Several psychiatric studies of black Caribbean immigrants to the United States have should low rates of mental health illness. Migrants range from refugees, asylum seekers, students and voluntary migrants. The study conducted investigated the psychological impact of pre migratory expectations and post migratory expectations among Caribbean immigrants. The Caribbean immigrants including Afro Caribbeans and West Indians were the study group chosen. First generation West Indian immigrants residing in urban Philadelphia participated in this study. To say the anxiety and depression among the Caribbean can be used to make a conclusion regarding all Black immigrants in the United States could be invalid.
Anxiety and Depression Among the Immigrant Caribbean Population
Human beings have always moving from place to place in search for a better life, better environment and the pursuit of happiness for a mighty long time. History has as hunters and gathers, nomads at times. The idea of moving is at times sad for the ones left behind and for those leaving as at times they are alone. No matter whether it is in the pursuit of happiness and the future is promising green grass anxiety can also kick in. Caribbeans and Africans have traveled to the United States for many generations now. Dating back to musician Bob Marley to todays former president Obamas father, many different reasons have brought them into this country.
The anxiety starts just as the idea of announcing to loved ones that you have deiced to move. This whole stage marks the pre-immigration stage. Physically making the move after obtaining the visa starts another part of this immigration process. At times this stage of the process can be done by just one member of the family or all the members usually when refugee status is involved. Adjusting to the new environment culturally and socially marks the post-migration phase.
Caribbeans like many Africans are not people who publicly acknowledge that depression and anxiety are issues that need to be addressed or even talked about. This does not mean that such issues do not exist. There have been studies that have looked at have expectations and outcomes contribute to the Caribbean Immigrants anxiety and depression (Mahlingam R., Murphy J. E., 2006)
Caribbeans have been migrating to the United States of America (USA) for many years for many different reasons. Currently the USA is experiencing a massive wave of immigration greater than the immigrant waves of the 19thand early 20thcenturies (Portes & Rumbaut, 2006).
The process whereby a person moves from one cultural setting to another for prolonged periods or permanently settling down is called migration (Bhangra, & Jones 2001). Various reasons contribute to migration, when it is by choice it known as voluntary migration. When its in pursuit of better economic opportunities, marriage, or to join family members who migrated previously it is involuntary. According to (J. D Kinzie 2006) refugees are migrants who flee their own country because of fears of violence or starvation. When it comes to Asylum often the seekers arrive illegally to seek refuge in the USA. There is an estimated 10,000,000 legal immigrants who have come to the USA in the decade ending in 2000 (Immigration and Naturalization Service data). In the United States of America asylum seekers cannot work legally until a work permit is issued by the immigration office which can take over one year. Voluntary immigrants generally work as doctors, engineers, or other professional who are always welcomed by receiving countries, (Louis, Duck, Terry, Schuller & Lalonde, 2007).
When a group of people hold shared meanings, understandings, or referents this is referred to as culture (Shore, 2002; Triandis, 1995). Caribbean culture is made up of a unique combination of Africans in the Diaspora and in the West Indians, and as immigrants to the United States and other colonizing countries (G. Dudley-Gran & W Etheridge 2005). Many different independent countries make up the Caribbeans. The region was colonized over the course of five centuries by Spanish, Dutch, French, and English forces, who imported first African slaves and later Asian laborers in the sugar, coffee and tobacco farms. (Palmie` S., Scarono F. 2013). The Indians and Asians who had been brought to work those plantations also integrated their own cultures into the Blacks (Africans) living on the island (GoPaul-McNicol 1993). Jamacians became internationally recognized with the Rastafarian movement began as a religious counteraction to the imperialistic outcomes of Eurocentric Christendom (GoPaul-McNicol 1993). Rastafarians believe of being close to God and the soil can serve as a source of resilience when tough times arise, according to (GoPaul-McNicol 1993). Haitians practice mainstream religions alongside the traditional beliefs from Vodoun, which emphasizes that modern medications & colonizes ways do not always provide the answers (Dudley, Grant 2003).
The ability to change after one comes into contact with culturally dissimilar people, groups and social influences is acculturation (Gibson, 2001). As immigrants acquire the values, practices, and beliefs of their new societies, they are expected to discard those from their cultural heritage. (Schwarts S. J 2010). Language as contended by commentators empirical studies shared as the cornerstone of national identity and the migrants who cannot speak the of the country or are not of the religion of where they living, are considered a threat to national unity. (Huntington, 2004, Barker et. 2001; Schildhraut, 2005).
As a major country that people migrate to, it is important to note that the USA was founded by English-Speaking Europeans, and with Great Britains dominant cultural practices and values (Portes & Rumbuat, 2001, 2006). Migration at a young age makes acquiring the receiving-cultures practices, values, and identifications easy and fluidly than when older. (C. Suarez-Orozco, 008). It is difficult for adult immigrants to willingly adapt to the practices, values and identifications of the new society (Schwartz, Pantin, Sullivan, Prado, & Szapocnzik, 2006).
Depression is a medical illness that negatively affects how you feel, think and act daily according to the American Psychiatric Association (APA) 2013. As a result of depression, one has feelings of sadness and loss of interest in activities that they generally enjoyed. This lack of interest affects ones ability to function at work and at home, per Diagnostic Statistical Manual of Mental Disorders (DSM -5) Fifth edition 2013. Migration can increase the risk factors for depression. As people move, they leave behind an environment they had learnt to survive in, and their loved ones which is a great loss. Loss and grief have their conceptual origin in psychoanalytic theory (Garza-Guerreo 1974; Grinberg and Grinberg1989) and Bowlbys (1980) attachment theory as well as the trauma framework developed in work with refugees (Nwoye 2009). Their travels and new environments might not be welcoming and when coming into the USA from a French speaking nation, this results in increased stress.
