At INTERFACE Referral Service, we focus on connecting members of our communities with mental health providers. We also value the importance of learning about the mental health conditions that may be affecting your thinking, feeling, behavior, or mood.

Therefore, we have created "Mental Health Topic Pages". The majority of our topic pages will direct you to Network of Care Massachusetts! Network of Care Massachusetts has a library database of over 30,000 fact sheets and articles. Topics on behavioral health issues are written by leading experts and organizations in their fields.

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Common Mental Health Challenges Experienced by Immigrants and Refugees

Refugees and immigrants to the U.S. experience unique stresses, prejudice, and poverty.  These individuals and families can be considered at-risk subpopulations for health, emotional, and behavioral problems, and, in the case of children, learning and academic difficulties as well (APA resolution on Immigrant Children, Youth, and Families, 2016). 

Some of the mental-health related issues faced regularly by immigrants and refugees include:

• Stress associated with the immigration and resettlement process
• Acculturation to language, economics, health care, education, religion
• Encounters with both individual and institutional bias, discrimination, and racism
• Multiple traumatic experiences

Stresses involved in immigration and resettlement experiences can cause or exacerbate mental health difficulties, including anxiety, depression, posttraumatic stress disorder (PTSD), somatic complaints, sleep problems, behavioral problems in children, substance abuse, suicidal ideation, and severe mental illness (APA resolution on Immigrant Children, Youth, and Families, 2016; Working with Immigrant-Origin Clients, 2013; Working with Refugee Children and Families, 2009).  These difficult experiences paired with acculturation related issues can exacerbate mental health issues, causing them to become more acute and complex.

Important markers of acculturation include language(s) spoken, ethnic identity, and the degree to which individuals participate in cultural activities. According to the U.S. Department of Education (2010), 20% of children speak a second language at home.  Parents and children may acculturate at different rates, which is common among resettled refugee and immigrant families.  Children often adapt to new language and cultural norms more quickly than their parents, which can lead to intergenerational misunderstandings, tensions between old and new cultures, and challenges to identity development, family conflict and loss of communication, role reversal, and facing loneliness and isolation (Working with Refugee Children and Families, 2009; Working with Immigrant-Origin Clients, 2013).  Families working to cope with these stressors coupled with immigration trauma can lead to symptoms of depression, suicidal ideation, posttraumatic stress disorder (PTSD), and various other mental health concerns.  What is more, the language barrier impacts refugee and immigrant individuals and families’ abilities to receive proper health care.

In addition to acculturation-related difficulties and mental health challenges, traumatic experiences play a large role in immigrant and refugee overall well-being.  Traumatic experiences that can occur at various stages in the immigration and resettlement process place immigrants at risk for mental health problems. This can affect the ways in which these individuals and families adjust to their new cultural context. 

Trauma-based presenting problems include:

• Migratory trauma, including pre-migration, migration, post-migration, and deportation
• Interpersonal difficulties and violence
• Depression, anxiety, PTSD
• Compromised identification with country of origin, and adopted country
• Feelings of persecution and distrust of authorities and institutions

Many immigrant and refugee individuals and families will have experienced and survived devastating and profoundly traumatic events.  Not only are they faced with pre- and post-immigration trauma, but the pairing of these adverse experiences with subsequent acculturation issues and other stressors makes for a uniquely complex trauma experience for many immigrants and refugees.  They are in great need of supportive services to promote health and wellbeing after resettlement in the United States, which can address a range of needs, including basic daily living, education, and physical and mental health.

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Barriers to Mental Health Services for Immigrants and Refugees

Despite the great need for supportive mental health services, there are often numerous barriers to mental health services for immigrants and refugees.  Some of these barriers include:

• Differences in symptom expression and attributions as well as conflicting views about the causes of, and ways of coping with, mental health problems
• Stigma associated with mental health problems
• Lack of access to appropriate and culturally sensitive mental health services in native languages
• Lack of access to interpreters (language barriers impact abilities to receive proper health care)
• Shortage of racial/ethnic minority mental health workers and/or persons trained to work with racial/ethnic minority persons and culturally diverse elders
• Lack of knowledge of available and existing mental health services and resources (e.g. transportation, insurance, and child care) for accessing services
• Lack of access to services and culturally competent service providers in rural areas
• Challenged sense of safety and belonging, and difficulty trusting that systems of care will help them when they are facing mental health challenges
• Fears related to unauthorized status or to frequent moves in search of work.

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To learn more, visit these Network of Care Resources:

Immigration Support Services