Immigration, culture, and mental health: The story of a Honduran immigrant

Latinos are the largest minority in the U.S. and are projected to grow substantially. As a group their mental health needs are poorly addressed due to culturally biased assessments, culturally inappropriate interventions, lack of insurance, discrimination, poverty, and inadequate access to services. Moreover, a confluence of barriers in language, symptom expression, and culture results in elevated rates of misdiagnoses. Immigration engenders feelings of detachment from one’s environment precipitating feelings of alienation, demoralization and distress, which are key factors in the onset of psychotic symptoms. Failure to address the disparity in mental health care for Latinos will result in an increasing social and economic burden to the U.S. Though these disparities are well documented, little is known about how immigration to the U.S. impacts daily occupational participation. Indeed, understanding the subjective experience of Latino immigrants will improve our knowledge about the course of their mental illnesses. Literature on this topic is primarily concerned with demographic data failing to grasp what occupational changes are experienced and the subsequent effect on mental health. This preliminary ethnographic inquiry traces the experiences of a man from Honduras who immigrated to North Carolina in the 1990‚s. Having left his wife and two daughters, he worked as many hours as possible to earn enough money to return home. Though successful at first, his pursuit of the American dream soon morphed into a capitalist nightmare laden with material obsession, fear of deportation, social isolation, and mounting frustration. Lacking social support to help him cope with difficult changes in his daily routine he experienced a spiraling decline into negative habits of thought and mental illness. Though formerly inactive at church in Honduras, he came to increasingly rely on a local Chapel Hill congregation for support. The latter opened a cascade of occupational opportunities through which he found meaningful engagements. Each new occupation offered him additional opportunities to combat isolation and further integrate into a supportive social fabric. He soon developed a healthier occupational routine that eventually curtailed his perseverating thoughts. This collaborative ethnographic inquiry produced numerous insights in understanding the importance of culture in promoting wellbeing and mental health