|
Article Excerpt
In this article, we present common mental health issues facing Russian speaking immigrants from the Commonwealth of Independent States (CIS), highlighting the necessity for counselors to have an understanding and appreciation of these issues in order to provide effective treatment services. An introduction to CIS mental health services and a historical description of the influence of the communist government on health care in the CIS are provided. Additionally, we review the cultural beliefs and values of CIS immigrants regarding mental health services and their underutilization. Finally, a series of practical suggestions for mental health counselors providing services to Russian speaking immigrants are offered.
**********
The number of Russian speaking immigrants from the Commonwealth of Independent States (CIS) has increased in dramatic proportions over the past 15 years. In 1994, the United States Immigration and Naturalization Services (INS) Bureau reported 334,000 documented CIS immigrants in the United States. In 2001, the number of CIS immigrants had increased to 450,000 (Statistical Yearbook of the Immigration and Naturalization Service [INS], as cited in Gutlin & Ebenkaump, 2001). Additionally, the INS estimated that another 250,000 undocumented Russian speakers arrived during the same time period, bringing the total number of CIS immigrants to 700,000 (Lashenykh-Mumbauer, 2005). Further, The New York Times reported in 2000 that over 200,000 CIS immigrants were living in New York City alone (as cited in Gutlin & Ebenkaump, 2001). These numbers reinforce Ginsburg (2002), when he declared the Russian speaking population in the United States is one of the fastest growing minorities.
The literature regarding the adjustment of Russian speaking immigrants to the United States has been limited. The research that has been published tends to focus on Jewish immigrants who left the Soviet Union in the 1970s (Goldstein, 1979; Simon, 1985), long before perestroika (economic and political restructuring) and the subsequent independence of Central Asian countries (i.e., Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan, and Kyrgyzstan). Further, compounding the challenge for researchers regarding Russian speaking immigrants has been the complexity of various cultures from the CIS, where the one common variable for CIS people was the Russian language forced upon them when they were part of the Soviet Union.
CIS people immigrating to the United States encounter unique challenges. According to Kozulin and Venger (1995), there has been more research completed relating to CIS immigrants to Israel than to the United States; where the majority of recent CIS immigrants to the United States are non-Jewish. Currently, research has begun to focus on the characteristics of non-Jewish CIS immigrants (Dimitrov, 2005; Lashenykh-Mumbauer, 2005). The limited research suggests that the majority of CIS immigrants come to the United States without the assistance of their friends or family, which was a common characteristic of Jewish refugees. Additionally, most of these immigrants do not receive government benefits or financial support from any religious community. As a result, they often struggle with their transition to the United States because they receive little or no outside support (Lashenykh-Mumbauer, 2005). Consequently, little is known about this increasing population of immigrants, presenting a challenge to the field of mental health counseling (Brod & Heurtin-Roberts, 1992).
There are two main reasons that underlie the challenge posed to the mental health profession by CIS immigrants. One is that they tend to underutilize mental health services, even when symptomology is present. Chow, Jaffee and Choi (1999) and Green (2004) suggested that many Russian speaking immigrants gravitate to the medical profession for support, instead of seeking out mental health services, due to the lack of knowledge about the United States healthcare system and the options available to them. Many health care providers, primarily nurses and physicians, recognize that these clients would benefit from mental health counseling services (Green, 2004). The other challenge is the stigma associated with discussing problems with "outsiders" (mental health service providers), as it is not a normally accepted practice among CIS immigrants (Green, 2004). Further, Visson (1998) stated that "mentioning health problems to a third party is as reprehensible as a public recounting of someone's sex life" (p. 187) for many CIS immigrants. It is important to note that mental health services (e.g., counseling, social work) never existed in the CIS (Green, 2004), where the culture is community oriented, and discussions related to mental health issues are taboo. Culturally, if a CIS immigrant was to seek mental health services, he or she may have been perceived as being "weak."
Despite the research supporting the social, psychological, and political challenges Russian speaking immigrants from the CIS encounter when arriving in the United States, there is a lack of information concerning their mental health needs and strategies mental health counselors may employ to address those needs. Additionally, Lambie, Davis and Miller (in press) suggested that to support counselors' ethical and culturally sensitive practice, necessitates increased self-awareness of personal and professional beliefs, appreciation of diversity in the counseling process, and tailoring of counseling interventions to clients' specific needs. Further, the American Mental Health Counselors Association (2000) Code of Ethics states that "mental health counselors will actively attempt to understanding the diverse cultural backgrounds of the clients with whom they work" (principle 1.E.2). Therefore, in this article we provide (a) an overview of the historical circumstances that have influenced CIS immigrants' perspectives (attitudes and beliefs) of mental health services, (b) present common mental health needs of CIS immigrants, and (c) offer practical implications for mental health counselors to address the psychosocial needs of CIS immigrants.
HISTORICAL PERSPECTIVE OF MENTAL HEALTH COUNSELING IN THE CIS
Most immigrants from the CIS to the United States rived under Communist rule for sometime. During Communist rule, virtually all aspects of life including medical and psychological services were controlled by the government (Bloch & Reddaway, 1985). The Communist Party was essentially in control of the entire health care system and used this control to the party's advantage (Bloch & Reddaway). In other words, the government system used its power to support its goals (not necessarily the welfare of its people).
Traditional Western mental health counseling services were nonexistent in the Soviet Union (psychiatry was the only mental health service provided). However, while the Soviet Union produced significant scientific scholars (e.g., Pavlov, 1951; Vygotsky, 1978), their research was referenced to neuroscience and...
|
