Mental Health of Immigrants and Refugees
TL;DR: The unique risk factors and mental health needs of the authors' new immigrant populations, as well as treatment and services approaches to address their unique needs are reviewed.
Abstract: The United States is a country of immigrants. With the exception of Native-Americans, every other American is, or descends from, an immigrant. First and second generation immigrant children are the most rapidly growing segment of the American population, with the great majority of this population being of non-European origin. This paper reviews the unique risk factors and mental health needs of our new immigrant populations, as well as treatment and services approaches to address their unique needs.
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TL;DR: Systematic inquiry into patients’ migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
Abstract: Background: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. Methods: We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. Results: The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. Interpretation: Systematic inquiry into patients’ migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
999 citations
Cites background from "Mental Health of Immigrants and Ref..."
...Working with community organizations Resettlement after migration is strongly affected by the policies, practices and opportunities of the resettlement society as well as existing ethnocultural community organizations and religious institutions, which support migrants in work and in legal, religious and social aspects of their adaptation.(9,23,132) The presence of welcoming links within ethnic communities or religious congregations can buffer the effects of migration losses, isolation and discrimination....
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TL;DR: It is argued that settlement specific policies and programs can ultimately be effective if embedded within a broader socially inclusive society - one that offers real opportunities for youth with refugee backgrounds to flourish.
364 citations
Cites background from "Mental Health of Immigrants and Ref..."
...Important structural factors include: the social climate of the host community (Ager & Strang, 2008; Pumariega et al., 2005); resources for achieving cultural and linguistic competency of the host country (Ager & Strang, 2008); opportunities to study (Valtonen, 2004) and a supportive school environment (Bond et al....
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...Youth may be encouraged by their families to stay loyal to their ethnic values while they are also asked tomaster the host culture in school and social activities (Pumariega et al., 2005)....
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...Important structural factors include: the social climate of the host community (Ager & Strang, 2008; Pumariega et al., 2005); resources for achieving cultural and linguistic competency of the host country (Ager & Strang, 2008); opportunities to study (Valtonen, 2004) and a supportive school…...
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...…living with supportive family members (Chapman & Calder, 2002; CMYI, 2006); feelings of belonging to one’s ethnic community (Brough et al., 2003; Lustig et al., 2004), and being able to develop positive relationships with the broader host community (Beirens et al., 2007; Pumariega et al., 2005)....
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..., 2004), and being able to develop positive relationships with the broader host community (Beirens et al., 2007; Pumariega et al., 2005)....
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01 Aug 2010
TL;DR: The Good Starts Study as mentioned in this paper used a mix of both method and theory from anthropology and social epidemiology to identify the psychosocial factors that assist youth with refugee backgrounds in making a good start in their new country.
Abstract: For young people with refugee backgrounds, establishing a sense of belonging to their family and community, and to their country of resettlement is essential for wellbeing. This paper describes the psychosocial factors associated with subjective health and wellbeing outcomes among a cohort of 97 refugee youth (aged 11-19) during their first three years in Melbourne, Australia. The findings reported here are drawn from the Good Starts Study, a longitudinal investigation of settlement and wellbeing among refugee youth conducted between 2004 and 2008. The overall aim of Good Starts was to identify the psychosocial factors that assist youth with refugee backgrounds in making a good start in their new country. A particular focus was on key transitions: from pre-arrival to Australia, from the language school to mainstream school, and from mainstream school to higher education or to the workforce. Good Starts used a mix of both method and theory from anthropology and social epidemiology. Using standardized measures of wellbeing and generalised estimating equations to model the predictors of wellbeing over time, this paper reports that key factors strongly associated with wellbeing outcomes are those that can be described as indicators of belonging e the most important being subjective social status in the broader Australian community, perceived discrimination and bullying. We argue that settlement specific policies and programs can ultimately be effective if embedded within a broader socially inclusive society - one that offers real opportunities for youth with refugee backgrounds to flourish.
324 citations
Journal Article•
TL;DR: Examination of the relationship between deportation concern and emotional and physical well-being among a group of Latino immigrants in a midwestern city indicates that Latino immigrants with concerns about deportation are at heightened risk of experiencing negative emotional and health states, Hispanic immigrant stress associated with extrafamilial factors and substandard health status.
Abstract: Among the many stresses that undocumented Latino immigrants experience, worries about their legal status and preoccupation with disclosure and deportation can heighten the risk for emotional distress and impaired quality of health To better document these effects, this study examined the relationship between deportation concern and emotional and physical well-being among a group of Latino immigrants in a midwestern city One-hundred-forty-three persons were recruited through community sources Fifty-six participants (39%) expressed concern with seeking services for fear of deportation, while 87 did not endorse this concern Measures of emotional distress, Hispanic immigrant stress and subjective health status were administered Results indicate that Latino immigrants with concerns about deportation are at heightened risk of experiencing negative emotional and health states (particularly anger), Hispanic immigrant stress associated with extrafamilial factors and substandard health status Findings inform policymakers of culturally relevant stressors of undocumented Latino immigrants that help to create and perpetuate the health and mental health disparities of this group
301 citations
01 Jan 2013
TL;DR: In this paper, the authors focus on the psychological experience of immigrants and their children and make recommendations for the advancement of training, research, and policy efforts for immigrant children, adults, older adults, and families.
