DEPRESSION AMONG OLDER IMMIGRANTS

Depression among Older Immigrant African Women in Metro West Massachusetts

Table of Contents

Abstract 4

Section 1: Foundation of the Study and Literature Review 5

Problem Statement 7

Purpose of the Study 9

Research Questions 9

Definition of Key Terms 10

Significance of the Study 12

Theoretical Framework 13

Review of Professional and Academic Literature 14

Cultural Competence 15

Mental Health of Immigrants 17

Depression Among Older African Immigrant Women 18

Stressors faced by Older African Immigrant Women 19

Summary 22

Section 2: Research Design and Data Collection 23

Research Design 23

Methodology 25

Data Analysis 29

Ethical Procedures 31

Limitations, Challenges, and/or Barriers 33

Summary 35

References 37

Abstract

This study titled Depression among Older Immigrant African Women in Metro West Massachusetts set out to understand the causes and prevalence of depression among older women coming from Africa to live in the United States of America. The study situated older women to be women above the age of 55 and focused on exploring the views of social workers in relation to issues of depression among these women. The present study is guided by the following questions: a) from the social work perspective, what factors influence older immigrant African womens adaptive capacity in Metro West Massachusetts? (b) from a social work perspective, what mental health service do social works offer to older women from Africa living in the USA? (c) How do social workers assess the need for mental health services for their clients and (d) what service modifications can social workers introduce to enhance mental health service delivery for older women coming from Africa? These questions led to the investigations in this study that was guided by the structural-functional theory. Data was collected using the quota sampling. Interviews and questionnaires were most appropriately used to collect date and the SPSS software was used to analyze data. The study respected ethical issues strictly.

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 indicated African American heterogeneity prevents 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 underscored 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.

Overview of…

Running head: DEPRESSION AMONG OLDER IMMIGRANTS

DEPRESSION AMONG OLDER IMMIGRANTS 30/p>

Depression among Older Immigrant African Women in Metro West Massachusetts

Table of Contents

Abstract 4

Section 1: Foundation of the Study and Literature Review 5

Problem Statement 7

Purpose of the Study 9

Research Questions 9

Definition of Key Terms 10

Significance of the Study 12

Theoretical Framework 13

Review of Professional and Academic Literature 14

Cultural Competence 15

Mental Health of Immigrants 17

Depression Among Older African Immigrant Women 18

Stressors faced by Older African Immigrant Women 19

Summary 22

Section 2: Research Design and Data Collection 23

Research Design 23

Methodology 25

Data Analysis 29

Ethical Procedures 31

Limitations, Challenges, and/or Barriers 33

Summary 35

References 37

Abstract

This study titled Depression among Older Immigrant African Women in Metro West Massachusetts set out to understand the causes and prevalence of depression among older women coming from Africa to live in the United States of America. The study situated older women to be women above the age of 55 and focused on exploring the views of social workers in relation to issues of depression among these women. The present study is guided by the following questions: a) from the social work perspective, what factors influence older immigrant African womens adaptive capacity in Metro West Massachusetts? (b) from a social work perspective, what mental health service do social works offer to older women from Africa living in the USA? (c) How do social workers assess the need for mental health services for their clients and (d) what service modifications can social workers introduce to enhance mental health service delivery for older women coming from Africa? These questions led to the investigations in this study that was guided by the structural-functional theory. Data was collected using the quota sampling. Interviews and questionnaires were most appropriately used to collect date and the SPSS software was used to analyze data. The study respected ethical issues strictly.

