Immigrant Adult Mental Health: Risk and Protective Factors

Background and Purpose. In recent years, immigrants have disproportionately encountered key risk factors (anti-immigrant policies, COVID-19, and heightened discrimination) for mental health (CDC, 2021), while also experiencing protective factors (social support and resilience) that can improve mental health status (Fang, 2021). Data are limited on the impacts of these factors on a diverse sample of immigrants or which immigrants most benefit from protective factors. In response, this study was designed to explore three research questions (RQ): 1) To what extent do key stressors impact immigrant mental health; 2) What are the roles of protective factors on immigrant mental health; and 3) Which immigrants are most vulnerable to lower social support and resilience?

Methods. Survey data were collected from 490 first- and second-generation immigrant adults using community-based recruitment and Qualtrics panels. Guided by a risk and resilience framework and minority stress theory, we used hierarchical multiple regression analyses to explore RQ 1 and 2. Demographic information was entered in the first block, followed by the main independent variables in block 2. We tested models for two dependent variables, depression and anxiety. To investigate RQ3, we used logistic regression analyses. Independent variables included the following demographic characteristics: age, immigrant generation, race/ethnicity, gender, household income, and education. Dependent variables included anti-immigrant policy stress and discrimination.

Results. Over half (60%) of the sample was female, 53% first-generation immigrants. Just under one-third (30.9%) were East Asian, 26.2% White, 23.3% Latino/a, 15.4% South Asian, and 4.3% Black. The mean age was 55.47 (SD=18.34). Hierarchical regression analyses indicated overall significant models for depression (F(14, 352)=23.326, p<0.001; R² = .291) and anxiety (F(5, 342)=16.581, p<0.001; R² = .258). Anti-immigrant policy stress and discrimination served as risk factors, with social support and resilience significant protective factors, for both depression and anxiety. For RQ3, results showed overall significant models for both dependent variables (i.e., policy stress and discrimination). For policy stress, immigrants who were younger, non-White, and who lived in a household with a lower annual income were at greatest risk. Participants who were second-generation immigrants, younger, male, and non-White reported higher perceived discrimination.

Conclusions & Implications. Findings extend the literature on immigrant mental health by assessing risks (anti-immigrant policies, COVID-19, and heightened discrimination) and protective factors (social support and resilience) for immigrants, in addition to identifying immigrants who might be most at risk in regard to protective factors. Providers can benefit from an increased understanding of these relationships for designing and delivery services that are targeted at reducing stress associated with risk factors and that promote social support and resilience and contributors to positive mental health. Social work advocacy is essential to reducing anti-immigrant legislation and to ensuring access to needed services, whether during a pandemic or not. Future research should include a longitudinal design in partnership with local provider organizations, in addition to intervention-based research to evaluate the effectiveness of treatment for immigrant mental health.