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Mexicans migrating to the United States may be giving their children better economic opportunities, but they may also be exposing them to a greater likelihood of experiencing mental illness, according to a study of about 3,000 residents of Fresno County, Calif.
The study, "Lifetime Prevalence of DSM-III-R Psychiatric Disorders Among Urban and Rural Mexican Americans in California," found that the rate of diagnosable mental illness for Mexican Americans born in the United States was twice the rate of that for recent immigrants or Mexicans who remained in their country. The risk of mental illness for Mexican Americans born in the United States, according to the National Comorbidity Survey, was 48.1 percent, a rate similar to that of white Americans. Among newly arrived immigrants the rate was 24.9 percent.
The study, which was published in the September issue of Archives of General Psychiatry, was funded by the National Institute of Mental Health (NIMH).
William A. Vega, Ph.D., of the School of Public Health at the University of California, Berkeley, and coauthors from San Diego State University, California State University, and the Mexican Institute of Psychiatry of Mexico City, studied the rate of psychiatric illness among newly arrived and more established Mexican immigrants. They found that those who had been in the country for at least 13 years had the same rate of mental illness as native-born Mexican Americans.
"Psychiatric morbidity among Mexican Americans is primarily influenced by cultural variance rather than socioeconomic status or urban versus rural residence," wrote Vega.
Drug abuse, anxiety, and depression were the most serious mental health problems for Mexican Americans. According to the study, substance abuse was four times higher among Mexican Americans than among Mexican immigrants.
"This is one more research study that shows something very surprising," said Javier I. Escobar, M.D., a professor in the department of psychiatry at the University of Medicine and Dentistry of New Jersey and the Robert Wood Johnson Medical School. The recent study, like NIMH's Epdemiologic Catchment Area (ECA) study from the 1980s, he said, goes against classical psychiatric tenets such as the damaging psychological effects of migration and the positive psychological effects of acculturation. In the 80s, he said, he and others working on the ECA study believed the instrument wasn't measuring what it was supposed to or that mistakes were made in the research.
In contrast, said Escobar, studies have also shown that children born to Mexican-immigrant mothers have lower mortality rates and higher birthweight rates than children born to U.S.-born mothers of Mexican descent, despite the fact that Mexican immigrants are poorer, less educated, and have less access to health care. The studies have shown that Mexican-immigrant women have more nutritious diets and are less likely to test positive for drugs at time of delivery.
In addition, he said the National Health Examination Survey (1988-94) showed that hypertension in Mexicans increased when they migrated to the U.S. and that U.S.-born Mexican Americans had higher rates of hypertension than recent immigrants. These results may be related to levels of stress, said Escobar, but more research is required to determine the exact explanation for the differences.
"One of the most likely explanations for these differences, besides frequency of substance abuse, more access to drugs, and the economic resources allowing access to drugs, is that the family system provides more support and protection," said Escobar. The Hispanic family system is more hierarchical and that may influence the behavior of children, he noted. Children in a structured family with a father in authority are less likely to experiment with drugs. The protection disappears when the family system changes, he added.
Escobar, who wrote an editorial for theSeptember Archives of General Psychiatry in response to the study, said he hopes Vega's study will stimulate more research on immigrants. "Research on minorities can contribute to mainstream psychiatry in identifying risk and protective factors for mental illness," he said.
The article about this study is available on the Archives of General Psychiatry Web site www.ama-assn.org/psych.