Many people from the former Soviet Union seek and receive culturally sensitive services from the FEGS Brooklyn Resource Center on Kings Highway in Brooklyn. This outpatient OMH licensed clinic provides psychiatric and counseling services to many Russian speaking individuals of whom a majority are between the ages of 60-85. Certainly, there are commonalities among older adults, but older adults who have immigrated to the United States as adults have a particular set of emotional issues that we are familiar with at the Resource Center Clinic, where I am a Supervisor.
The trauma of immigration is a primary stressor and can lead to emotional disorders in the older adults we serve. The transition into life in a new country often triggers frustration and stress. Some common stresses of immigration are: learning a new language, getting more education, finding employment, and dealing with the changes in family roles and family relationships.
Immigration also comes with many personal and significant losses including: loss of loved ones or friends who were left behind, loss of property and possessions, and loss of social status.
One of the most profound losses, leading to tremendous stress, financially, socially and personally, is the loss of previous employment status. No matter how educated you were in the former Soviet Union and what personal and professional accomplishments you had, once you immigrate, you have to start everything from the beginning. You are challenged to prove yourself professionally. There are many instances when people, who were scientists, teachers, lawyers, and doctors in the former USSR, could not attain their professional status in the US and started working as car-service drivers or home-attendants. Such a tremendous change in one’s social status could cause persistent frustration and contribute to emotional disorders including major depression.
Another major stressor leading to emotional problems for elderly Russian-speaking immigrants is isolation due to very limited English language skills and a poor social and community network.
Yet another is the pressure to meet citizenship requirements in a new language that is increasingly difficult to learn with age, for many immigrants).
How do Russian-speaking immigrants deal with their mental health issues? Once again, a cultural perspective is vital to consider. In general, psychiatry in the former Soviet Union was associated with social oppression. It was used by government as a sentence to deal with many dissidents whose opposition was defined as only possible as a consequence of mental illness; at least this was the popular perception. People who needed mental health care were severely ostracized out of fear of association.
Russian-speaking immigrants may view visits to mental health specialists as threatening because of ideologically based stigmas in their native country. The Russian-speaking immigrants often experience “psychophobia” – a strong denial of psychological problems and mask their depression by multiple somatic complaints.
During an intake interview with a Russian-speaking client, when he is asked about his presenting problem, you will often hear “My back hurts, I have terrible headaches” rather than “I feel sad” or “I feel lonely.” Fear of coming to a mental health clinic and denial of psychological problems in the Russian-speaking population often makes doctors and medical facilities the primary mental health resource for this population.
However, when seeing a Russian-speaking patient a medical doctor may easily miss the depression behind somatic complaints and may refer the patient for an inappropriate treatment for a physical illness. Untreated depression not only limits a person’s daily functioning and places a difficult burden on their family, but also dramatically increases the risk of suicide. The timely treatment of depression is important to prevent an exacerbation of the symptoms and escalation of suicidal behaviors.
Education about depression and other mental health disorders for Russian-speaking immigrants may help reduce the cultural stigma about getting help for mental health problems.
Since Russian-speaking immigrants don’t often refer themselves to mental health professionals for the treatment of psychological problems, it’s extremely important that the community members; educators, clergy, doctors, and family members, recognize the signs of emotional disorders in this population and make referrals that might save lives.
At the FEGS Brooklyn Resource Center Clinic we have helped many older adults overcome depression through medication and counseling, with sensitivity to their individual cultural perspective. As a result, clients forged better relationships with family members and found connections in the community that lessened their social isolation. This then made their lives fuller and helped alleviate their depressive symptoms. Many psychological problems could be prevented, and the treatment of depression would be more effective if a person has a reliable support network that is attuned to a contemporary approach to mental illness. Thus, more family involvement and community education are still important tools in treating clients as members of communities, especially immigrant communities.
More about the F.E.G.S Brooklyn Resource Center: In addition to the OMH licensed mental health clinic, with a fully bi-lingual clinic staff, the Center also houses a computer resource center, employment preparation and job placement services and the agency’s long standing citizenship program where thousands of refugees have received tutoring for the written test and interview to become a U.S. citizen.
For information about FEGS programs please call 212-366-8038 or visit our website www.fegs.org.