Depression Among Older Immigrant African Women in Metro West MA

Introduction and Problem Statement

In Metro West Massachusetts, the most common health disorders affecting elderly immigrant women aged between 50 and 79 years are anxiety and depression (Agbemenu, 2016). Despite a variety of efficacious interventions for these conditions, elderly immigrant women continue to experience mental health care disparities in both their access to services and the quality of treatment they receive. Research indicates that African American heterogeneity impacts access to depression and anxiety treatment. African Americans are also an increasingly visible minority within the United States, particularly in West Massachusetts, and are often identified as Black. The present study sought to understand the causes and prevalence of depression among older immigrant African American women in Metro West Massachusetts, as well as how these older immigrants cope with depression.

A total of 12 self-identified social workers were interviewed about their patients' mental health symptoms and treatment experiences, perceived causes of their patients' anxiety, stressors facing their patients in West Massachusetts, their patients' access to mental health services, and how patients coped with depression. Results indicated considerable variability across the two groups, with African American elderly immigrant women endorsing higher rates of depression and anxiety — as well as higher rates of treatment seeking — than their white counterparts. Individual gender, age, marital status, and country of origin played major roles in the endorsement of anxiety and depression. Although the two groups differed in the extent to which they experienced stigma about mental health issues, stigma did not predict symptom endorsement or treatment-seeking behavior for either group. These findings underscore the importance of attending to both between-group and within-group differences in the mental health experiences of different ethnic communities.

The intent of this study is to explore the views of social workers in relation to depression among older immigrant African women currently living in West Massachusetts. "Older immigrant African women" refers to women over 55 years of age who relocated from any African country after acquiring permanent residency in the United States. Depression among elderly immigrant women is an important phenomenon for study within social work, given the extent to which the condition affects vulnerable populations. Derr (2017) pointed out that immigrants typically face stressors related to the migration experience that may cause or intensify mental health problems. Moreover, immigrants tend to access mental health services at a lower rate than non-immigrants (Derr, 2017). This situation leaves immigrants at risk of untreated health conditions, leading to an increased disease burden (Lynch, Berg, Manna, & Schade, 2016). This negative health predisposition creates a greater need for mental health services among immigrants, who appear more susceptible to developing depression.

Migration can be challenging, and many immigrant women experience difficulties that affect their mental health (Foo et al., 2018). Changes in practices, values, social factors, and cultural identification are considered contributing risk factors for developing mental health issues (Alegría, Álvarez, & DiMarzio, 2017). Similarly, Foo et al. (2018) asserted that migration into a new country leads to drastic changes in essential aspects of daily life. The process of assimilating to new environments and cultures causes considerable levels of acculturative stress, which researchers have linked to the occurrence of psychiatric disorders (Foo et al., 2018). Examining the stressors surrounding the migrant experience from a social work perspective should offer insights into the issues faced by this vulnerable population, especially for women aged 50 years and above.

Determining the views of social workers from West Massachusetts who work with older immigrant African women affected by depression may reveal service modifications — such as giving patients with language barriers additional time — needed to enhance access to quality mental health services (O'Donnell et al., 2016). Immigration can create worry that increases the risks of depression, and this can be exacerbated by cultural factors such as language barriers, which may complicate diagnosis and treatment among immigrant populations (Landa, Skritskaya, Nicasio, Humensky, & Lewis-Fernández, 2015). Failure to determine the views of social workers on depression within a community translates to neglecting social health and welfare (Baldwin-Clark, Ofahengaue Vakalahi, & Anderson, 2016). The intent of this study is therefore to obtain the perspectives of social workers regarding depression within the selected migrant population, as well as insights into ways healthcare professionals can help meet emerging needs.

Purpose, Research Questions, and Key Terms

In this study, the views of social workers regarding depression in older immigrant African women in Metro West Massachusetts are examined. Through analyzing these perspectives, insights can be provided into how the social work sector can assist in meeting the emerging needs of the population. Expected among the results are service modifications needed to address the needs of the immigrant African women in Metro West Massachusetts (Takeuchi, 2016). These findings can enhance access to quality mental health services and ensure that women understand the implications of not seeking mental health care. By examining the stressors faced by migrant women, insights can be gained into the issues women face and targeted solutions can be developed (Agbemenu, 2016). Social workers will also benefit, as they can use the findings to determine methods for reaching out to the study population.

Research Questions

This study is focused on the following research questions:

1. From the social work perspective, what factors influence older immigrant African women's adaptive capacity in Metro West Massachusetts?

2. From the social work perspective, what mental health services do social workers offer to older immigrant African women in Metro West Massachusetts?

3. How do social workers assess the need for mental health services for their clientele, particularly older immigrant African women in Metro West Massachusetts?

4. What service modifications can social workers introduce in practice to enhance mental health service delivery for older immigrant African women in Metro West Massachusetts?

Definition of Key Terms

Culturally informed — Culturally informed is defined as the offering of care by healthcare professionals that respects, acknowledges, and integrates the patient's cultural values, practices, and beliefs. In this study, culture extends beyond identifying the patient and family by race and ethnicity to include variables such as faith, country of origin, education level, socioeconomic status, and level of acculturation. Culturally informed practice refers to the ability of social workers to offer services that recognize, affirm, and value the worth of clients, their families, and their communities, while preserving and protecting their dignity.

Older immigrant African women — This term refers to women who are over 55 years of age and who relocated from any African country to the United States, whether legally or illegally, including those who came as refugees and have remained into their advanced years. For this study, the focus is on older immigrant African women living in West Massachusetts who suffer from depression.

Immigrant — According to the Oxford University Press (n.d.-b), an immigrant is a person who comes to permanently live in a foreign country. There are four types of immigration status: citizens, residents, undocumented, and non-immigrants. This study does not focus on the status of the immigrant; however, immigration status is expected to influence how individuals access mental health services. The study will consider all immigrants who emigrated from Africa and currently reside in the selected community.

African women — African women refers to a native or female inhabitant of Africa, or a woman of African ancestry. In this study, the term refers to older immigrant African women who were born in Africa and migrated to the United States — either legally or illegally — and who currently reside in West Massachusetts, having lived a significant portion of their lives in Africa before immigrating.

Coping mechanisms — A coping mechanism is defined as an adaptation to environmental stress based on conscious and unconscious choice that enhances control over behavior. In this study, coping mechanism refers to the various cultural strategies the women use to deal with stressful situations they encounter, and the methods they employ to adjust to stress and maintain their emotional well-being.

Migration — Migration is the movement of people or animals from one place to another. In this study, migration refers to the movement of people from any African country to the United States. The focus is on women who have migrated from Africa to the US — either alone, with their families, or with relatives — and who currently live in West Massachusetts. The migration process itself is not a primary focus but may be relevant for understanding barriers to mental health service access.

Host country — According to the Oxford University Press (n.d.-a), a host country is a country that holds a cultural or sporting event to which others are invited. In this study, host country refers to the country accommodating the African immigrants — in this case, the United States.

Significance of the Study

The findings of this study will contribute new knowledge to address the gap in research regarding depression in older immigrant African women residing in Metro West Massachusetts. Findings will offer insights into ways social workers can meet the emerging needs of this population. The study results will assist community social workers in better addressing the challenges older immigrant African women face when accessing mental health services. More specifically, the study will focus on how the target population is affected by depression when barriers prevent them from receiving support. The findings will equip social workers with the knowledge to develop strategies for treating depression and bring awareness to the unique needs of this population.