Research has attempted to better identify people dealing with depression to aid in offering early intervention and prevention the development of depression. Unfortunately, the USA has its issues regarding racial discrimination; ethnic minorities are not usually held as highly as White migrants (Simon & Lynch, 1999). After leaving a friendly loving Caribbean community and entering an individualized society can contribute to depression.
Anxiety disorders involve excessive fear which is unlike our normal reaction to stress affecting our everyday function according to the APA (2013). High expectations paired with poor outcomes generally lead to anxious symptoms (Furnham, 1987; Misra & Kilroy, 1992). Perceived match between premigratory expectations and postmigratory realities is an issue central to the psychological adjustment of most immigrants, regardless of the circumstances under which they migrated, Landau-Stanton (1990). It the realities do not match up favorably to the immigrants expectations, the resultant anger and frustration can lead to anxiety, Misra & Kilroy (1992). Upon receiving to Visa its the fear of not knowing where what is ahead in the USA that results in increased levels of anxiety. West Indians living in the Caribbean are told exaggerated stories of economic and professional success from friends or relatives who migrated (Baptiste et al., 1997; Crawford-Brown & Rattray, 2001). Social media feeds people false information about the daily life of an average American. Most of the postings that people living in the Caribbean islands see of their friends in the USA on Facebook can cause fear of not being able to fit in.
There have been studies that have looked at mental health of Black Caribbean Immigrants (Haile et. al, 2007, Gibbs et. al 2013). African Caribbean immigrants were considered to have lower rates of mental illness in any form than USA born nationals. These studies acknowledge a relationship between race/ethnicity and personality with mental illness among Caribbean Blacks in the United States. Further research aids in understanding psychiatric illness within the population of Blacks in the United States (Gibbs et. al 2013)
Participants were recruited from the International Students Office at Temple University. There was a total of 100 participants and a stratified sampling method was used. The sample included 50 participants immigrants from French speaking countries and those from English speaking countries. The participants were all Black Caribbean immigrants Temple students to the United States. Ages ranged from 18 -30 years some had come as minors with undocumented parents, some as Refugees, others Asylum seekers and economic immigrants. To be included in the study one had to have lived in the United States for not less than five years and not more than ten years.
Questionnaires were utilized to measure the degree of anxiety that each participant had and the presence of signs / symptoms of depression. Participants, to measure the level of anxiety. had to answer the questions on the (Beck 1988). The total score was calculated by finding the sum of the 21items. If the participants scored 0-21 = low anxiety, score of 22 35 = moderate anxiety and score of 36 and above =potentially concerning levels of anxiety.
To measure the level of Depression the Hamilton Depression Rating Scale (HAM -D) (Hamilton 1960) was used. HAM-D contains 21 items scoring was based on the first 17 items, and the score determined the level of depression. Levels of depression scale 0-7 = normal, 8 13 mild depression, 14 8 moderate, 19-22 severe and 22 >23 = very severe depression.
Four other questions were included; to assess migrant experiences
- At what age did the participant come to the United States?
- What is your current immigration status?
- Do you have any immediate family in the Unites States?
- Write a minimum of one word to describe your stay in the United States so far?
Participants were told that the study was designed to explore the impact that migration has on a person leading to the development of anxiety and depression. Approval had to be obtained from the University to conduct this research. All participants had to sign an informed consent about the confidentiality of any sensitive information which included immigration status. An agreement was made that all participants would be willing to participate in the research for over a year. Initially the participants answered the questioners in the Spring Semester of their first year at Temple and completed it in the Spring Semester of their second year. The independent variables being measured were the levels of depression and anxiety, while the dependent data was age, gender, and age of migration. The students came to the International students lounge and could complete the questions at their own time. Generally, they were able to do this within two hours or less. Participants generally completed the questioner within one hour. Debriefing was done with all participating groups emphasizing the importance of the second visit. At the end of the study participants were given a card thanking them for taking to the time to participate in the study.
- Beck, A T., Steer, R., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory; Twenty-Five years of evaluation Clinical Psychology Review, 8, 77-100
- Hamilton M: (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23:56-62
- Mahalaingam R., Murphy E. J. (2006). Perceived congruence between expectations and outcomes: Implication for mental health among Caribbean Immigrants. American Journal of Orthopsychiatry 76, 1, 120-127
- Lynch J. P., Simon R. J. (1999). A comparative assessment of public opinion towards immigrants and immigration policies. International Migration Review 33:455-467
- Thomas-Hope, E (1992) Explanation in Caribbean migration: Perception and the image. London: Macmillian Caribbean.
- Bhugra D., Jones P. (2001) Migration and mental illness. Advances in Psychiatric Treatment 7, 216-223
- Kinzie D. J. (2006), Immigrants and Refugees: The Psychiatric Perspective. Transcultural Psychiatry 43, 577-591
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental (DSM-5), Fifth edition. 2013
- Schwartz S. J., (2010) Rethinking the Concept of Acculturation. Implications for Theory and Research. American Psychological Association 65,4 237-251
- Bacigalupe G., Camara M. (2012). Transnational Families and Social Technologies: Reassessing Immigration Psychology. Journal of Ethnic and Migration Studies 38, 9, 1425 -1438
- G. R, Dudley-Grant, W. Ethredge. Caribbean Black: (Haitians, Jamaicans, Virgin Islanders, eastern Caribbean) Responses to Disasters in Cultural Context
- Mood, anxiety, and personality disorders among first and to the United States. Psychiatry Research 220:1028-1036, 2014
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