Perspectives of Black Immigrant Women on Mental Health: The Role of Stigma

Abstract

Background: Black immigrants are a major growing segment of the United States population. The intersection of race, gender, and migration places black immigrant women at the confluence of multiple social determinants of health, and thus, black immigrant women experience ongoing mental health disparities. Understanding their perspectives, mental health needs, and associated stigma is critical to promoting positive mental health outcomes. Methods: We conducted five focus groups ( N = 22) among women from two black immigrant community organizations from February 2019 to June 2019. We used an inductive driven thematic analysis to identify codes and themes related to mental health and the role of stigma. Results: Overall five core themes associated with mental health and associated stigma concepts were found: The critical role of trusted sources and confidentiality, Conceptualization of mental illness and anticipated discrimination, Acculturative influence and migration as a source of emotional distress, Spirituality as a source of support and source of stigma, and Management of mental illness and addressing stigma. Conclusion: The conceptualization of mental illness and the associated stigma may be rooted in cultural and religious belief systems among black immigrants. Cultural beliefs and biopsychosocial models can coexist positively without interrupting the pathway toward optimized engagement in mental health care. Our mental health systems need to take these factors into consideration to implement programs that effectively serve black immigrant women's mental health needs.

A Qualitative Exploration of Sources of Help for Mental Illness in Arabic-, Mandarin-, and Swahili-Speaking Communities in Sydney, Australia

“…This view may have both positive and negative ramifications for help seeking. For example, black immigrant women in the USA identified spiritual resources as both sources of support and sources of stigma in the community [47]. Religious and community leaders are well placed to provide information to the community, which allows for well-informed mentalhealth-related decisions.…”

“…Comparatively, the Swahili-speaking community mentioned formal sources of help less frequently. Sub-Saharan African migrants may have alternative views on the appropriateness of formal sources of help, which may stem from historical and current experiences of racism and discrimination, as well as mistrust in the cultural responsiveness of Western mental health services [31,47]. Seeking help from Western mental health services carries the risk of misunderstanding and stigmatisation [31].…”

Asian Americans’ intention to seek help: The mediating influence of self-stigma on the theory of planned behavior.

“…Eisenberg et al (2009) specifically found that personal stigma was highest among younger, Asian, international, and more religious students, and that it was associated with low levels of help-seeking. Self-stigma may impair the provider–patient relationship through concerns regarding cultural mistrust and perceived substandard care (Bamgbose Pederson et al, 2022). Consequently, minoritized individuals may rely on alternative forms of support, as sharing personal information with a therapist may be perceived as a failure of primary community support or a lack of willpower, leading to potential feelings of shame.…”

Understanding the Mental Health Perspectives and Experiences of Migrants to Canada

“…19 The emotional stress associated with migrating from one country to another can negatively impact one's perceived sustainability after migrating. Bamgbose Pederson et al 20 conducted focus groups with black immigrant women, soliciting their mental health perspectives. Participants reported that the loss of financial security and status after migrating to North America was related to increased feelings of not being welcome in their new country.…”