Columbia University and New York State Psychiatric Institute, New York, New York, USA
Immigration and Mental Health: Stress, Psychiatric Disorders and Suicidal Behavior Among Immigrants and Refugees. Hauppauge, New York: Nova Science Publishers, 2010, 350 pages.
The term “immigration” is usually used to denote international immigration. The United Nations considers a long term international migrant to be “A person who moves to a country other than that of his or her usual residence for a period of at least a year (12 months), so that the country of destination effectively becomes his or her new country of usual residence.” Immigrants’ voyages to a new land have been among the most exciting and noble of human endeavors . It is the amazing courage to flee oppression, to leave behind everything that is familiar, and to chance the hostility of a completely alien culture in order to find freedom, opportunity, and a better life. Many and many immigrants and refugees, including Albert Einstein, Ernst B. Chain, Selman A. Waksman, Enrico Fermi, Sigmund Freud, Eric Fromm, Bertold Brecht, Jean Gabin, Charles de Gaulle, Thomas Mann, Jean-Jacques Rousseau, François-Marie Arouet (Voltaire), Victor Hugo, David Ben-Gurion and Henry A. Kissinger, have made a remarkable contribution to the welfare and happiness of mankind. The editors of this book, Leo Sher, M.D. and Alexander Vilens, M.S. are also immigrants. Immigration is difficult and stressful. Many immigrants suffer from psychiatric disorders and some immigrants attempt or commit suicide. In this chapter, I propose a model of suicidal behavior among immigrants with psychiatric disorders. All immigrants experience pre-immigration, immigration and post-immigration stress. Immigrants are frequently depressed. Depression in immigrants is associated with anxiety, post-traumatic symptoms, alcohol and/or drug use/abuse/dependence, pessimism, and stress-related medical illnesses such as hypertension, metabolic syndrome, and diabetes. Psychiatric and medical problems, genetic make-up, childhood experiences, availability of a social support, cultural acceptability of suicide, the degree of pre-immigration, immigration, and post-immigration stress, and other factors determine the vulnerability for suicidal behavior among immigrants with psychiatric disorders. Suicidal acts can be attributed to the coincidence of a trigger with a vulnerability for suicidal behavior. Triggers for suicidal behavior among immigrants include financial problems, relationship problems, mood instability (e.g., the onset of a major depressive episode), alcohol intoxication, abuse/assault, and acute medical illness. Suicide prevention among immigrants requires comprehensive, coordinated, and continuous health and mental health services for immigrant populations provided by culturally competent professionals.