Immigration The U.S. is a nation of immigrants. In the past decade, there has been increasing attention focused on immigrants and refugees in this country. While the racial, ethnic, and immigrant diversity within American society is often cited as one of its greatest strengths, it has also been a challenge for America and for Americans in terms of fully accepting and embracing the broad array of immigrant groups that have become American. Since 1965, the number of immigrants in the U.S. has quadrupled (Budiman, 2020). Individuals from all different parts of the world desire to immigrate to the U.S. in search of increased opportunities. Immigration can be a hazardous, long, and dramatic process. Thus, many immigrants will have various experiences of loss, adjustment, and abuse (Budiman, 2020). Historically, every new immigrant group has experienced various degrees of prejudicial and discriminatory treatment and exclusion from mainstream society. However, the experience of many European (e.g., Irish, Italian, German) immigrants was one of initial discrimination followed by swift acculturation and assimilation, likely aided by the physical appearance and language similarities to those of earlier settlers (Brown & Bean, 2006). Asian and Latina/o immigrants have experienced prejudicial treatment due to readily identifiable physical and language differences. Historical evidence of mistreatment is well documented, with perhaps one of the most egregious examples being the internment of Japanese Americans during World War II (Nagata, Kim, & Nguyen, 2015). Americans often think of the journey of voluntary immigration of the many ethnic groups that come to America to build a “better” life. However, many immigrants arrive in this country due to war, famine, and natural disasters (Bunch, 2016; Coates, 2014). For instance, the legacy of the forced immigration of enslaved Black Americans is often overlooked. Black Americans endured 250 years of enslavement followed by 60 years of “separate but equal” status and continuing racist practices in our education, housing, health, and criminal justice systems (Bunch, 2016; Coates, 2014). Black Americans’ systemic and continuous oppression is a direct legacy of this forced immigration and has resulted in enduring educational, health, and wealth disparities (Bunch, 2016; Coates, 2014). Culture plays an extremely relevant role in counseling and psychotherapy. Immigration is a dominant event in a person’s life, shaping and distorting everything that comes before and after. Changing countries results in unique challenges at any age. Neighborhood relationships are particularly critical for new immigrants because many aspects of the new environment can be disorienting (Bunch, 2016; Coates, 2014). Living in ethnic communities protects immigrants from cultural isolation and benefits their initial psychological adjustment. However, pressure to assimilate may be strong outside their ethnic group, resulting in discrimination and its negative consequences. Within immigrant and refugee communities, collectivist cultural backgrounds prevail. The experience of psychological illness is often attributed to culture-specific or religious phenomena or both. Thus, in many immigrants or refugee cultures, conditions or disease are not considered positioned in the body or mind alone but may be seen as drawing on physical, supernatural, and moral realms (Sue & Sue, 2016). Mental illness may be understood heavily by ancestors and spirits rather than internal emotional factors. This creates an exciting position that workers need to both acknowledge and respect. While practitioners do not need to agree with or practice these beliefs, providers are expected to withhold judgment and support clients and their values. Even immigrants who have lived in the U.S. for a long time and who appear to have adopted the American lifestyle may maintain strong identification with, and hold the values of, their culture of origin (Korngold, 2009). Integrating the social and cultural values, ideas, beliefs, and behavioral patterns of the culture of origin with those of the new culture may lead to acculturation stresses. These stresses can cause or
increase mental health difficulties, such as anxiety, depression, post-traumatic stress disorder (PTSD), substance abuse, suicidal ideation, and others (Korngold, 2009). Acculturation involves changes in many aspects of immigrants’ lives, such as language, cultural identity, attitudes and values, ethnic pride, types of food and music preferred, media use, social and ethnic relations, cultural familiarity, and social customs (Korngold, 2009). Acculturation may occur in stages, with immigrants learning the new language first, followed by gradual participation in the new culture (Korngold, 2009). While some settings, such as workplaces or schools, are predominantly culturally American, others, such as an immigrant’s ethnic neighborhood and home environment, predominantly comprise the heritage culture (Korngold, 2009). Many immigrants and refugees are also unaware that there are professionals, such as counselors, who can help them navigate this strange new landscape (Korngold, 2009). Those who work with these populations say that as part of the cultural diversity that the counseling profession has embraced, counselors have a responsibility to help immigrants and refugees with everyday challenges associated with community, school, work, health care, and other systems. Therefore, as a mental health professional, you must adopt an open mind regarding the immigration experiences the individuals have. Challenges Immigrant communities encounter many challenges, including discrimination, such as being told to “go back to your own country,” language difficulties as many immigrants do not speak English upon their arrival, lower access to healthcare due to lower-paying jobs without benefits, and visa issues as some immigrants are undocumented, among many others (NAMI, 2019). There is also the added challenge of isolation from the larger national community. Many immigrant families live close to their immigrant community, which may reinforce a sense of separation (NAMI, 2019). Coping with these challenges can lead to mental health issues or mental illness, particularly for those with a pre-existing biological vulnerability to a mental illness. Common stereotypes of immigrants that they are less educated, more blue-collar, and more conservative can adversely impact mental health (NAMI, 2019). To avoid these perceptions, immigrants may feel a need to disassociate from their immigrant community. This may lead to a loss of network support, a risk factor for mental health issues (NAMI, 2019). Immigrants may not feel accepted in the U.S. Finding their “tribe” and developing an identity could be a long and challenging process, complicated and troublesome for mental health. A sense of belonging can be critical to good mental health. A lack of cultural competency and confidence is also a challenge for immigrants. Many immigrants and refugees report that when they have discussed their cultural upbringing and experiences with practitioners, they have been minimized, misunderstood, and dismissed (NAMI, 2019). The challenges are even more significant for those who cannot speak when and when they see a doctor or therapist; expressing emotions in their nonnative language can be challenging (NAMI, 2019). Translation can help, but a therapist might provide a more robust understanding of cultural context to help a patient. Different dialects can also complicate translation. Many immigrants are far less likely to seek treatment or trust a healthcare provider due to a lack of cultural understanding and competency. Cultural competence involves learning and maturation processes related to children’s inborn unique capacity to adapt to various social and cultural circumstances, including bi- and multicultural contexts. By mentally switching between different cultural codes (scripts or schemas), they accommodate their behaviors to the demands of the context. Counselors’ understanding of the differential treatment of current and past immigrant groups based on their ethnic, racial, religious, and linguistic backgrounds is paramount to their
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Book Code: PCTX1324
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