DEPRESSION AMONG OLDER IMMIGRANTS
Depression among Older Immigrant African Women in Metro West Massachusetts
Section 1: Foundation of the Study and Literature Review
In West Massachusetts United States, the most common health disorders are anxiety and depression, which are prevalent in elderly immigrant women aged between 50 and 79 years (Agbemenu, 2016). Despite a variety of efficacious interventions for depression and anxiety, it is clear elderly immigrant women experience mental health care disparities in their access to mental health services and the quality of treatment they receive. Research indicates African American heterogeneity impacts access to depression and anxiety treatment. In addition, African Americans are becoming an increasingly visible minority within the United States especially in West Massachusetts and are often depicted as Blacks. 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 the older immigrants cope with depression. A total of 12 self-identified social workers were interviewed about their patients mental health problem symptoms and treatment experience, what they thought was the cause of their patients anxiety, stressors facing their patients life in West Massachusetts, their patient 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 the whites. Individual's gender, age, marital status, and origin played a major role in the endorsement of anxiety and depression for the immigrants. Finally, 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 any of the two groups. These findings underscore the importance of attending to both between-groups and within-group differences in the mental health and mental health treatment experiences of different ethnic groups.
The data collection methodology that will be used for the research study will be discussed in this section. The methodology will be semi-structured interviews, which will give the researcher an opportunity to explore the participants responses further in order to provide clarification of an answer given. Semi-structured interviews make use of open-ended questions that require an explanation and not just a yes or no answer. Data collection will be done using interviews and the study participants will comprise of social workers working in Metro West Massachusetts. All the interviews will be conducted using internet services like GoToMeeting, skype, Zoom, or any other web-based service due to the current pandemic of Covid-19. Only 10 questions will be asked. The reason for using social workers is for the researcher to get information that is credible and to also be able to get varied insights as the social workers will be dealing with numerous clients. The study participants will be social workers who have been working in the area for a minimum of three years. The idea for this criterion is to ensure that the researcher only interviews social workers who have enough knowledge, and they have been attending to clients in the area for some time. The researcher anticipates to have at least 10-12 social workers taking part in the study. It is assumed that this number will be representative of the population and it is an easy number to work with. Having a large number of participants would result in a lot time spent conducting the interviews and data analysis, which may not offer any considerable difference in the results.
The data analysis process will begin with transcription of the audio tapes.…
Running head: DEPRESSION AMONG OLDER IMMIGRANTS
DEPRESSION AMONG OLDER IMMIGRANTS
Depression among Older Immigrant African Women in Metro West Massachusetts
Section 1: Foundation of the Study and Literature Review
In West Massachusetts United States, the most common health disorders are anxiety and depression, which are prevalent in elderly immigrant women aged between 50 and 79 years (Agbemenu, 2016). Despite a variety of efficacious interventions for depression and anxiety, it is clear elderly immigrant women experience mental health care disparities in their access to mental health services and the quality of treatment they receive. Research indicates African American heterogeneity impacts access to depression and anxiety treatment. In addition, African Americans are becoming an increasingly visible minority within the United States especially in West Massachusetts and are often depicted as Blacks. 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 the older immigrants cope with depression. A total of 12 self-identified social workers were interviewed about their patients mental health problem symptoms and treatment experience, what they thought was the cause of their patients anxiety, stressors facing their patients life in West Massachusetts their patient 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 the whites. Individual's gender, age, marital status, and origin played a major role in the endorsement of anxiety and depression for the immigrants. Finally, 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 any of the two groups. These findings underscore the importance of…
Running head: DEPRESSION AMONG OLDER IMMIGRANTS
DEPRESSION AMONG OLDER IMMIGRANTS
Depression among Older Immigrant African Women in Metro West Massachusetts
Section 1: Foundation of the Study and Literature Review
In West Massachusetts United States, the most common health disorders are anxiety and depression, which are prevalent in elderly immigrant women aged between 50 and 79 years (Agbemenu, 2016). Despite a variety of efficacious interventions for depression and anxiety, it is clear elderly immigrant women experience mental health care disparities in their access to mental health services and the quality of treatment they receive. Research indicates African American heterogeneity impacts access to depression and anxiety treatment. In addition, African Americans are becoming an increasingly visible minority within the United States especially in West Massachusetts and are often depicted as Blacks. 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 the older immigrants cope with depression. A total of 12 self-identified social workers were interviewed about their patients mental health problem symptoms and treatment experience, what they thought was the cause of their patients anxiety, stressors facing their patients life in West Massachusetts, their patient 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 the whites. Individual's gender, age, marital status, and origin played a major role in the endorsement of anxiety and depression for the immigrants. Finally, 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 any of the two groups. These findings underscore the importance of attending to both between-groups and within-group differences in the mental health and mental health treatment experiences of different ethnic groups.
