Mental Health Challenges Of First-Generation Immigrants

First-generation immigrants are at risk of significant mental health complications. This risk may be related to the stress of adapting to a new culture, navigating immigration status, and balancing family expectations while discovering strategies for maintaining overall well-being. The psychological impacts of international migration can manifest differently depending on an individual’s life stage. Below, explore these impacts and how to find culturally-informed support.

Quick definition: What does first-generation immigrant mean?

Before we explore the potential mental health challenges of being a first-generation immigrant, it can help to understand precisely what a first-generation immigrant is. 

How the term is defined and referred to in different contexts

Generally, a first-generation immigrant is someone who was born in a foreign country. This is how it is defined by the U.S. Census Bureau, as well as some academic sources. That said, some people may colloquially refer to the first people born in a new country as first-generation immigrants. In Asian countries, the context is entirely different: a person born in another country is referred to as generation zero, and those born in the new country as first-generation. 

To avoid any confusion, in this article, we will refer to people who were born in another country and relocated to a new one as first-generation immigrants.

First generation vs second generation vs 1.5 generation

To understand how the immigrant experience can impact mental health, it can help to have an idea of other immigrant generations.

• To recap, first-generation immigrants are those who were born in another country and immigrated to a new one.
• Second-generation immigrants are those who have at least one parent who is foreign-born and were themselves born in the host country. 
• Third-generation immigrants are the children of second-generation immigrants with at least one foreign-born grandparent.

There can be other distinctions made, too, that generally depend on life stages, including: 

• Generation 1.25 refers to those who arrive in the host country during adolescence, whose experiences may be closer to those of first-generation immigrants than to those of second-generation immigrants born in the host country. 
• Generation 1.5 includes those who immigrate to the host country before or during their early teens, generally between ages 6 and 12, meaning they are old enough to retain their native language and cultural traits but young enough to fully assimilate into their new home and community. 
• Generation 1.75 are children who arrive in the host country before age 5, who do not retain many memories of their birth country, and learn their new language without an accent.
• Generation 2.5 comprises children born to one foreign-born parent and one native-born parent. 

The psychological impact on children of first-generation immigrants

According to the World Health Organization, first-generation immigrants are at an increased risk of mental health challenges compared to the domestic population of a host country. While first- and second-generation immigrant children who migrate with their foreign-born family members may not face the same active intensity of psychological ramifications as older generational cohorts, they can still experience psychological impacts. These implications may be exacerbated by the immigrant generations with which an individual identifies.

How children may experience international migration firsthand

Children in the 1.5 generation may assimilate the fastest. However, a child often has no input in the decision to move abroad. Research indicates that immigration may function as a source of significant stress for children, even if it represents an opportunity for a better life for their parents. 

Cultural identity development at a young age

Having immigrant parents or one foreign-born parent can impact a child, even if they were born in the host country. For second-generation immigrants, psychological impacts may stem from foreign-born parents’ life experiences that are instilled in subsequent generations.

For this generation, developing a cultural identity may not be straightforward. They grow up in the culture of their new country, in a home where aspects of their native country and ancestry are still cherished, including the language, traditions, and values. This can mean navigating two cultural worlds simultaneously, often from a very young age.

This concept may be referred to as bicultural identity, and this type of exposure can shape their identity in many ways. Some children may be able to move fluidly between cultures, while others may experience tension between what is expected of them at home and what is expected at school and/or among their peers.

Mental health struggles among immigrant adolescents

Adolescence can be a challenging time in which people explore their individuality and express their personal identity in new ways. An immigrant adolescent may have trouble deciphering and navigating their new social environment, which can be exacerbated by language barriers and racial tensions.

Further, an immigrant parent may have similar difficulty balancing the cultural environment of where they grew up versus that of their child, potentially leading to clashes that may result in the adolescent experiencing heavier social pressures and discrimination in school. Some research suggests that in parent-child dyads where acculturative conflict (stress arising from differences in cultural values, behaviors, and adaptation rates) is low and parenting remains supportive, mental health outcomes may be more positive. On the other hand, when acculturative conflict is high, it may be associated with increased psychological risks.

How immigrant adolescents may take on a caretaking role

According to the Migration Policy Institute, approximately 23.5% of documented immigrant households speak limited English. Teen children of immigrants may learn the host country's language faster than their parents, allowing them to outperform their parents socioculturally. This acculturation gap may result in the adolescent acting as a translator and caretaker of their parents, assisting them in matters outside the home where language would present a challenge for the parent, and emotionally supporting them in adjusting to the new environment.

Statistics on the impact of caretaking roles in first-generation immigrant children 

Children and adolescents in a caretaking role experience psychological distress at nearly double the rate of their first-generation parents, facing depressive symptoms, restlessness, nervousness, hopelessness, and a sense of worthlessness. Structural and interpersonal racial tensions can exacerbate the rates of depression, anxiety, and post-traumatic stress disorder (PTSD) in children of immigrants, as can documentation concerns and, in some cases, the risk of deportation for the adolescent and their parents. Those who witness the deportation of their parents, grandparents, or other first-generation immigrants may also experience extreme grief and trauma, sometimes upheaving their entire lives to accompany their family member back to the country they fled.

