Working with Korean Immigrant Alcohol Abusing Clients

Abstract

As cultural and ethnic diversity increases in American society, it becomes crucial for professionals working with alcohol abusing clients to gain cultural sensitivity. This article seeks to aid the clinician in culturally sensitive treatment with Korean immigrant alcohol abusers. As an aid to providing effective treatment for this population, the following areas are discussed: the pattern of Korean immigration to the United States; the prevalence of alcohol abuse among Korean Americans; the influence of sociocultural, psychological, and physiological factors on Korean American alcohol use; and intervention strategies for working with this population.     

Chapter 3. Mental Health Care of Hispanic Immigrant Children

Abstract

This chapter addresses the mental health care of Hispanic immigrant children within a school-based context. The school system is presented as a natural support agent that is psychologically, culturally and geographically accessible for the delivery of culturally competent mental health services. The development of a multifaceted New York City public school-based program created, by the first author of this chapter, in response to the psychosocial needs of Hispanic immigrant children is discussed as a viable approach that may be used in the provision of ethnic-sensitive mental health care.     

Strengthening Intergenerational/InterculturalTies in Immigrant Families (SITIF)

Abstract

Intergenerational/intercultural conflict is a significant stressor in immigrant families that occurs because of differential acculturation between migrant parents and their children. In spite of its negative mental health consequences, few empirically tested interventions address this problem. Strengthening Intergenerational/Intercultural Ties in Immigrant Families (SITIF) is a culturally-sensitive, community based intervention that aims to strengthen the intergenerational relationship. It promotes immigrant parents' emotional awareness and empathy for their children's experiences, cognitive knowledge and understanding of differences between their native and American cultures, and teaches behavioral parenting skills with the objective of enhancing intergenerational intimacy. SITIF was tested with a group of 16 middle class and 14 working class immigrant Chinese parents. Using objective and subjective assessment tools, the findings provide empirical support for SFTiF's effectiveness in enhancing parenting skills and strengthening the inter-generational relationship in immigrant Chinese American families.     

“If You Want to Be Russian Go to the United States”

Abstract

The latest and largest group of Russian immigrants arrived in the United States after 1983, when the Soviet Union collapsed. This was the first time in over seventy years that Russia's Jews were allowed to leave Russia. Unlike many other immigrants, this group had lived in a country where little or no contact had been allowed with the outside world. Not unlike Plato's characters living in a cave, the Russian Jews saw the outside world only as it had been portrayed in Russian propaganda. Mistrust of the Soviet regime led to fantasies and confusion about it.

Understanding this group of immigrants requires knowing something of Jewish life in Russia during the last hundred years. In an enclosed, totalitarian, oppressive society, individuals developed character traits that were necessary for survival. Some of these will be discussed in this article. Lack of knowledge on the part of the immigrants as well as on the part of American human services professionals has often led to culture shock for both groups. Misunderstandings, unrealistic expectations, and difficulties with language have caused frustration, anger, and hurt.

Increased cultural knowledge has been necessary to open up communication between immigrant clients and American service providers. Many signs have begun to point the way to different attitudes and greater     

Mexican Immigrants

Abstract

Social Work's history is embedded in this profession's service and commitment to immigrant populations. This new century presents itself with a new mixture of immigrants who come to United States (U.S.) shores seeking a better life. The challenge to social workers is to be well-versed in social policy, human behavior, and practice realms related to serving these immigrants. Schools of social work must insure that curriculum reflects the needs and situations of this new mix of immigrants. One of the largest groups in this mix are those immigrants from Mexico. Of particular concern is the adaptation of Mexican and other Latino immigrants who come to this country without documentation. Social workers have an ethical responsibility to serve these clients in a culturally competent and informed manner. They must keep updated on immigration policy and entitlement or eligibility issues that mitigate these immigrants' ability to survive.     

