People around the country are struggling to navigate another contentious election season amidst a malingering pandemic, a far-right social offensive, an economic downturn, and the aftermath of the military repression of the largest social movement in the U.S. to date. In many ways, immigrants are especially vulnerable to each of these stressors. As they grapple with familiar economic and personal hardships like job loss, family death, and health issues, structural and cultural hurdles also impact immigrants’ mental health.
Fourteen percent of immigrant workers live in overcrowded housing, making it difficult to practice social distancing as the U.S. risks a third winter COVID wave (Center for Immigration Studies, Yahoo!). Immigrants and children born to immigrant parents are also more likely to experience food insecurity, an issue that will only become more acute with the economy on the brink of a recession (PubMed, MSN). Coupled with COVID-19 stress, they are dealing with job and health insurance loss, hampering mental health access.
• Support the victims of the Monterey Park shooting. Changing Tides is offering a free support group for those needing community support.
• Learn more about mental health resources for immigrants and refer immigrants to the services from the Immigrant Learning Center’s list.
• Share this curated list of diverse and inclusive therapists from InclusiveTherapists.com that can meet the needs of immigrants.
• Asian Mental Health Collective has a directory of therapists and support groups offering support for the AAPI community. You can find more resources here.
A study found that immigrants were much less likely than nonimmigrants to utilize mental health services, especially among communities of color (National Institutes of Health). Two types of barriers hamper mental health access for immigrants, cultural and structural (PubMed). Cultural barriers include stigma, norms, and attitudes, whereas structural barriers are factors such as costs, transportation, and discrimination.
Oftentimes, access to mental health services is seen as an extra or unnecessary expense, especially in communities where stigma is prevalent, making it hard to justify its need to family members (The University of Chicago Press Journals).
Stigmatization while growing up in an uninsured immigrant household prevented my family and me from seeking mental health services. My sisters and I were always met with, “You don’t need it. There’s nothing wrong with you,” when trying to seek mental health care. So when the pandemic hit, our mental health was hit hard. Some of my family members had lost their jobs, experienced stress from surmounting bills, and were socially isolated. I witnessed the repercussions of the pandemic on my family and knew we weren’t alone in experiencing these barriers.
A 2021 survey found that 77% of people of color reported struggling to talk about their mood disorders compared to white people (NAMI). Additionally, Hispanic, Black, and Asian people were more likely to want mental health treatment but struggled to get support and did not receive it.
Structural barriers to mental health care treatment, like inadequate language services, can also effectively block entire communities from accessing care (Psychiatry Online). The 1964 Civil Rights Act, the Americans with Disabilities Act, and the Affordable Care Act require healthcare providers and medical facilities to provide language access programs and assistance to patients whose primary language isn’t English (U.S. Health and Human Services). Still, people with “limited-English proficiency are less likely to have routine health visits, more likely to defer needed health care, and more likely to leave the hospital against medical advice” because of communication and language barriers (Centers for Medicare and Medicaid Services).
“What does this mean?” was a common question my grandmother would ask whenever we visited the doctors. Because English was my grandmother’s second language, I translated healthcare information in the doctor’s office from Cantonese to English so that she could understand. Understanding health information can be daunting for many immigrants where English is not their native language. There is a need for multilingual mental health providers who are culturally competent and can understand the mental health needs of immigrants.
The for-profit healthcare system is another structural barrier. Of the 44.8 million immigrants living in the United States in 2018, nearly 20% were uninsured (Pew Research Center). Between February and March 2020, the number of unemployed immigrants increased by 30%, doubling the unemployment rate of U.S.-born workers (Migration Policy Institute). Because health insurance coverage is tied to employment, immigrants were more likely to lose their health insurance and mental health care coverage. Health insurance access is even harder for undocumented immigrants, who are banned from the Affordable Care Act (ACA) and Medicaid (Health Insurance).
When members of our community thrive, we all thrive. And right now, immigrants’ mental health should be a priority. We can support them by destigmatizing mental health, supporting policies that shape health insurance access for immigrants, and supporting community organizations amplifying their mental health needs.
Mental health impacts every facet of our lives. It governs our daily actions and shapes our behavior. Therefore, access to affordable mental health should be prioritized and made available. Mental healthcare is a human right.
• The pandemic and recession disproportionately impact immigrants’ mental health.
• Cultural and structural barriers hamper immigrants’ mental health access (PubMed).
• Undocumented immigrants pay taxes but aren’t protected or covered under federal programs like the Affordable Care Act and Medicaid.
*This piece was originally published on 12/10/20. It was updated and edited by The ARD on 1/24/23.