Understanding The Service Needs Of African Immigrants In NYC
Olatunde Olusesi, Ph.D., Coordinator, Project Stay, NYC Children’s Services; Co-Founder and Vice President, Nigerian Social Workers Association, Inc.
Editor’s Note: For related articles about social work with immigrants in NYC, see previous issues of Currents in the “Members Only” section of the Chapter website. (Asian immigrants in May 2006; Latino immigrants in May 2007)
According to the 2000 US Census, African immigrants’ population in New York City is growing. A broad based understanding of the hopes, fears, challenges, and needs of these immigrants is sin-qua-non to promoting their well being and encouraging their optimal contributions to America’s social, economic, cultural, and technological advancement.
African immigrants are often erroneously classified as one homogenous group whose needs are analogous to those of African Americans and Caribbean immigrants. This error constitutes a formidable bulwark against effective service delivery especially to recent African immigrants, who by no means are a monolithic group. In fact, African immigrants have their origins in over fifty countries with distinct histories; and varied linguistic, social, economic, cultural, religious, and political systems. Also, when categorized by legal status, they are mainly naturalized citizens, legal permanent residents, students, refugees, asylees, and undocumented or out-of-status newcomers. Further, a significant number of these mostly highly educated immigrants are bicultural and transnational.
Generally, African immigrants’ pre-migration expectations of the available opportunities in the US are often inordinately high, and the enormity of the likely challenges they might face are grossly minimized. Therefore, after the initial euphoria of reaching the US, disappointment and alienation may ensue, leading to mental health crises like depression, anxiety, and Post Traumatic Stress.
Push and pull individual, societal, political, economic, religious, and historical factors cause Africans to migrate to the United States, and they follow different trajectories in their immigration journeys. Understanding the reasons for African immigrants’ migration is pivotal to helping them with the challenges they face in their new environment.
Many Africans arrive in the US as individuals, leaving behind other family members in their home countries. Being undocumented may result in years of physical separation from those left behind. Long distance marital relationships and trans-national parenting that become ineluctable, even though now made significantly easier with modern technology, create significant economic and mental health difficulties. Deportation of family members has also been known to cause marriage dissolution, family disruption, and other crises.
Difficulties in the areas of employment, finance and housing, marital and parent-child conflicts, problems with child welfare and the criminal justice system, and the often Sisyphean legalization battles may also engender mental health difficulties for Africans. Social-isolation, the “wayfarer mentality,” and structural inequities may also impede their participation in the mainstream of the American society.
African immigrants, like a significant number of disenfranchised groups in the US, often underutilize the available mental health services or delay seeking outpatient preventive or early rehabilitative mental health care until costly emergency care or psychiatric hospitalizations becomes inevitable. Rather than seeking help from psychiatrists, psychologists, or clinical social workers for mental health difficulties, they may rely on informal help from pastors, imams, traditional healers, friends, and support groups; or seek care from general medical practitioners.
The underutilization of formal mental health services by African immigrants (as evidenced by their low enrollment rates and premature termination of mental health services) is caused by broad demographic, practical, and attitudinal variables. These include their failure to recognize mental illness or denial of its existence; not seeing symptoms as being severe enough to warrant treatment; thinking symptoms would remediate on their own; lack of faith in the efficacy of mental health services, especially psychotherapy; pre-migration help seeking patterns; lack or insufficiency of health insurance; or refusal to use the available health insurance for fear of being labeled a “public charge” because it may lead to deportation or denial of immigration benefits.
Other barriers include absence or inadequacy of culturally tailored services; language barriers; poverty and economic need; fear of losing confidentiality or invasion of family privacy; fear of stigma; negative attitudes of formal service providers towards immigrant clients; mistrust of the mental health system; institutional discrimination/racism; lack of proximity to the available services; and lack of ethnically diverse or bilingual service providers.
Efforts to provide meaningful help to address the multifaceted challenges that Africans face in the US must be holistic, taking into account the barriers adumbrated above, their pre-migration experiences, resiliency, experiences in the US, and their unique and divergent worldviews. African immigrants urgently need, inter-alia, accessible culturally sensitive medical, mental health, youth empowerment, elderly, and domestic violence services; immigration and citizenship preparation clinics; translation and interpreter services; employment training opportunities; vocational English as second language training; and so on.
While cultural sensitivity is crucial to effective service delivery to African immigrants, social workers should avoid stereotypes, but instead develop individual, group, outreach, and socialization interventions that take into account not just Africans’ cultural beliefs but modifications to these beliefs engendered by their education, socialization, acculturation, and immigration experiences in the US.
Social workers should realize that African immigrants’ lukewarm attitude toward formal services to deal with their mental health difficulties and their continued reliance on informal help may be an indication of their attitude to acculturation to the mainstream of the American society. Discordant socio-cultural dictates that threaten their indigenous values and beliefs may hinder their acculturation. Holding on to these beliefs, therefore, may be the ballast that keeps them psychologically grounded.
The feasibility of home-based intervention should be explored to enable practitioners to assess the functioning of their clients in their natural environment, as well as to encourage their participation in services. In matching immigrant patients with social workers, the following factors, among others, should be considered to ensure a good fit: age, gender, cultural background, language, ethnicity, national origin, level of acculturation, and cultural knowledge of both the practitioners and the clients.
Also, to truly help African immigrants, the social and economic factors they confront in their new environment should be addressed through social action. Government and charitable organizations should support programs that seek to the economic empowerment of African immigrants.
Social workers should also endeavor to engage in advocacy aimed at improving services to African immigrants, expanding health insurance coverage for them, addressing discrimination and prejudice, and participating in the ongoing efforts to shape immigration policies.
Schools of social work should help develop curricula that promote capacity building for culturally competent social work practice with African immigrants. They should also encourage them to participate in research to evaluate old knowledge and generate new knowledge. Special efforts should be made to recruit more African students into social work programs.
Some of the organizations providing direct services, community awareness, and advocacy to African immigrants in New York, most of which are underfunded and understaffed, include the Nigerian Social Workers Association, Inc., Sauti Yetu, Sanctuary for Families, Nah We Yone, Association des Sénégalais d’Amérique, and African Services Committee, Inc.