When Mental Health Problems Become Another Hurdle for Immigrants

By Rahinur Akther

In his small office in Jackson Heights, Queens, Dr. Ferdous Khandker cares for many immigrants and says he is as much of a counselor to them as a physician.
In his small office in Jackson Heights, Queens, Dr. Ferdous Khandker cares for many immigrants and says he is as much of a counselor to them as a physician.

Dr. Ferdous Khandker had finished with his last patient of the day, a Bangladeshi immigrant. In his in his small office in Jackson Heights, Queens, Khandker sees immigrants from Bangladesh, India, Pakistan, Nepal and various African and Hispanic countries.

“Eighty percent of immigrant patients start their opening conversation expressing anxiousness, feeling pain in the body here and there, and most definitely talking about stress in life,” Khandker says.

To many of his patients, Khandker has become less like a doctor and more like a counselor with whom to share problems. In fact, researchers have found that discrimination and family cultural conflict appear to play a significant role in the likelihood that many immigrants will eventually develop psychiatric disorders.

Khandker says he sees three predominant problems in his work with immigrants.

The first he calls the school-and-job adjustment problem, particularly prevalent among 18-to-35-year-old immigrants.

“This group of people is facing the identity problem,” says Khandker firmly. “They are young and dreaming for a better future. In reality they are struggling to fit in school among native students.”

One aspect of this, he continues, is that “their non-fluent communication skills create barriers for their desirable jobs; for instance, someone who came from India at age 20 and now is trying to make his or her identity in New York, new culture and ceaseless demands of adjusting with a new society are making their lives harder, yet they want so badly and quickly to fit into the society.”

The frequent result, he says, is “when they are not completely achieving what they want, that is making them insecure and feeling unfit in the society.”

The second category Khandker has found is depression, and he finds this most commonly among 36-to-50-year-olds. Basically they are highly depressed and frustrated by their jobs and the lack of other opportunities.

“They are missing their high-profile jobs and positions back home,” says Khandker. “They used to have a good job. Now, they cannot have an official job here unless they go to school, and 90 percent of people do not go to school due to the financial responsibilities for their families.”

One of his patients, Jahanara Begum, 42, a Bangladeshi immigrant who now works at a Dunkin’ Donuts, says in broken English: “My entire life I speak Bengali and live as a housewife. It was so miserable when I first came to New York, because of the language.”

After she came to the United States in February, it took her five months to find a job, she says with a sigh, and during that time “my family and I survived a dispossessed life.”

She continues, “I have two sons and my husband is a heart patient. I had to go out every day looking for job. It took me five months to get a job in Dunkin’ Donuts because of my language problem. I did not understand English when someone was saying anything to me. In Bangladesh, I never speak in English.”

Khandker’s third category of problems is loneliness. People who are over 50 are at risk of feeling lonely, he says, because no one has time here to keep them company. “Traditionally in Bangladesh those who are 50-plus retire from work and stay home with their children,” says Khandker, gesturing with his hands.

Ready to leave for the day, Khandker says, “When this age group of people comes to USA, they basically stay home all day without doing anything. They do not know enough English to go out to communicate with others. They have to wait until someone comes home.”

It’s hardly surprising that life is stressful for many immigrants, as they adapt to new places, new cultures and new languages. And for those who are undocumented, the strains are surely worse.

According to the Department of Homeland Security’s 2010 Yearbook of Immigration Statistics, 1.04 million foreign nationals entered the United States legally in 2010.

Many researchers and scholars have studied immigration issues, with the focus primarily on Latino populations. Whether comparable studies have been done of East Asian, South Asian or other immigrant groups is not clear. (Searches of scholarly literature do not turn any up.)

Researchers at the University of California-Davis School of Medicine, for example, found that Mexicans who came to the United States were “far more likely to experience significant depression and anxiety than people who stay in Mexico.”

But interestingly, other studies have found that Latino immigrants to the United States have better mental health than Latinos born in the United States (what researchers call the “immigrant paradox”). Researchers also say that the mental health of immigrants declines over time in the host country (what they call the “acculturation hypothesis”).

Miguel Chavez, 24, a Mexican-born immigrant, has been living in the United States for more than five years. He is a waiter in an Italian restaurant in Manhattan and is studying English literature at Queens College.

“I do not know what would be my future in America,” he says. “When I go for a job interview and see an American-born person is also waiting for the interview, I deeply feel, as an immigrant, my chance is already low to get the job.”