Caribbean Women's Migratory Journey

SUMMARY

For Caribbean women who leave their children behind to migrate to the United States, the decision-making process is filled with pain and fraught with ambivalence. In response to open-ended questions about their migratory journey, immigrant women who migrated to New York City describe the process-from initial thoughts about leaving their home country, through the actual move, to their early days in the United States. This case study examines the painful and difficult experiences of undocumented women as they balance feelings of freedom and exhilaration with the challenges of economic survival, leaving their loved ones behind, parenting children from a distance, loneliness, and adjusting to a new environment while supporting themselves and family members at home. This exploratory study identifies the significant milestones in Caribbean women's migratory journey-points at which they access internal and external resources. Practitioners will understand the process, and resources these women call upon. Both the process and the accompanying resources are vital to future work with immigrant women and their families, as well as those women considering migrating and leaving their children behind.     

Disparities in Infant Mortality Rates Among Immigrant Caribbean Groups in New York City

SUMMARY

This study examined infant mortality rates (IMR) in New York City (NYC) to identify those groups reporting higher IMR concentrations in recent years and to determine what factors and explanations are associated with this new trend.

Analysis of data from NYC Department of Health (DOH) identified infant mortality patterns throughout the City by both maternal birthplace and NYC Health Districts. In addition, infant mortality rates for those NYC populations with the highest concentrations were compared to the most recently available IMR data from their countries of origin. Focus group sessions were conducted with women in the identified groups in New York City in an effort to obtain their perspectives on causality and other factors associated with the new trend.

Strong patterns emerged from this study pointing to a concentration of the City's highest IMR among groups from the circum-Caribbean region. Results of focus group sessions with women in the identified population groups yielded a list of specific barriers faced by this population in the utilization of perinatal care services. In addition, the study resulted in some clearly delineated program and policy approaches that can help to address the disparities in IMR.

Myriad causative factors contribute to the high rates of IMR among Caribbean immigrant groups. Expanding the availability of both successful program models and promising practices is critical to decreasing infant mortality in immigrant communities. Specific recommendations are for the development of a strategic set of interventions designed to eliminate this most serious challenge to the health of new immigrant groups in NYC.

Any references to comparisons between data from NYC and data from the countries of origin were merely to serve as a reference point as it is not often possible to determine the level of scientific rigor applied to the collection and analysis of data external to the United States (U.S.).

Implications for social work practice with immigrant populations include the need for delivery of culturally competent services in general and for cultural sensitivity to health beliefs surrounding maternal child health issues in particular.     

A Clinical Trials Recruitment Education Program for Immigrant Chinese Americans

Abstract

This study was designed to develop and evaluate a community-based education program to facilitate enrollment of immigrant Chinese into clinical cancer screening trials. The program included workshops with culturally tailored health education materials. It was piloted to recruit persons into an ongoing lung cancer screening trial from a senior citizen center in Manhattan's Chinatown and compared with a control program at a second senior center. Survey results from a convenience sample of seniors showed that the workshop raised awareness about cancer screening and clinical trials. However, it did not change attitudes towards cancer screening. The results highlighted prior focus group findings in which factors influencing participation in cancer screening and clinical trials are similar. Important facilitative factors include doctor recommendation, friend/family recommendation, the belief that early detection could “save lives,” no cost, and having an-interpreter.     

Management of the kidnap risk

Abstract

Paradoxically, Britain, where kidnapping is rare, has been a pioneer in kidnap insurance, prevention, and negotiation, largely due to the experience of Lloyd's of London in underwriting every kind of risk worldwide. The premium income of Lloyd's for kidnap insurance has grown from $150,000 in 1970 to $50 million in 1976. As with fire risks, with kidnap risks Lloyd's found that it saved money both for the underwriters and their clients if they sent specialist consultants to advise on reducing the risk and, in the event of a kidnap, to advise on negotiation. A firm at Lloyd's founded such a consultancy (Control Risks Ltd.) which has now expanded to meet a rising demand, not only from insured clients, but also from an increasing number of uninsured clients who engage them on a consultancy fee basis. This article examines the growing attractiveness of kidnapping as a high‐yield low‐risk crime (whether for political dividends or criminal gain); describes how kidnaps are organized; advises on the various means of protection against it; and discusses the acts of contingency planning and crisis management if a kidnap occurs.     