Family dynamics, including siblings and role shifts

In addition to caring for their parents, older children may take on supervisory roles in the home. Younger siblings look to them, rather than to their parents, for guidance and support. This phenomenon can be referred to as parentification and may have the potential for adverse mental health outcomes, including: 

• An increased risk of depression 
• An increased risk of anxiety
• Insomnia
• Substance use
• Developmental, physical, and academic challenges

Immigrant adolescents may also become points of contact between their families and the wider community, mediating interactions with schools, healthcare providers, and local services. Learning to take on these adult situations at a young age can affect childhood in ways that carry significant psychological weight. Research in recent years suggests that, while some adolescents may respond well, others can find the cumulative pressure of these responsibilities a significant source of stress.

Career, education, and well-being of young adult immigrants

Given their own sacrifices, immigrant parents often set high expectations for their children’s success, potentially cultivating a high-pressure environment for children to elevate the social standing of the family Simultaneously, if the young adult has historically taken on a caretaking role for their parents, their duties may hamper their ability to establish independence, as they may consider it their responsibility to remain in close proximity to help. Family ties are often highly important in certain cultures, which can lead to difficulty setting boundaries. 

University and education transitions for immigrant young adults

Higher education can pose unique challenges for young immigrants, which some researchers describe as a deficit in social capital. Students may face unfamiliar institutional systems and financial challenges largely on their own as they may not have family members who understand the application process, financial aid options, or academic expectations. 

Employment and early career stressors in a new country

Entering the workforce can be a stressful transition for immigrants who may face various barriers to employment despite being qualified. First-generation immigrants who arrive in their new home with degrees or certifications from their native country may find that their credentials are not accepted in their host country, which can force them into roles that they are overqualified for. 

Post-education, a young adult immigrant may face challenges in career advancement due to cultural adaptation and systemic barriers that may be related to authorized legal status or other institutionalized issues. For example, it was estimated that, in 2023, roughly 14 million U.S. immigrants live without full lawful status, which can shape the educational and economic realities of immigrant families. 

Family responsibilities and stress in immigrants in midlife

If a family makes an international move to a country with little or no support system for immigrants, balancing family life's financial and emotional responsibilities in the host country can be a challenge. This complexity may be compounded by aging parents who may or may not have migrated with them. In addition to the potential language barrier that may make finding work especially difficult, the emotional burden of supporting immigrant adolescents in the new environment while maintaining cultural traditions may take a toll on an immigrant parent.

Balancing work and family obligations

For young immigrants, personal ambitions and family duties may be intricately intertwined. Many may have responsibilities that their domestic peers do not, such as contributing to the household income or caring for their parents or younger siblings. These obligations can directly interfere with pursuing education and career development, placing heavy demands on their time and energy. 

The mental health challenges of aging first-generation immigrants

Community and cultural connections are often helpful in maintaining mental health and well-being. Loneliness and social isolation may be elevated among immigrant populations, as many immigrants rely on one another for social support.

Community connection, belonging, and inclusion in later life

For first-generation immigrants, the community can provide a source of social comfort and support. Decades of shared experience in the host country's society, as well as a shared history of strong identification with the language and customs of another culture, can help build strong connections. 

While full inclusion in the host society can remain elusive for many older first-generation immigrants, their world can shrink as challenges related to mobility and loneliness increase. Belonging to a culturally responsive and welcoming community that embraces diversity can help people address these challenges in ways that benefit their overall mental health.

Barriers to mental health support for first-generation immigrants

Support for the physical and mental health of first-generation immigrants and their descendants is often limited due to factors like high costs, lack of social programs and state support, and cultural stigmas around mental health. In host countries without socialized healthcare, immigrants with jobs that leave them uninsured or underinsured may face prohibitive costs.

Immigrants with unauthorized status in their host country may distrust formal services for fear of family separation, system inequities that may result in detainment, and other factors. Language barriers may give rise to anxiety and stress when seeking help from outside their immediate community. Because of a combination of factors, many immigrants do not seek mental health support. In one study, only 21.2% of immigrants surveyed reported seeking medication or counseling for mental health care. Researchers also determined that immigrants who have been in the United States for less than five years had 46% lower odds of seeking care than those who have been in the country for longer than five years.

Mental health coping strategies for international migration 

Immigrants may build strong support systems within their community, be it with family, friends, support groups, religious consultants, or mental health professionals. Self-care and stress-management techniques may also assist first-generation immigrants in their daily lives as they acclimate to their new environment and seek a new life balance.

Getting support in online therapy

For those who are interested in speaking with a licensed mental health professional, online therapy through a platform like BetterHelp can be a way for first-generation immigrants to access culturally sensitive counseling. While it cannot be guaranteed to be matched to a professional therapist who is from your specific cultural background, the platform matches you with an appropriate counselor based on factors like your state and/or the issues you’re dealing with. From their preferred Wi-Fi-enabled space, the individual seeking therapy can avoid cultural stigmata related to seeking help for mental health concerns.

The availability of online therapy has opened the possibility of mental health services to various populations, including immigrants. One 2021 study analyzing the effects of internet-based cognitive behavioral therapy (ICBT) on Arabic-speaking immigrants in Sweden concluded that ICBT somewhat mitigated mental health stigma and acted as a precursor to seeking other forms of treatment for mental health concerns. For the general population, ICBT through platforms has proven to be an effective treatment option for anxiety and depression. These two mental health concerns may be particularly prevalent among first-generation immigrant families.