U.S.-born Children of Immigrants May Have Higher Risk for Mental Disorders Than Parents

January 17, 2007 • Science Update

In the first studies to examine the effects of immigration and years of residence on the mental health of Caribbean Black, Latino, and Asian populations in the United States, NIMH-funded researchers found that immigrants in general appear to have lower rates of mental disorders than their U.S.-born counterparts. A special section of the American Journal of Public Health published in January 2007 provides early findings from the National Survey of American Life (NSAL) and the National Latino and Asian American Study (NLAAS) on the prevalence of mental disorders and patterns of mental health service use among minority immigrants and later generations born in the U.S. It is also the first time that comparable studies of nationally representative samples of Caribbean Blacks, Latinos, and Asians have been published together in the same journal.

Overall, immigrants appear to have lower rates of mental disorders than second- or later-generation individuals, as seen in the table below. However, within each group, risks for particular disorders may differ depending on ethnic subgroup, gender, English-language proficiency, years of living in the United States, and age at immigration. For example, Caribbean Black men in the United States had higher risks for mood and anxiety disorders in the past year than African American men. Caribbean Black women had lower past-year and lifetime risks for anxiety and substance abuse disorders compared with African American women. Among the Latino population in the United States, those who reported lower self-ratings of ability to speak, read, and write in English showed a reduced risk for substance use disorders and a lower overall risk for mental disorders. In contrast, Asian men who spoke English well were at lower risk for mental disorders over a lifetime; nativity was the most stable predictor of mental disorders in Asian women, with foreign-born women reporting fewer lifetime cases than U.S.-born women.

Prevalence Rates of Mental Disorders among Different U.S. Population Groups

* National Comorbidity Survey-Replication, 2005

Patterns of mental health service use also varied among the different groups, but overall, U.S.-born children and grandchildren of immigrants showed greater service use than immigrants themselves. Among the diverse ethnic subgroups, the researchers also observed differences in patterns of service use according to a variety of ethnic- and immigration-related factors. For example, while Caribbean Blacks and African Americans showed similar mental health service use patterns overall, blacks from the Spanish-speaking Caribbean were more likely to report using specialty mental health services such as psychiatrists, psychologists, or mental health hotlines within the past year than African Americans or blacks of other Caribbean origins. Puerto Ricans reported significantly higher rates of overall mental health service use and specialty service use than all other Latino subgroups; however, foreign-born Latinos and those who spoke primarily Spanish, while much less likely to seek specialty services, used general medical services for mental health issues at comparable rates to other Latinos, suggesting lower recognition of psychiatric problems among these populations. While Asian Americans in general showed low rates of help-seeking, children of Asian immigrants, or second-generation individuals, showed more similar patterns of service use to immigrants than to third-generation individuals, who showed patterns comparable to the general population.

Both the NSAL and NLAAS were part of the NIMH-supported Collaborative Psychiatric Epidemiological Survey (CPES) program, which also included the National Comorbidity Survey Replication. Together, these national surveys provide improved data on the mental health of racial and ethnic minorities living in the United States. The relative lack of this type of information in the past has created a barrier to service for immigrants and subsequent generations. Further research like the CPES studies that increases the understanding of mental health risks and service use among different population groups is critical for developing programs and services that meet the specific needs of these populations and may help reduce current health care disparities.

References

Boyce CA, Cain VS. Disentangling Health Disparities Through National Surveys. Am J Public Health. 2007 Jan;97(1):10.

Takeuchi DT, Alegria M, Jackson JS, Williams DR. Immigration and Mental Health: Diverse Findings in Asian, Black, and Latino Populations . Am J Public Health. 2007 Jan;97(1):11-2.

Williams DR, Haile R, Gonzales HM, Neighbors H, Baser R, Jackson JS. The Mental Health of Black Caribbean Immigrants: Results from the National Survey of American Life . Am J Public Health. 2007 Jan;97(1):52-9.

Jackson JS, Neighbors HW, Torres M, Martin LA, Williams DR, Baser R. Use of Mental Health Services and Subjective Satisfaction With Treatment Among Black Caribbean Immigrants: Results from the National Survey of American Life. Am J Public Health . 2007 Jan;97(1): 60-7.

Alegria M, Mulvaney-Day N, Torres M, Polo A, Cao Z, Canino G. Prevalence of Psychiatric Disorders Across Latino Subgroups in the United States. Am J Public Health . 2007 Jan;97(1):68-75.

Alegria M, Mulvaney-Day N, Woo M, Torres M, Gao S, Oddo V. Correlates of Past-Year Mental Health Service Use Among Latinos: Results From the National Latino and Asian American Study. Am J Public Health . 2007 Jan;97(1):76-83.

Takeuchi DT, Zane N, Hong S, Chae DH, Gong F, Gee GC, Walton E, Sue S, Alegria M. Immigration-Related Factors and Mental Disorders Among Asian Americans. Am J Public Health . 2007 Jan;97(1):84-90.

Abe-Kim J, Takeuchi DT, Hong S, Zane N, Sue S, Spencer MS, Appel H, Nicdao E, Alegria M. Use of Mental Health-Related Services Among Immigrant and US-Born Asian Americans: Results from the National Latino and Asian American Study . Am J Public Health. 2007 Jan;97(1):91-8.