations, including different desires for assimilation among family members. These shifting and potentially diverse priorities often lead to increased intergenerational conflicts.
Also, separation from family can be traumatic, especially for children, and can lead to mental health symptoms.
Suggested assessment and treatment
In order forto be better prepared to address the unique needs of these populations, here are some suggestions from the American Psychiatric Association (APA):
- Provide consistent and accessible follow-up. Undocumented immigrants often distrust the health care system. They may require more frequent and consistent follow-up to create a sense of trust.
- Minimize language barriers. Attempt to offer resources in patients’ native languages. Provide opportunities to learn English if patients show an interest.
- Be sensitive to culturally specific phenomena when treating patients and treat each patient as an individual and assess what their culture means to them.
- Evaluate, challenge, and address structural and practice-level factors that perpetuate explicit bias, discrimination, and inequalities for immigrant and other vulnerable populations.
- Use a “socio-cultural ecological framework” that considers the complex interplay between individual, relationship, community, cultural, and societal factors that influence mental health.
- Given the high risk for trauma among undocumented immigrants, consider screening for trauma and practicing trauma-informed care even if patients do not meet the official diagnostic criteria for PTSD.
- Recognize the impact of violence on development, coping, and resilience, and identify recovery from trauma as a primary goal.
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 300 evaluations and work with dozens of lawyers in the various states. Immigrants are my passion, I believe they add to the fabric of our country.
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