Section 1: Foundation of…

Running head: DEPRESSION AMONG OLDER IMMIGRANTS

DEPRESSION AMONG OLDER IMMIGRANTS

Depression among Older Immigrant African Women in Metro West Massachusetts

Table of Contents

Abstract 4

Section 1: Foundation of the Study and Literature Review 5

Problem Statement 7

Purpose of the Study 9

Research Questions 9

Definition of Key Terms 10

Significance of the Study 12

Theoretical Framework 13

Review of Professional and Academic Literature 14

Cultural Competence 15

Mental Health of Immigrants 17

Depression Among Older African Immigrant Women 18

Stressors faced by Older African Immigrant Women 19

Summary 22

Section 2: Research Design and Data Collection 23

Research Design 23

Methodology 25

Data Analysis 29

Ethical Procedures 31

Limitations, Challenges, and/or Barriers 33

Summary 35

References 37

Abstract

This study titled Depression among Older Immigrant African Women in Metro West Massachusetts set out to understand the causes and prevalence of depression among older women coming from Africa to live in the United States of America. The study situated older women to be women above the age of 55 and focused on exploring the views of social workers in relation to issues of depression among these women. The present study is guided by the following questions: a) from the social work perspective, what factors influence older immigrant African womens adaptive capacity in Metro West Massachusetts? (b) from a social work perspective, what mental health service do social works offer to older women from Africa living in the USA? (c) How do social workers assess the need for mental health services for their clients and (d) what service modifications can social workers introduce to enhance mental health service delivery for older women coming from Africa? These questions led to the investigations in this study that was guided by the structural-functional theory. Data was collected using the quota sampling. Interviews and questionnaires were most appropriately used to collect date and the SPSS software was used to analyze data. The study respected ethical issues strictly.

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 indicated African American heterogeneity prevents 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 underscored 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.

Overview of the Problem, Its History and Significance Related To The Study

In recent years, there has been a growing need for social work for immigrants, particularly the old immigrants aged 65 years and above (Social Work Today, n.a.). They are the ones who experience the relocation in an entirely new geographical region .......gative impacts on their physical and cognitive health. The impacts could be observed in social isolation, loss of independence, cognitive declines and health problem in old age.

Old age is the critical time of life when the elderly people need special care and attention. Their socialization patterns are changed, especially when they have to migrate. The negative effects may emerge in economic, social, psychological, political and cultural terms (Lotfi, 2020). Immigration has adverse effects on ageing people as they are mentally weakened to take the pressures enforced on them by various changes. Their family and social relations are affected, resulting in more complex problems like physical, psychological and sociological difficulties.

<>Social work interventions are innovative strategies to uplift the emotional and physical wellbeing of elderly migrating people. Social workers help the elderly individuals towards the adaptation process so that social exclusion should be mitigated and social justice could be served (Haidar, n.a.). Since they work with mixed status families, they have to take care of their rights, especially targeting their ethnic backgrounds.

An increase in African American older migrants is expected to increase by the year 2050 with racial ethnic needs arising and those who have low educational levels (Gilmore, 2013). Their social and emotional needs must be addressed by culturally competent social workers so that medical and therapeutic healthcare services should be appropriately provided to the needy. However, it has been observed that there are healthcare access barriers to the racial and ethnically diverse older immigrants (Koehn, 2009). There is a vast disparity of healthcare provision to the native populations and those aging migrants who are transferred to other regions, adversely affecting these populations' morbidity and mortality rates (Kristiansen et al., 2016).

Problem Statement

The intent in 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 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, & Schade, 2016). As such, this negative health predisposition created 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. It is due to an inference that Metro West Massachusetts has a cluster of cities and towns where one of the fastest growing communities in African Americans, having a rate of 95% growth since 2000 (Impact Metro West, n.a.). However, disparities in educational and social gains are still seen for the people of color, as are evident in other parts of the United States (Rosenberg, 2020). 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 ofthe 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.

Research Questions

This study would focus on answering the following research questions:

1. From the perspective and benefits of social workers, 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 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 (Health Policy Institute, n.a.). 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 families, communities, and preserves and protects their dignity.

1. Older immigrant African women - Older immigrant African women refers to women who are over 65 years of age (Noubicier & Charpentier, 2013), 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 Gimeno-Feliu, Caldern-Larraaga, Daz, et al (2019), 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