This study examines how the migration experience affects the mental health status of recent Asian and Latin American/Caribbean immigrants. It analyzes the relationship between stress among immigrants and their adaptation patterns. Specifically, this study focuses on the psycho-social transition processes associated with migration, examining how disruption of cultural norms, and restructured lifestyle may lead to stress, or other mental health difficulties. In addition, this study highlights "transnationalism," a newly defined adaptation pattern of recent immigrants, especially among Latin immigrants. It focuses on "transnational activity" as a potential mediator of the relationship between immigration stressors and mental health outcomes among recent migrants from Asia and Latin America/Caribbean countries. Previous research has been largely dedicated to two aspects of immigrants' mental health status, post-traumatic stress disorder and acculturative related stress. This study includes both aspects, focusing on both the context of exit and the context of reception to analyze the factors associated with immigrants' mental health problems. Based on previous research, this study incorporates various theories and concepts, including stress theory, acculturation theory, the life course perspective and transnationalism to establish a synthetic model to explain mental health problems. Using the first wave data from New Immigrant Survey, this study includes a broad range of variables, employs logistic regression to examine the effects of pre-migration experiences and post-migration trajectories on symptoms of depression and distress among Asian and Latin American/Caribbean immigrants. Statistical results show that in general Asian immigrants have slightly better mental health than Latino/Caribbean immigrants. Socioeconomic status, gender, pre-migration persecution, social support, acculturation, transnationalism, and sub-ethnicity all predict symptoms of depression among immigrants with the exception of the age at arrival in the U.S. The effects of factors examined in this study vary slightly across ethnic groups. Future research should use longitudinal data in order to track the long-term effects and the patterns of immigrants' incorporation and their mental health status. In addition, the development of more synthetic theories and key concepts are suggested to better understand how the post migration trajectories of each sub-ethnic group within Asian and Latino/Caribbean immigrants' populations are related with their mental health status.

Individuals with multiple sclerosis (MS), especially those living in Latin America, often require assistance from family caregivers throughout the duration of disease. Previous findings suggest that family caregivers may experience positive and negative effects from providing care to individuals with MS, but few studies have examined the impact of MS caregiving on caregivers from Latin America. The current study examined the relationships between MS impairments (functional, neurological, cognitive, behavioral and emotional), unmet family needs (household, informational, financial, social support, health), and caregiver psychosocial functioning (satisfaction with life, anxiety, burden, and depression) in a sample of 81 MS caregivers from Guadalajara, Mexico. Canonical correlations revealed that behavioral impairments were associated with higher burden and decreased satisfaction with life, and that unmet financial, social support, and informational needs were associated with higher caregiver burden. A structural equation model demonstrated the meditational effect of unmet family needs on the relationship between MS impairments and caregiver mental health. These findings suggest that interventions for MS caregivers in Latin America should focus on reducing caregiver burden by addressing unmet family needs for information, financial, and social support while teaching caregivers ways to manage the patient’s behavioral symptoms.

Latino populations continue to utilize mental health services at lower rates than their non-Latino counterparts. This is concerning for several reasons. Mental illness, is extremely prevalent in the general population. The population of Latinos (particularly younger individuals) in the United States is rapidly increasing. Acculturation has been found to negatively impact mental health issues in Latino populations. And finally, emerging adult’s unmet mental health needs / issues place them at risk for failing to adapt to adult roles, impacting their lives in many ways. This mixed methods study implores primarily quantitative design and includes two qualitative questions to explore the beliefs about mental health services among emerging adult (18-25) Latinos. Data for this study was derived from a survey, which was developed by adapting current qualitative research focused on Latino mental health and barriers to service. Additionally, questions were created by adapting the Community Attitudes Toward the Mentally Ill to explore stigma towards mental health services and illness. Forty-three completed surveys were analyzed; the findings are presented within this thesis.

Latinos generally have equal or lower rates of mental illness relative to their White counterparts (the so-called Hispanic paradox). In addition, first-generation Latino immigrants have decreased odds of psychiatric illness than second-generation Latino immigrants (referred to as the immigrant paradox). Unfortunately, our understanding of mechanisms underlying the Hispanic and immigrant paradoxes has been limited by methodological issues in extant research, resulting in only a vague understanding of the resiliency of Latinos to psychiatric illness. The current project addresses these shortcomings by comparing risk and protective factors to mental illness among first- and second-generation Latinos. Results of this study indicate that first-generation Latinos report higher national identity exploration, pressure to acculturate, and social status and lower language-based acculturation in comparison to second-generation Latinos. Regression analyses suggest that higher ethnic discrimination and acculturative stress, lower perceived social status, and residency in an ethnic enclave increase Latinos' risk to mental illness, whereas higher American and Latino identification and social support reduce this risk. Results of moderation analyses indicate that ethnic discrimination and certain dimensions of acculturative stress exacerbate associations between age of immigration and years in the U.S. and negative mental health outcomes for first-generation Latinos. These findings, taken together, provide a greater understanding of the underlying processes of the Hispanic and immigrant paradoxes. Study limitations, policy and clinical implications, and future directions are presented.

This qualitative study examines the challenges that community health workers or Promotores face when implementing their programs to produce better outcomes in the Latino community. Data collection was derived from five local promotores with an adequate knowledge base of expertise in promotores programs. Study themes focused on how promotores implement their programs, the challenges they face and providing professional and personal insight on working with the Latino community. Present day research emphasizes that promotores or the community health worker model approaches have been promoted as a strategy to address health disparities experienced by Latino communities in the U.S. These programs have been implemented in an effort to improve the health of Latino families and bring awareness to public health issues. However, not much is known about the challenges that they face when implementing these interventions. Study results indicated five emerging themes pertaining to the challenges that promotores face when implementing their programs and include: mental health stigma, recruitment, funding barriers, and lack of evaluation. Finally, suggestions for further research on promotores and the Latino community are discussed.

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