New Insights on how Mental Health is Influenced by Culture and Immigration Status

Culturally-relevant research provides clues that may help reduce health disparities

July 11, 2007 • Science Update

A special issue of Research in Human Development, published in June 2007, examines current trends in prevalence and risk factors for mental disorders across the lifespan in diverse U.S. minority populations. Past research suggests that factors such as culture, race, ethnicity, gender and age can significantly influence overall health, as well as health care attitudes and access, and responses to treatment. A better understanding of the complex role that cultural backgrounds and diverse experiences play in mental disorders is crucial, as NIMH strives to create personalized treatment for those with mental disorders.

Originally presented at a workshop organized by NIMH and the Family Research Consortium IV, the five articles in this issue provide insight into NIMH-sponsored national studies of mental health among minority populations in the United States, potential cultural risk factors for suicide among Native American youth, as well as one of the first major studies of mental illness among ethnically diverse teens. NIMH research scientist Cheryl Boyce, PhD, and Andrew Fuligni, PhD, of the University of California, Los Angeles, discuss in an introductory article the main themes represented in the special issue and particular cultural considerations that appear to be the most relevant at different stages of life for the mental health of U.S. minority populations. Recommendations for further research may help inform efforts to reduce health disparities.

Notable findings from this special issue include:

• Age at immigration appears to affect the onset of mental disorders in Asian Americans. Based on data from more than 2,095 Asian Americans collected for the National Latino and Asian American Study (NLAAS), David Takeuchi, PhD, University of Washington, and colleagues found that those who immigrated during childhood, as well as U.S. born Asians, were much more likely to have a mental disorder in their lifetimes than other immigrant generations. Asian immigrants who arrived at age 12 or younger had a greater risk for psychiatric disorders during childhood than their U.S. born counterparts; this risk, along with risk for substance abuse, increased during adolescence. Asian immigrants who arrived before age 41 also had a greater risk of onset for mood disorders during or shortly after immigration, whereas those who arrived after age 41 were more likely to have experienced onset before immigration.
• Information on more than 2,554 Latinos interviewed for the NLAAS showed that age at immigration was also key in the mental health of this diverse minority population, found Margarita Alegría, PhD, Harvard University, and colleagues. In general, past age 7, the older the person at immigration, the later the onset of psychiatric disorders. Those who arrived later in life had lower lifetime prevalence rates than younger immigrants or U.S. born Latinos. However, after about age 30, the risk of depressive disorders increased among these later-arriving Latino immigrants, whereas risk tended to decrease between ages 30-40 for U.S. born Latinos and immigrants arriving before age 7. Latinos arriving between ages 0-6 had very high risks of onset shortly after immigration, but after several years, their lifetime prevalence rates approached those of Latinos born in the United States.
• Researchers working with Harold Neighbors, PhD, University of Michigan, studied the interactions between culture, race, and ethnicity with depressive symptoms among a subset of participants from the National Survey of American Life, comprising 3,438 African Americans, Caribbean Americans, and white Americans. They evaluated social, group, and individual characteristics related to behavioral responses (such as coping strategies) to life stressors, group and personal identity, ideology, and beliefs about racial relations, and how these factors intersected with symptoms of depression. African Americans in this study did not show a significant relationship between depressive symptoms and high-effort coping strategies, while Caribbean Blacks and white Americans experienced increasing symptoms of depression linked to increasingly high-effort coping, in relationship to other beliefs and values.
• Nearly 20 percent of Native American middle school students in a single reservation attempted suicide, double the rate for the general teenage population, according to a study led by Teresa LaFromboise, PhD, Stanford University, and funded by the Substance Abuse and Mental Health Services Administration. The researchers evaluated 122 students who belonged to the Metis or Ojibwa tribes living in the Northern Plains and found that a sense of connection or belonging to their school community appeared have a strong, protective effect against suicidal thoughts. Overall, the two strongest predictors for thinking about suicide were depression and substance abuse.
• Data on the mental health of diverse teens in the Houston area suggest few differences in risk for mental disorders based on ethnicity. Robert Roberts, PhD, and Catherine Ramsay Roberts, MPH, PhD, both at the University of Texas, interviewed 4,175 European American, African American, and Mexican American youth and found that, overall, teens of European American descent were at lower risk for anxiety disorders, and African American youth were at lower risk for substance use disorders and having more than one mental disorder. Unlike adults, total family income (or socioeconomic status) was not linked to increased risk for any disorder for any of the three groups; however, the perception of lower income was associated with increased risk for all groups.

Reference

Boyce CA, Fuligni AJ. Issues for Developmental Research Among Racial/Ethnic Minority and Immigrant Families. Res Hum Dev. 2007 Jun;4(1&2):1-17.