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Immigrants and mental health: U-M study

University Of Michigan : 11 April, 2007  (Technical Article)
Black Caribbean immigrants now make up more than one-quarter of the Black population in New York City, Boston, Miami and other U.S. cities. But until now, little has been known about this growing segment of the increasingly diverse U.S. Black population.
Black Caribbean immigrants now make up more than one-quarter of the Black population in New York City, Boston, Miami and other U.S. cities. But until now, little has been known about this growing segment of the increasingly diverse U.S. Black population.

The American Journal of Public Health highlights findings from a University of Michigan study that includes the first national probability sample of Blacks of Caribbean descent. The results help disentangle how ethnicity, gender, age at immigration and years of living in the U.S. are related to racial disparities in mental health and the likelihood of receiving treatment for mental disorders.

The analysis is part of a special section in the journal that examines the mental health of Latino and Asian as well as Black immigrants. Overall the studies, which are part of the National Institute of Mental Health Collaborative Psychiatric Epidemiology Surveys, find that immigrants have lower rates of mental disorders than native-born Americans. But within each population group, risks for particular disorders may differ depending on various factors.

'It used to be thought that new immigrants were at greater risk for mental health problems than their U.S. born counterparts, and that as they got used to life in the U.S., the risk of mental health problems would decrease,' notes an editorial in the issue. 'We now know that what happens is just the opposite, for Black, Latino and Asian immigrants as well as for other groups.'

The U-M study assessed the prevalence of psychiatric disorders and the use of mental health services and subjective satisfaction with treatment among Black Caribbeans and other Blacks in the U.S. Directed by U-M social psychologist James S. Jackson, the study, known as the National Survey of American Life, consisted of mainly face-to-face interviews with a national household probability sample of 3,570 African Americans, 1621 Blacks of Caribbean descent, and 891 non-Hispanic whites aged 18 and older.

'Much of the previous research on mental health in Black immigrants of Caribbean descent has been conducted in the United Kingdom and in other European nations, comparing Caribbean Blacks to the native white populations,' said Jackson, who directs the U-M Institute for Social Research, the world's largest academic social science survey and research organization.

'This study is the first to examine within-race ethnic differences in mental health and use of mental health services in the U.S. population.'

A related analysis conducted by former U-M ISR sociologist David R. Williams, now a researcher at the Harvard School of Public Health, found that Black Caribbean immigrant men were more likely than U.S.-born African American men to have experienced mood and anxiety disorders in the last year. Black Caribbean immigrant women, however, were less likely than U.S.-born African American women to have experienced anxiety or substance abuse disorders in the last year and over their lifetimes.

Only about one-third of those who met the diagnostic criteria for mental disorders received formal mental health care services, Jackson and colleagues found, with U.S.-born Blacks more likely to receive care than first-generation Black immigrants.

But immigrants who had lived in the U.S. for more than 21 years reported the highest use of services. 'The longer Black Caribbeans live in the U.S. and younger they are when they immigrated, the more likely they are to use mental health services,' Jackson said. 'This suggests that socialization and access may play an important role in seeking and receiving treatment for mental health problems.'

The study also found that:
Caribbean Blacks from Spanish-speaking countries were much more likely to report using mental health services than were Haitians or Caribbean Blacks from English-speaking countries.
Caribbean Blacks reported significantly greater satisfaction with mental health services than did African American respondents.
Those who arrived in the U.S. when they were aged 12 or younger were more likely to receive any mental health service.
Caribbean Blacks who were third generation or later (they and their parents were born in the U.S. but at least one grandparent was born in a Caribbean country) were much more likely to report using mental health services.

'Our findings reveal that combining data for Caribbean Black immigrants or U.S.-born Caribbean Blacks with data for native African Americans obscures a great deal of variability in patterns and frequency of formal mental health service use,' concluded Jackson. 'It's important that we finally recognize the simple truth that all Black Americans are not the same.'
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