Stressors and Barriers to Using Mental Health Services Among Diverse Groups of First-Generation Immigrants to the United States

Community Ment Health J (2012) 48:98106

DOI 10.1007/s10597-011-9419-4

ORIGINAL PAPER

Stressors and Barriers to Using Mental Health Services Among Diverse Groups of First-Generation Immigrants to the United States

Fay Saechao Sally Sharrock Daryn Reicherter

James D. Livingston Alexandra Aylward

Jill Whisnant Cheryl Koopman Sarita Kohli

Received: 25 January 2010 / Accepted: 25 May 2011 / Published online: 8 June 2011 Springer Science+Business Media, LLC 2011

Abstract This study examined stressors and barriers to using mental health services among rst-generation immigrants in San Jose, California. Focus groups for 30 immigrants from Cambodia, Eastern Europe, Iran, Iraq, Africa, and Vietnam were audio-recorded, translated and transcribed. Two researchers coded the data and identied themes pertaining to mental health stressors and barriers. Six primary stressors were identied: economic, discrimination, acculturation due to language differences, enculturation, parenting differences, and nding suitable employment. Primary barriers included: stigma, lack of a perceived norm in country of origin for using mental health services, competing cultural practices, lack of information, language barriers, and cost. A conceptual model is presented that may be used to inform the design and implementation of mental health services for this population.

Keywords Immigrant Mental health services Stress

Barriers

Introduction

Specic immigration-related factors may affect mental health and create barriers to utilizing mental health

services. Yakushko and colleagues (2008) found that stress associated with acculturation, maintaining cultural values and traditions, economic struggles, and oppression surrounding employment were the most signicant concerns of immigrants. Research has indicated that the circumstances under which people migrate to the United States, English prociency, and acculturative stress play a significant role in mental health (Hovey 2000; Oh et al. 2002; Pumariega et al. 2005; Takeuchi et al. 2007). In addition, stigma and a lack of awareness or understanding of services function as barriers to seeking mental health services (US Department of Health and Human Services 1999). For example, Nadeem and colleagues (2007) found that stigma-related concerns were signicantly related to lower desire for mental health treatment for immigrant women from ethnic minority groups.

Both pre-migration risk factors, such as previous traumatic experiences, and post-migration stressors must be considered as important contextual factors associated with the mental health of immigrants (Pumariega et al. 2005). Pre-migration exposure to political violence is associated with emotional distress among recent...