The data collection methodology that will be used for the research study will be discussed in this section. The methodology will be semi-structured interviews, which will give the researcher an opportunity to explore the participants responses further in order to provide clarification of an answer given. Semi-structured interviews make use of open-ended questions that require an explanation and not just a yes or no answer. Data collection will be done using interviews and the study participants will comprise of social workers working in Metro West Massachusetts. All the interviews will be conducted using internet services like GoToMeeting, skype, Zoom, or any other web-based service due to the current pandemic of Covid-19. Only 10 questions will be asked. The reason for using social workers is for the researcher to get information that is credible and to also be able to get varied insights as the social workers will be dealing with numerous clients. The study participants will be social workers who have been working in the area for a minimum of three years. The idea for this criterion is to ensure that the researcher only interviews social workers who have enough knowledge, and they have been attending to clients in the area for some time. The researcher anticipates to have at least 10-12 social workers taking part in the study. It is assumed that this number will be representative of the population and it is an easy number to work with. Having a large number of participants would result in a lot time spent conducting the interviews and data analysis, which may not offer any considerable difference in the results.
The data analysis process will begin with transcription of the audio tapes. The researcher aims at uncovering patterns and making codes for use in the themes that they will discover. The researcher will try to assign each code to a particular theme if possible. However, the researcher is aware there are some codes they will not be using. The data analysis process will comprise of familiarization with the data, assigning preliminary codes for describing the content, searching for patterns in the codes, reviewing themes, defining and naming themes, and producing the report. These steps will be followed systematically to ensure the study does not miss out on anything vital.
This researcher has analyzed the ethical procedures that will be used to ensure they safeguard the interview participants, and the research study is ethical. The researcher will seek approval of the IRB since they are using human subjects in this study. This is a requirement for all studies that will be involving human subjects. Once they get the approval, the researcher will need to get written consent from the potential participants before they can begin data collection. During the consent seeking process, the researcher will discuss with the participants the role they will play, the purpose of the study, the benefits, risks, and alternatives to participation. It is the duty of the researcher to ensure the potential subjects understand the information given and the participants can ask questions to clarify anything they did not understand. While the researcher might be time pressed, they will give the potential subjects adequate time to review all the information presented before they sign the consent forms. Only after they have signed can they be included in the study. The study participants will have a right to withdraw from the study at any time and they will be provided with all the data collected up until the point of their withdrawal. The study participants shall be provided with information on their right to withdraw as part of the consent seeking process. All the data collected in the study will be securely stored to protect it from prying eyes and the researcher plans to store the data for at least one year after the results are published. Access to the data will be restricted to only authorized personnel. All the data will be destroyed after the specified period has lapsed.
The intent in ....... African women currently living in west Massachusetts. Older immigrant African women refers to women who are over 55 years of age and they 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 taking into consideration the extent to which the condition affects vulnerable populations. Derr (2017), pointed out immigrants typically face stressors relating to migration experience which may cause or intensify mental health problems. Moreover, Derr (2017) also discussed that immigrants tend to access mental health services at a lower rate as compared to non-immigrants. Subsequently, this situation leaves immigrants at risk of untreated health conditions leading to increased disease burden (Lynch, Berg, Manna, and Schade (2016). As such, this negative health predisposition creates greater need for mental health services among immigrants who seem more susceptible to develop depression. This situation makes it imperative to establish the views of social workers addressing the mental health needs, especially depression, among older immigrant African women in Metro West Massachusetts. In turn, insights gained should play a critical role in the development of comprehensive mental health programs aimed at improving the immigrants health outcomes.
As noted, migration can be challenging, and many immigrant women experience challenges that affect their mental health (Foo et al., 2018). For example, the changes in practices, values, social factors and cultural identification are considered as factors contributing to the potential risk of developing mental health issues (Alegra, lvarez, & DiMarzio, 2017). Similarly, Foo et al. (2018) asserted migration into a new country leads to drastic changes in essential aspects of normal day life. Here, 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). Therefore, examining stressors surrounding the migrant experiences from the social work perspective should offer insights into the issues faced by this vulnerable population, especially for women aged 50 years and above.
Based on the highlighted problem, it is imperative to determine the views of social workers from West Massachusetts who work with older immigrant African women in Metro West Massachusetts affected by depression (ODonnell et al., 2016). Such an undertaking may reveal service modifications such as giving patients with language barriers more time needed to enhance access to quality mental health services (ODonnell et al., 2016). As suggested by researchers, immigration can create worry, which may increase the risks of experiencing depression, and this can be exacerbated by cultural factors, such as language barriers which may cause difficulty in diagnosing and treating this disorder among immigrant populations (Landa, Skritskaya, Nicasio, Humensky, & Lewis-Fernndez, 2015). Failure to determine appropriately the views of social workers on depression within a certain community translates to neglecting social health and welfare (Baldwin-Clark, Ofahengaue Vakalahi, & Anderson, 2016). In response, the intent of this study is to obtain the perspective of social workers regarding depression within the selected migrant population as well as insights into the ways in which professionals in the healthcare sector can help meet emerging needs.
Purpose of the Study
In this study, the views of social workers regarding depression in older immigrant African women in Metro West Massachusetts will be obtained. Through analyzing these perspectives, insights can be provided into ways the social workers sector can assist to meet the emerging needs of the population. Expected in the results of this study will be any service modification needed to meet the needs of the immigrant African women located in Metro West Massachusetts (Takeuchi, 2016). These findings can enhance access to quality mental health services and ensure the women understand the implications of not seeking mental health services. Having examined the stressors faced by the migrant women, insights will be gained into the issues the women face within the population and solutions directly targeted to the population can be developed (Agbemenu, 2016). Social workers will also benefit as they will use the findings of this study to determine methods they can use to reach out to the population under study.
