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Strategies for Naming and Addressing Structural Racism in Immigrant Mental Health
Ivo H Cerda1, Anjeli R Macaranas1, Cindy H Liu1
1Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston.
Abstract:
Immigrants account for 13.7% of the US population, and the great majority of these individuals originate from Latin America or Asia. Immigrant communities experience striking inequities in mental health care, particularly lower rates of mental health service use despite significant stressors. Structural barriers are a significant deterrent to obtaining needed care and are often rooted in racist policies and assumptions. Here we review and summarize key pathways by which underlying structural racism contributes to disparities in immigrant mental health, including anti-immigration policies, labor and financial exploitation, and culturally insensitive mental health services. Significant accumulated research evidence regarding these barriers has failed to translate into structural reform and financial investment required to address them, resulting in pronounced costs to both immigrant populations and society at large. We propose specific strategies for addressing relevant structural inequities, including reforming economic and financial policies, community education initiatives, and task-sharing and strengths-based interventions developed in partnership with immigrant communities to promote access to mental health care for populations in dire need of culturally appropriate services. (Am J Public Health. 2023;113(S1): S72-S79. https://doi.org/10.2105/AJPH.2022.307165).
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