Understanding Immigration and Psychological Development

Abstract

Approximately one in five children in the U.S. are born to immigrant families in which at least one parent is foreign-born. Existing theoretical frameworks suggest that immigration experiences can increase acculturative stress and lead to developmental psycholopathology in immigrant children. These models, however, do not account for levels in the environment that trigger this stress and/or serve as forms of resilience. Drawing from Bronfenbrenner's multilevel, bioecological model of development, this paper presents a framework that charts environmental processes which generate or buffer acculturative stress and, therefore, mediate the impact of immigration on psychological well-being. Empirical research shows that Mexican immigrants, on the whole, fare better than U.S.-born groups in terms of mental health outcomes. These results are explained in the context of the presented theoretical model. Though further research is needed, preliminary evidence suggests that encouraging “enculturation,” as opposed to “acculturation,” has positive mental health repercussions for Mexican American children. Further research using the presented theoretical framework as well as policies and practices that incorporate and leverage the cultural strengths of Mexican immigrant children should be pursued.     

SHIFTING REALITIES IN HIGHER EDUCATION: TODAY'S BUSINESS MODEL THREATENS OUR ACADEMIC EXCELLENCE

ABSTRACT

American institutions of higher education have an excellent reputation throughout the world as first rate academic centers that do an exceptional job of preparing young citizens for their future roles of leadership in business, government and our society. Colleges and universities are expected to develop young learners by teaching them knowledge, skills and above all, the ability to engage in critical thinking. This article opines that our universities' outstanding reputations are challenged by the unique pressures upon administrators, faculty, and students to prepare those in our classes for their careers. This treating of the student body as customers has lessened the rigor of the curricula and teaching methods. The authors present several recommendations for improvement of our liberal arts schools in today's rapidly changing world community.     

Chapter 2. Mental Health in the Hispanic Immigrant Community

Abstract

This chapter addresses the mental health status of Hispanics in the United States. The prevalence and incidence of mental health disorders among different Hispanic ethnic subgroups is examined. Patterns of mental health services utilization and barriers to mental health care are also reviewed. Research specific to best mental health practices with Hispanics is stressed.     

Chapter 4. Concepts of Mental Health and Mental Illness in Older Hispanics

Abstract

The effect of cultural context in symptom expression and interpretation among older Hispanics, and how they experience psychological distress are not well-understood. We use the illness representation model to learn about older Puerto Ricans' and Dominicans' conceptions and causes of positive mental health, the causes of emotional problems, the conceptions and causes of depression and anxiety, the distinction between depression and anxiety, and the relationship between age and depression. Greater understanding of the meaning of symptoms and syndromes of depression and anxiety might help to define more culturally-sensitive mental health treatments and service delivery systems.     

Health Services Considerations Amongst Immigrant Populations

Abstract

The foreign-born population comprised 11.5% of the U.S. population in 2002. Immigration to the U.S. has grown substantially and continues to grow. A close examination of the immigration data shows that immigrant community in the U.S. is not homogeneous and in fact is very diverse both within itself and from the native-born population. U.S. Census Bureau data reveal that these differences create pockets of divergent populations within the country. How these populations assimilate into the U.S. healthcare system is not clearly understood. Cultural values, beliefs, and practices often juxtapose the immigrant to the healthcare system. Religious differences coupled with educational and income disparities add to the challenge of developing and implementing healthcare programs. This paper concludes with suggestions for more research in healthcare to immigrants.     

Chapter 7. Mental Health Intervention with Dominican Immigrants

Abstract

Dominicans are a significant force in the changing composition of Hispanic immigration in the United States, and all indications are that they will continue to be in the years to come. A framework has been applied in which Dominican culture, psychosocial strengths and risks, and treatment implications are explored in the context of how Dominicans appear to be similar to and different from other Hispanic groups in the U.S. Much more needs to be done in terms of elaborating this combination of homogeneity and heterogeneity. Mental health practitioners who are open to such inquiry, and to keeping an open mind regarding the possibilities of modifications in therapeutic techniques and modality choices, will find Dominicans to be a clinically responsive, and an enjoyable population to work with.     

