Depression Among Older Immigrant African Women in Metro West Massachusetts

Introduction and Overview

This paper presents a literature review and research design for a study examining depression among older immigrant African women in Metro West Massachusetts. The data collection methodology used for the research study will be semi-structured interviews, which give the researcher an opportunity to explore participants' responses further in order to clarify the answers given. Semi-structured interviews make use of open-ended questions that require explanation rather than a simple yes or no answer. Data collection will be conducted through interviews, and study participants will comprise social workers working in Metro West Massachusetts. All interviews will be conducted using internet services such as GoToMeeting, Skype, Zoom, or any other web-based platform due to the ongoing COVID-19 pandemic. Only 10 questions will be asked per interview.

The reason for focusing on social workers is to obtain credible information and to gather varied insights, as social workers interact with numerous clients. Study participants will be social workers who have been working in the area for a minimum of three years. This criterion ensures that only social workers with sufficient knowledge and experience attending to clients in the area are interviewed. The researcher anticipates having at least 10–12 social workers participate in the study. It is assumed this number will be representative of the population and manageable in terms of workload. Having a large number of participants would result in considerable time spent conducting interviews and performing data analysis, without offering a proportionate difference in results.

The data analysis process will begin with transcription of the audio recordings. The researcher aims to uncover patterns and develop codes for use in identifying themes. Each code will be assigned to a particular theme where possible, though the researcher acknowledges that some codes may not fit neatly into a theme. The data analysis process will comprise familiarization with the data, assignment of preliminary codes to describe content, searching for patterns in codes, reviewing themes, defining and naming themes, and producing the final report. These steps will be followed systematically to ensure nothing vital is missed.

In Metro West Massachusetts, the most common mental health disorders are anxiety and depression, which are prevalent among elderly immigrant women aged between 50 and 79 years (Agbemenu, 2016). Despite the availability of efficacious interventions, elderly immigrant women experience significant mental health care disparities in access to services and quality of treatment. Research indicates that African American heterogeneity impacts access to depression and anxiety treatment. African Americans are an increasingly visible minority within the United States, particularly in West Massachusetts. The current study sought to understand the causes and prevalence of depression among older immigrant African American women in Metro West Massachusetts, as well as how older immigrants cope with depression. A total of 12 self-identified social workers were interviewed about their patients' mental health symptoms and treatment experiences, the perceived causes of their patients' anxiety, stressors their patients face in West Massachusetts, patients' access to mental health services, and how patients cope with depression.

Results indicated considerable variability across groups, with African American elderly immigrant women endorsing higher rates of depression and anxiety, as well as higher rates of treatment-seeking, than white counterparts. Gender, age, marital status, and country of origin played a major role 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 mental health and treatment experiences across ethnic groups.

Problem Statement

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 who are over 55 years of age and who relocated from any African country after acquiring permanent residency in the United States. Depression among elderly immigrant women stands out as an important phenomenon for study in the context of social work, given the extent to which the condition affects vulnerable populations. Derr (2017) pointed out that immigrants typically face stressors related to migration experiences that may cause or intensify mental health problems. Moreover, Derr (2017) also noted that immigrants tend to access mental health services at a lower rate compared to non-immigrants. This situation leaves immigrants at risk of untreated health conditions, leading to 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. It is therefore imperative to establish the views of social workers addressing the mental health needs — particularly depression — of older immigrant African women in Metro West Massachusetts, so that insights gained can inform the development of comprehensive mental health programs aimed at improving health outcomes for this population.

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 risk factors for developing mental health issues (Alegría, Álvarez, & DiMarzio, 2017). Foo et al. (2018) similarly 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. Examining stressors surrounding the migrant experience from the social work perspective should therefore offer valuable insights into the issues faced by this vulnerable population, especially for women aged 50 and above.

Based on the highlighted problem, it is imperative to determine the views of social workers in West Massachusetts who work with older immigrant African women affected by depression (O'Donnell et al., 2016). Such an undertaking may reveal necessary service modifications — such as allowing patients with language barriers additional time — that could enhance access to quality mental health services (O'Donnell et al., 2016). As researchers have suggested, immigration can create worry and increase the risks of depression, a process that may be exacerbated by cultural factors such as language barriers, which can make diagnosing and treating this disorder among immigrant populations more difficult (Landa, Skritskaya, Nicasio, Humensky, & Lewis-Fernández, 2015). Failing 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 perspective of social workers regarding depression within the selected migrant population and to gain insights into how professionals in the healthcare sector can help meet emerging needs.

Purpose of the Study and Research Questions

This study aims to obtain the views of social workers regarding depression in older immigrant African women in Metro West Massachusetts. By analyzing these perspectives, insights can be provided into ways the social work sector can assist in meeting the emerging needs of the population. Expected findings include any service modifications needed to meet the needs of immigrant African women in the Metro West Massachusetts region (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, the study will gain insights into the challenges these women face and support the development of solutions directly targeted to this population (Agbemenu, 2016). Social workers will also benefit, as they will be able to use the findings of this study to determine methods they can employ to reach out to the population under study.

Research Questions

This study is focused upon 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?

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