Challenges and barriers for engaging with and accessing mental health support among MENA immigrant and refugee youth in the United States.

• In Event: Roundtable Session 1
  In Refereed Roundtable Session: Health, Identity and Education

Proposal

Background
Adolescent migrants, including refugees, from the Middle East and North Africa (MENA) region in need of mental health support face multiple challenges and barriers in seeking and engaging in mental health services in the U.S. In addition to the challenges faced by other minority youth, MENA adolescents may grapple with unique barriers related to language, culture, cultural competency of providers, religion, interfamilial communication, and economical constraints. This qualitative analysis sought to explore the barriers to and challenges in seeking and engaging in mental health care and strategies for overcoming these barriers in both school and community settings.

Methods
Semi-structured virtual interviews were conducted with twenty-seven key informants in three cities: Chicago, IL, Detroit, MI, and Harrisonburg, VA. Key informants included teachers, principals, school administrators, school-based mental health providers, and staff at local organizations serving refugees. Additionally, four group discussions from a Photovoice project with MENA students in Detroit, MI were also recorded and analyzed. Topics covered in both the interviews and group discussions related to the barriers and challenges refugee and immigrant youth face in seeking help and engaging with mental health services as well as strategies employed by both providers and students to overcome these barriers. Interviews and group discussions were audio-recorded and transcribed, and transcripts were coded and analyzed using thematic analysis procedures.

Results
Data analysis identified the following major barriers: 1) cultural barriers related to the importance of family reputation, adhering to cultural and familial expectations, and fear around damaging students' marital prospects; 2) stigma around mental health services; 3) students and parents' communication around mental health services; 4) language barriers;5) cultural competency of providers; and, 6) employment and economical constraints.

Conclusion
The identified barriers may discourage students and their families from seeking and engaging with available mental health services, subsequently failing to receive needed care or treatment for distress. Interventions, treatments, and supports efforts must include ways to overcome these barriers which promote students' and families' utilization of mental health services to address their needs. Given the centrality of the core and extended family units in MENA adolescents’ lives, interventions targeting parents, caregivers, and families to increase awareness around mental health issues and existing services might contribute to adolescents' psychosocial well-being. Special attention should also be given to challenges faced by many MENA families, including language barriers and differing perceptions of mental health conditions and services between host and migrant communities.

Authors

• Najat Qushua, Washington University in St. Louis

• Danielle Sarraf, Washington University in St. Louis

• Ilana Seff, Washington University in St. Louis