The COVID-19 pandemic has placed some of the struggles that Americans experience on a daily basis in the spotlight, including financial concerns, relationship toils, and the need for social reform, whether that looks like policing or masking up. Yet, one specific experience that has consistently made it to the forefront of these conversations are the beliefs and stigmas associated with mental health.
The fight for mental health awareness is not uniquely American, however. In fact, according to a study done by Krista M. Perreira and India Ornelas, foreign-born adolescents and their parents in the U.S. experienced large numbers of trauma-exposures. In order to understand the consequences of trauma exposures, we must examine how they are intertwined with the immigrant experience in the US.
PTSD in Refugees and Immigrants
In particular, the development of Post-Traumatic Stress Disorder is a major risk for refugees and immigrants in the United States. The researchers found that 29 percent of foreign-born adolescents and 34 percent of foreign-born parents experienced trauma during the migration process. Within the sample of individuals who experienced trauma, 9 percent of adolescents and 21 percent of their parents were at risk for PTSD. Some of the factors that increased the risk of trauma and PTSD symptoms include clandestine entry into the United States and pre-migration poverty. Once inside the states, further risk factors included victimization to discrimination, especially for immigrants with “distinctive phenotypical characteristics or religious practices” and immigrants settling down in unsafe neighborhoods.
What is Trauma?
According to the American Psychological Association, trauma is defined as “an emotional response to a terrible event.” These events can range from witnessing or experiencing life-threatening accidents like a fire or a flood, to combat, war, rape, childhood abuse, or neglect. The APA goes on to state that shock and denial are typical immediately following the event. Longer term reactions may be embodied by “unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea.” Consequently, many people have trouble moving on with their lives.
In congruence with this, Miller et al. maintain that even though immigrant and refugee youth retain immense resilience, repeated and prolonged exposure to trauma position them at risk for adverse health outcomes. The trauma and toxic stress that these children and their parents undergo “are associated with higher rates of depression, anxiety, post-traumatic stress syndrome (PTSD), heart disease, metabolic syndrome, and early death.” As a result, refugee families are more likely to contract physical and mental disease as a result of their disproportionate exposure to such traumatic events.
Some Stats…
The United Nations High Commissioner for Refugees states that by the end of 2019, 79.5 million individuals were forcibly displaced worldwide as a result of persecution, conflict, violence or human rights violations. That was an increase of 8.7 million people over the previous year, and the world’s forcibly displaced population remained at a record high. Moreover, 2017 saw the forcible displacement of 30 million youth under the age of 18. Of these youth, 17 million of them experienced violence or conflict in their home country and about 13 million were deemed eligible for refugee status.
The significant trauma that these children experienced prior to migration stem from adverse experiences, such as civil war or unrest, the destructive effects of climate change, gang or drug related violence, and/or poverty. During the migration journey, these children are then subject to additional dangers that exacerbate damage, such as “physical or sexual abuse, unsafe travel conditions, separation from family members, and trafficking.” The trauma experience occurs at a heightened frequency both for refugee parents and for refugee children and youth.
Effects of Trauma
This trauma not only affects physical health and mental health, but as previously mentioned, the experience within the United States. The effects of perceived racial-ethnic discrimination that many immigrants, refugees, and/or displaced persons experience serve as social stressors that cause this population to feel both threatened and powerless. Not only do these effects act as social stressors, but they become biological stressors that influence biochemical changes, increasing the aforementioned risks of poor physical and mental health outcomes. Many of these individuals live within segregated and impoverished areas that have higher rates of crime and violence, subjecting them to additional exposures of violence and discrimination.
The immigrant and refugee experience in the United States is extensively dependent on context. The combination of experiences prior to, during, and following migration creates a situation in which poor mental health can become a significant complication, requiring that Americans devote attention to teasing out solutions. Mental health struggles are an experience where immigrants and Americans can find commonalities. While the exact experiences that accompany these struggles may not always be shared, individuals can unite knowing that they each fight similar internal battles. Knowing this, we must approach immigrant and refugee policy with an intersectional understanding and be sensitive to the adversity of the immigrant experience.
In my next piece for this series, I will be exploring some of the factors that can combat the frequency and likelihood of developing PTSD symptoms in refugees and the ambiguity of acculturation in this context. As always, feel free to email me with any questions or comments; this is a topic that I have not seen much information about and would love to have more conversations and resources regarding the subject!
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