Abstract: The United States today has approximately 39.9 million immigrants—the largest number in its history (Passel & Cohn, 2012; U.S. Census Bureau, 2011b). As a nation of immigrants, the United States has successfully negotiated larger proportions of newcomers in its past (14.7% in 1910 vs. 12.9% today) and is far from alone among postindustrial countries in experiencing a growth in immigration in recent decades. Notably, nearly three quarters of the foreign-born are naturalized citizens or authorized noncitizens (Congressional Budget Office [CBO], 2011). One in five persons currently residing in the United States is a firstor second-generation immigrant, and nearly a quarter of children under the age of 18 have an immigrant parent (Mather, 2009). As such, immigrants and the second generation have become a significant part of our national tapestry. Just as this demographic transformation is rapidly unfolding, the United States is facing international, domestic, and economic crises (Massey, 2010). Like other historical economic downturns (Simon, 1985), the current recession has served as a catalyst to make immigration a divisive social and political issue (Massey & Sánchez, 2010). Across the nation, immigrants have become the subject of negative media coverage (Massey, 2010; M. M. Suárez-Orozco, Louie, & Suro, 2011), hate crimes (Leadership Conference on Civil Rights Education Fund, 2009), and exclusionary political legislation (Carter, Lawrence, & Morse, 2011). Given the demographic growth, however, we now face an “integration imperative” (Alba, Sloan, & Sperling, 2011)—not only for the well-being of this new population but also for that of the nation’s social and economic future. Psychologists are, and increasingly will be, serving immigrant adults and their children in a variety of settings, including schools, community centers, clinics, and hospitals, and thus should be aware of this complex demographic transformation and consider its implications as citizens, practitioners, researchers, and faculty. This report aims specifically to describe this diverse population and address the psychological experience of immigration, considering factors that impede and facilitate adjustment. The report, which includes the recent theoretical and empirical literature on immigrants, (a) raises awareness about this growing (but poorly understood) population; (b) derives evidenceinformed recommendations for the provision of psychological services for the immigrant-origin population; and (c) makes recommendations for the advancement of training, research, and policy efforts for immigrant children, adults, older adults, and families.
233 citations
References
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TL;DR: In this paper, a rapidly expanding research literature on acculturation has accompanied the growth of international migrations, and the authors identify points of convergence and new directions for research, as well as problems and limitations.
Abstract: Acculturation, the process whereby immigrants change their behavior and attitudes toward those of the host society, is a fundamental part of migration-induced adaptations to new sociocultural environments. A rapidly expanding research literature on acculturation has accompanied the growth of international migrations. In response to the need to integrate the growing literature on acculturation and mental health status among Hispanics in the United States, and to identify points of convergence and new directions for research, 30 publications were examined. Points of convergence are identified, as are problems and limitations. The research needs new directions, proceeding from but not constricted by the assumptions and procedures in the work already done.
803 citations
TL;DR: Investigating the direct and moderating connections between perceived discrimination, acculturative stress, and mental health (CES-D) in adults of Mexican origin found discrimination was directly related to depression, but this effect was moderated through nativity/country of residence, English-language acculturation, sex, and country of education variables.
Abstract: We contend that perceived discrimination has an independent effect on depression outcomes among adults of Mexican origin. Using a sample of 3,012 Mexican-origin respondents in Fresno, California in 1995/96 (ages 18-59) we investigate the direct and moderating connections between perceived discrimination, acculturative stress, and mental health (CES-D). We also investigate the social patterning of perceived discrimination. While more highly acculturated immigrant respondents were more likely to experience discrimination than their less acculturated counterparts, more highly acculturated U.S. born respondents were less likely to experience discrimination. Discrimination was directly related to depression, but this effect was moderated through nativity/country of residence, English-language acculturation, sex, and country of education variables. Moderate levels of legal status acculturative stress were especially depressive for native-born U.S. residents.
800 citations
TL;DR: In this paper, the authors discuss two dimensions of bicultural involvement and report on the development and validation of a biculturalism and a cultural involvement scale for operationalizing both of these dimensions.
547 citations
Book•
01 Jan 1988
TL;DR: The Gang Subculture as a Lifeway: Structure, Process, Process and Form as mentioned in this paper is a well-known example of a gang subculture that originates in the Mexican American youth.
Abstract: * Foreword * Preface *1. Introduction *2. Ecological and Socioeconomic Background to Emergence of Street Gangs *3. Sociocultural Factors in the Choloization of the Mexican American Youth * Population *4. Four Life Histories-Wizard, Geronimo, Freddie, and Henry *5. The Gang Subculture as a Lifeway: Structure, Process, and Form *6. The Notorious Side of the Gang Subculture *7. Psychodynamics of Gangs *8. Conclusion * Glossary * References * Index
484 citations
TL;DR: This report, which uses standardized interviews by psychiatrists, describes the psychiatric effects on 40 Cambodian high school students in the United States who suffered massive trauma from 1975 to 1979.
Abstract: This report, which uses standardized interviews by psychiatrists, describes the psychiatric effects on 40 Cambodian high school students in the United States who suffered massive trauma from 1975 to 1979. They endured separation from family, forced labor and starvation, and witnessed many deaths because of the Pol Pot regime. After 2 years of living in refugee camps, they immigrated to the United States at about age 14. Four years after leaving Cambodia, 20 (50%) developed posttraumatic stress disorder; mild, but prolonged depressive symptoms were also common. Psychiatric effects were more common and more severe when the students did not reside with a family member.
483 citations
"Mental Health of Immigrants and Ref..." refers background in this paper
...In terms of the long term effects of trauma, Kinzie et al. (1986) and Berthold (1999) followed Cambodian adolescents who had suffered severe trauma in Khmer concentration camps in two different studies, with 25 50% were diagnosed as having PTSD years after the trauma....
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