Mental Health Interventions for African Immigrants and Refugees Resettled in the Western Nations: A Systematic Review

Background: The number of Africans migrating to the Western nations has increased significantly over the past decade.  Africans relocate for various reasons including fleeing persecution, displacement following natural disasters or conflict, searching for better economic opportunities, among others. The United States (U.S.) is among the Western nations that receive African immigrants (United States Census, 2014). Between 2010 and 2016, the U.S received over 400,000 Africans fleeing conflict. African immigrants face challenges associated with migration as well as mental health disorders such as anxiety, depression, and post-traumatic disorder symptoms, often exacerbated by post-resettlement stressors (Li, Liddell & Nickerson, 2016). The growing numbers of African immigrants in Western nations coupled with a prevalence of mental health disorders signal an urgent need to address their mental health issues (Brown, Cohen & Mezuk, 2015). This systematic review consolidates mental health interventions tailored to African immigrants residing in different western nations, highlighting the best practices and underscoring the existing gaps.

Methods: This review was conducted following the Preferred Reporting Items for Systematic Reviews and guidelines. The authors ascertained that at the time, there was no existing protocol on ‘African immigrants mental health interventions in Western Nations.’ The authors searched six databases with publications in the fields of social work, public health, medicine or psychology including Academic search premier, PubMed/MEDLINE, CINAHL, PsycINFO and Scopus and Social services premium collection.  The search combined terms or keywords characterizing: (1) the relevant population (‘refugee*’ or ‘immigrant*’, ‘African*’, ‘adult*’), (2) the relevant subject matter (‘mental health*’or ‘mental disorders*’), and (3) a term describing treatments (‘intervention*’,or ‘program*’, or ‘mental health services*’). Searches were not limited to a publication period, and the authors slightly modified search strategies for each database, including checking the references of obtained articles. The search included interventions in formal health systems and community studies. Full length, peer-reviewed, empirical studies were systematically obtained (n=1,444) and screened (n=64). Retained studies (n=9) provided information about interventions and programs aimed at treating mental health disorders among African immigrants in Western Nations.

Results: Findings indicate that cognitive behavioral therapy (Pratt et al., 2017), cognitive reframing (Iskason, 2013) and ethnopsychiatry (Sargent & Larchanché, 2009) were effective treatments within formalized medical systems. Moreover, fostering empowerment (Iskason, 2013), building self-efficacy (Goodkind et al., 2013) through psycho-educational groups (Mitschke, Praetorius, Kelly, Small, & Kim, 2016), paid work and volunteering (Wood et al., 2019), parties and weddings (Guerin, Elmi, & Guerin, 2006) and social support (Johnsdotter, Ingvarsdotter, Östman, & Carlbom, 2011) were successful in addressing mental health disorders within community settings. Furthermore, psychosocial spiritual and religious activities provided tools for mental health diagnoses and treatment (Agyekum & Newbold, 2016; Fenta, Hyman, & Noh, 2006; Johnsdotter et al., 2011). Overall, providing culturally specific mental health interventions is a viable option for treating mental health issues among African immigrants.

Conclusions and Implications: There is a need to contextualize and incorporate some cultural beliefs and practices in mental health interventions for African immigrants to promote greater service utilization and ascertain more effective mental health interventions.