Focused upon in this study will be the following research questions:
1. From the social work perspective, what factors influence older immigrant African womens 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 to 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
1. 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 our study, culture extends beyond identifying the patient and family by race and ethnicity to include variables like faith, country of origin, education level, socioeconomic status, and level of acculturation. In this study culturally informed refers to the ability of the social workers to offer services that recognize, affirm, and value the worth of the clients, their familes, communities, and preserves and protects their dignity.
1. Older immigrant African women - Older immigrant African women refers to women who are over 55 years of age and they relocated from any African country to the United States. The women could have come to the US legally or illegally. The phrase also refers to women who came to the US as refugees and they have remained there till their advanced age. For this study, the focus will be on older immigrant African women who live in West Massachusetts and suffer from depression.
1. Immigrant - According to the Oxford University Press (n.d.-b), an immigrant is defined as a person who comes to permanently live in a foreign country. There are four types of immigration status namely citizens, residents, undocumented, and non-immigrants. In this paper the focus will not be on the status of the immigrant, but we expect the status of the immigrant to contribute to how the immigrant access mental health services. Therefore, the study will consider all immigrants provided they immigrated from Africa and they have been living in the selected community.
1. African women - African women refers to a native or inhabitant woman of Africa or a woman who has African ancestry. In this study, African women refers to the older immigrant African women who were born outside of US in Africa and they had to migrate to the US either legally or illegally and they currently reside in West Massachusetts. The women will have lived almost half their life in Africa before they immigrated to the US.
1. Coping mechanisms - Coping mechanism is defined as "an adaptation to the environmental stress based on the conscious and unconscious choice and that enhances control over behavior." In the study, coping mechanism refers to the different cultural strategies used by the women and to deal with the stressful situations they encounter. The methods the women will use to adjust to the stress they face and assist them to maintain their emotional well-being.
1. Migration - Migration is the movement of people or animals from one place to another. In the study, migration refers to the movement of people from any African country to the United States. The focus will only be on the women who have migrated from Africa to the US either alone, with their family, or with a relative and they are currently living in West Massachusetts. The process of the women migrating will not be a major focus, but it can be relied upon to determine if it contributes to the women failing to access mental health services.
1. Host country - According to the Oxford University Press (n.d.-a), a host country is a country that holds a cultural event or sporting event to which others are invited. In this study, host country refers to the country that is accommodating the African immigrants or where the immigrants are living, which is the US.
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 the community social workers to better address the emerging needs and 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 there are barriers to them receiving support. Findings in the study will equip social workers with the knowledge to develop strategies they can use to treat depression and bring awareness to the unique needs of the older immigrant African women.
The theoretical framework that can be used to frame this project is the Structural-Functional Theory. Some theorists such as Cassel (1995) and Cobb (1976) expressed social support serves as a resistance factor, and plays an important role in reducing adverse impact of exposure to negative life events (Thoits, 1985). This theory should play a key role in understanding the onset of depression among older immigrant African women, given the various social demands associated with being a migrant. Further, Kinser and Lyon (2014) emphasized that depressing experiences may increase a persons possibility to suffer from stressful episodes. Stress and vulnerability add up to the possibility of developing depression, where changes in the environment, lack of coping mechanisms and lack of support have an adverse impact on the mental health outcome of this group (Alegra et al., 2017). Cultural influences can be revealed that will be vital in determining the methods that can be used to treat this population. To become culturally competent when dealing with this population, social workers would need to be familiar with the Structural-Functional Theory. Explained in this theory is why society functions the way it does, and it emphasizes on the relationships between the different social institutions that make up society (Emadpoor, Lavasani, & Shahcheraghi, 2016). Some of these social institutions are education, law, government, religion, and culture. The social worker should understand society is like a system where all the parts will work together to create a whole society. Emadpoor et al. (2016) posit societies will need culture for them to function. Therefore, being culturally informed is beneficial to the social worker and it will allow them to reach out to the community members and approach them in an acceptable manner (Sabbioni et al., 2018).
Review of Professional and Academic Literature
From the review conducted, a lack of literature exists in which the primary focus was placed on older African immigrant women (Okudo & Ross, 2016). This shortage is due to numerous factors that mosly involve with the perception that African immigrants have regarding depression (Thomson, Chaze, George, & Guruge, 2015). Most times, depressed individuals are stigmatized, and most African communities believe depression is caused by bad spirits. With this notion it becomes difficult for the women to seek professional health services as they would be labelled and judged by other community members harshly (Snchez et al., 2014). For this study, search was conducted for peer-reviewed publications focusing on mental health among older African immigrant women, from the following sources, MEDLINE, PsycINFO, CINAHL, EBSCO, Research Gate, ProQuest, SAGE Journals, and EMBASE. The keyword(s) used to search for the appropriate literature for this study was older African American women, older immigrant African wome
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