The Migrating Mind: New Studies Unlock Impact of Immigration on Mental Health

John Watson


May 18, 2017

Effective Interventions

Knowing the biological underpinnings of migration-related mental health disorders may one day yield preventive measures. For now though, treatment strategies require therapeutic methods tailored to these populations' unique needs.

Selective serotonin reuptake inhibitors can be effective for PTSD, two of which have been approved by the US Food and Drug Administration. Prolonged-exposure therapy, cognitive processing therapy, and eye-movement desensitization and reprocessing can also help those suffering from trauma and its lingering painful memories and associations. Yet crucial to treating immigrants and refugees is ensuring that these patients feel socially enmeshed within their community.

"One of the most helpful things we can offer them is getting them connected to services and helping them settle," said Karen Fournier, a social worker at CAMH's New Beginnings Clinic, which provides mental health services to anyone within their first 2 years of arrival to Canada and claiming refugee status.

According to Laura Simich, PhD, a former research scientist at CAMH and current direction of immigration and legal services issues at the Vera Institute in New York City, "Education about mental health and mental health services helps, but so does promoting the idea that many settlement stresses (which are sometimes as troubling as the problems that drove people to migrate) can be ameliorated by nonmedical means, such as social support groups."

Simich, who in 2014 coedited the book Refuge and Resilience on mental health strategies in forcibly displaced persons, said clinicians need to treat with an eye to the past even in non-PTSD patients, because such patients are often distressed by family and friends they left behind.

"It doesn't always help to treat just the individual in the 'here and now,' because people carry the past and sense of community with them even when confronting new problems in a receiving country," Simich said.

This knowledge should encompass not just the clients' needs, but also a broader understanding of the culture they're bringing with them, said Mona Makki, director of the ACCESS Community Health and Research Center in Dearborn, Michigan, the largest Arab-American nonprofit organization in the United States.

"Most refugees who come to the United States are coming from a situation where there was a mistrust of government and authority. They continue to present these issues here," she said. "There is also a lot of stigma in our community around mental illness. That, coupled with fear of discrimination, creates hesitation about seeking services."

ACCESS offers comprehensive behavioral health services, with 30 on-site mental health professionals for immigrant and refugee families. Many of the staff come from the Arab-American community, and are therefore sensitive to these challenges.

These considerations are particularly important at a moment when refugees and immigrants find themselves the objects of hostile acts, ambient discrimination, and wholesale campaigns of misinformation.

"If you feel that you're less valued, that you're stressed because of the environment, certainly this will affect chemistry more," said Dr Mizrahi. "I think this is likely to play a significant role."


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