Mental Health among Asylum-Seeking Migrants: A Critical Topic of Discussion and Suggestions for Improvement

At over 45 million people, the United States houses the largest number of immigrants in the world1. Specifically, according to the US Department of States, there are over 3 million asylum-seeking migrants with more than 300,000 estimated new arrivals in 20212. These immigrants face a multitude of stressors throughout their migration experience. Pre-migration stressors can include the threat of violence, food insecurity or famine, natural disasters, poverty or financial hardship, and parting with loved ones. Migration stressors include navigating a complex journey over hundreds if not thousands of miles, the potential for more violence and unsafe conditions, and uncertainty about settlement in their new destination. Post-migration stressors include difficulty obtaining resources and finding employment, difficulty understanding a new language and culture, confusion surrounding the trail of paperwork and pathway to citizenship, a fear of being cultural “misfits”, and prejudice.

Given the various stressors associated with the migration experience, it is necessary to understand the prevalence of mental health disorders among refuges and asylum-seeking migrants. Research has shown that in high income countries, such as the United States, the prevalence of mental health visits with asylum-seeking migrants continue to rise3. Psychiatric illnesses among refuges are common, as high as 40%, 44%, and 36% for anxiety, depression, and post-traumatic stress disorder, respectively4. Hence, increasing attention should be devoted to improving mental health practices for refuges and asylum-seeking migrants. In a review article5 published in the Canadian Journal of Psychiatry, Dr. Rousseau from McGill University provided the following recommendations:

  • Medical education should include cultural competence training that increases awareness of refugee predicament and dismantle any associated negative perceptions.
  • Besides directly psychiatric care, non-specific psychosocial interventions, which include establishing immigration status, education, employment, should also be prioritized, which can involve community organization.
  • Increased advocacy efforts from psychiatrists to speak on immigrant mental health and to initiate protective social policies.

In San Diego, the following agencies provide services to the refugee communities:

Thanks to contributors:

Leo Meller, BS, is a first-year medical student at UCSD School of Medicine passionate about immigrant health.

Shawn Sidhu, MD, FAPA, is a child and adolescent psychiatrist at UCSD/Rady and program director of the Child & Adolescent Psychiatry Fellowship Program at UCSD.


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