Mental Health Policy and Immigrant Elderly: The South Asian Experience

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Advisor: D Harris Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA


South Asians frequently migrate at an advanced age to join their adult children in the United States. This project examines the difficulties they face that result in mental distress, and the barriers that limit their use of mental health services. Two policy objectives of this study are: to identify an intervention model that best addresses common mental disorders in this group, and to make effective policy recommendations to improve South Asian senior immigrants’ access to needed care. Senior distress impacts entire families, and is deepened by South Asian cultural reluctance to acknowledge mental health issues. Specific interventions for common mental disorders (CMD) in this group have not been studied. Using literature reviews and qualitative interviews this study assessed the causes of CMD in South Asian senior immigrants and examined the different interventions used in other immigrant populations. Intervention approaches were assessed to identify those that may be more culturally acceptable to this population. The resulting policy recommendation is that programs should holistically address the needs of the affected population and should leverage local, culturally representative resources in delivering care. For this population, an Ecosystem Focused Therapy model was found to meet many of the criteria for success. The second key objective was to identify barriers to care for this group and determine what policy changes can address these barriers. Key policy issues identified are the lack of affordable health insurance options for this group, and the need for culturally competent care. Recommendations include policy changes to public insurance programs, and mandating reimbursement for mobile technology use in mental health treatment. Cultural competency metrics need to be added to quality measurement programs in order to motivate physicians and health systems to better understand their local immigrant populations.

Presentation: 42:08

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