Some cities in the US have a large number of immigrants. In New York City, over a third of the population was born in another country, which makes it among the highest immigrant-populated cities in the US. Immigrants in New York, like those around the world, face a higher risk of mental health problems and lack of medical care. Here are some of the causes behind the mental health concerns in the immigrant populations in New York City.
Language Barriers
Many immigrants in New York City speak languages other than English and may struggle to access mental health services because of a lack of bilingual providers. For many families who immigrate to the city and have no cultural community nearby, language barriers are added to cultural barriers. When there is no supporting community or organization in place to help immigrants, not only can they not find providers, but they are unlikely to even know what services are available or where to look for them. For example, AA meetings in New York can be hard to find for those with language barriers or who don’t know what services to look for.
Cultural Stigma
In some cultures, mental health issues are not acknowledged or are stigmatized, making it difficult for immigrants to seek help. Medical providers, schoolteachers, social service workers, and other professionals must approach the issue of mental healthcare carefully and should be respectful and understanding of cultural differences. Understanding how the culture of their patients can affect their care and treatment is vital to helping people of all communities access the mental health care they need.
Trauma Related to Migration
Many immigrants have experienced trauma, such as war-related violence and persecution, in their home countries and may have difficulty coping with these experiences. Trauma can be caused by viewing violence, even if the person wasn’t directly affected by it. Trauma can also be related to being a refugee, food insecurity in their home country, the treatment they received while immigrating, and prejudices they experienced upon arrival. These traumatic experiences can increase the rate of mental health care needs in the immigrant community compared with the community as a whole. Because trauma-related mental health sufferers are often hesitant to ask for help, those serving these communities can play a big part in increasing healthcare access.
Limited Access to Mental Health Services
Immigrants may have limited access to mental health services due to financial constraints or lack of health insurance. For those immigrants who aren’t connected to a community or don’t have support, this can be especially difficult. For some immigrants, getting the necessary paperwork and documents to apply for financial help or insurance is difficult or impossible. Immigrants without legal status may have no options for medical treatment other than emergency care, which can result in increased visits to the emergency room and, in the case of mental health concerns, a greater risk for serious complications such as suicide or addiction problems.
Fear of Deportation
Immigrants may be afraid to seek help for mental health issues because they fear being reported to immigration authorities. People who are living in the United States without the proper paperwork or identification, many of whom are seeking asylum or trying to find work, will avoid any contact that could increase their chances of legal action. While most legal immigrants don’t need to fear deportation, they may not know this if there is a language barrier. Instead, immigrants prefer to stay below the radar and not raise any possible suspicions about their presence in New York.
Difficulty Adjusting to a New Culture
Immigrants may struggle to adjust to a new culture, leading to feelings of isolation and depression. This is especially true for those who don’t have connections to a cultural community in New York, or who are without immigration support. For these people, isolation and the language barrier, as well as the culture shock they may experience, can lead to hesitancy to pursue any healthcare or community support options.
Limited Understanding of Mental Health
Some immigrants may not have a good understanding of mental health and may not know how to access services. Without knowing that mental health services are available for a variety of concerns, they are unlikely to ask for them, or even mention the things they are struggling with. Healthcare providers and other support people may have to explain which services are available and what they are used for to any immigrant patients, even if they don’t mention any specific symptoms or concerns.
Lack of Trust in the Healthcare System
Some immigrants may have had negative experiences with healthcare systems in their home countries and may not trust the healthcare system in the US. They may also have had negative experiences with authority systems and governments in general, making them distrustful of government-based medical care or healthcare services. They may not trust local government services, such as financial assistance, and may be hesitant to fill out applications that require paperwork and personal information.
Difficulty Finding Culturally-Competent Care
Immigrants may struggle to find mental health providers who understand and can accommodate their cultural beliefs and values. Healthcare and mental health are closely connected to religious beliefs, cultural customs, and traditional care in many cultures. Immigrants need access to medical providers who are knowledgeable about their culture and religion and can provide respectful care that doesn’t violate their beliefs. When immigrants have access to cultural connections they are more likely to find compassionate care. Those who aren’t connected to a community of others from their culture will have a harder time finding mental health support.
Re-Traumatization
Immigrants who have experienced trauma in their home countries may be re-traumatized by being in an unfamiliar and overwhelming environment. This trauma can be caused by prejudice, intentional unkindness or persecution, and xenophobia. However, it can also be caused unintentionally by the culture shock of being in a city so different from the immigrant’s home country, and from the confusion and fear that comes with arrival in a new country under difficult circumstances.
Conclusion
While immigrants in the United States face many mental health challenges and struggles, access to healthcare of all kinds can improve with compassion, knowledge, and connection. With a better understanding of the problems fueling the lack of access to mental health care, we can start to close the gap between immigrants and native-born citizens.