Chapter 6. Psychosocial Stressors,Psychiatric Diagnoses and Utilization of Mental Health Services Among Undocumented Immigrant Latinos

Abstract

The combined effects of minority status, specific ethnic group experiences (political, economic, trauma and immigration history), poverty, and illegal status pose a set of unique psychiatric risks for undocumented Latinos in the United States. Restrictive legislation and policy measures have limited access to health care, and other basic human services to undocumented immigrants and their children throughout the nation. However, little is known about the patterns of mental health care use, psychiatric diagnoses and psychosocial problems prevalent among the undocumented who do succeed in presenting to clinical settings and to the mental health sector. To begin to address the need for further understanding in this area, we completed a clinical chart review of 197 outpatient adult psychiatric charts in a Latino mental health outpatient treatment program located in an urban hospital system.

We compared the diagnoses and mental health care use of undocumented Latino immigrants (15%) with that of documented (73%) and US born Latinos (12%) treated in this clinical setting. The undocumented Latinos in our study were more likely to have a diagnosis of anxiety, adjustment and alcohol abuse disorders. The undocumented also had a significantly greater mean number of concurrent psychosocial stressors (mean number = 5, p < .001) ascompared to documented immigrants and US born groups, which both had a mean number of 3 stressors identified at evaluation. The undocumented were more likely to have psychosocial problems related to occupation, access to healthcare and the legal system. However, the undocumented had a lower mean number of total mental health appointments attended (mean visits = 4.3, p < .001) in which to address these stressors as compared to documented immigrants (mean visits = 7.9) and US born (mean visits = 13.3). In terms of other previous mental health service use, the undocumented group had lower rates of lifetime inpatient and outpatient treatment use.

The results of this study suggest the importance of early assessment of psychosocial stressors, substance use and barriers to care when treating undocumented immigrants. Although all Latino groups included in this investigation demonstrated numerable concurrent stressors, our investigation highlights the particular importance of accessible social services and supports for addressing psychosocial stressors in the lives of undocumented patients. Our results stress the importance of reexamining policies, that restrict access to social services and healthcare for the undocumented. Our results also suggest the importance of culturally appropriate evaluation and treatment of substance abuse disorders as well as addressing other psychological and behavioral responses to multiple stressors among undocumented individuals.     

The Experience of College Challenges Among Chinese Americans

Abstract

The current investigation examined the experience of college challenges in 112 American-born, 121 early immigrant, and 110 late immigrant Chinese American students. Due to differential acculturation, it was hypothesized that late immigrants would encounter the most difficulties and American-born Chinese the least. Using the 13-domain Inventory of College Challenges for Ethnic Minority Students, we found that late immigrants reported more problems than American-born Chinese on six academic, social, and general living domains and experienced more problems than early immigrants on two academic and social domains. Additionally, early immigrants fared worse than American-born Chinese on two social and general living domains. Service implications, particularly for late immigrants, are discussed.     

Introduction: The Symposium and Its Authors

Abstract

This symposium addresses the question “Has public administration grown up?” as a provocative vehicle for free-ranging inquiry into the state of the field. Its articles originated from a panel of the same name held at the 2003 national conference of the American Society for Public Administration. The authors, each of whom make a quite different response, consist of the panel's original five members plus four participants from the audience who later contributed their ideas in written form.     

Newly Arrived West Indian Adolescents

Abstract

This study explores patterns of adjustment among newly arrived West Indian adolescents. In particular, it focuses on the concurrent developmental and cultural transitions of immigration and adolescence. Barriers to adjustment and patterns of identity formation are explored and discussed within the context of a typological developmental model. Findings of this study are based on the responses of 25 newly arrived adolescents from six Caribbean countries regarding their adjustment to New York City schools. The data analysis identifies various structural and immigration-based factors, which challenge the social and psychological adjustment of new immigrant adolescents. It highlights the effect of culture and immigration on attachment to school and society and supports the need for increased social work intervention in mediating between homes and schools of new immigrants.