Migration-Related Stress and Depression Among First Generation Haitian Immigrants in Florida

Previous studies, while limited, document high levels of depression among Haitian migrants, and postulate that migration-related stress (MRS) may play a significant role. Recognizing, appropriately treating depression, and meeting the mental health needs of the growing number of Haitian migrants continue to pose a challenge because of differences in culture, beliefs, idiom of distress, expression of depression and specific stressors associated with migration.

Among first generation Haitian immigrants, this study aimed to 1) identify demographic factors associated with depression and MRS as separate constructs and, 2) examine the relationship between MRS and depression, and the extent to which this relationship is modified by other factors, through the lens of the stress process model. This cross-sectional descriptive study used purposive sampling methods to recruit 76 first generation Haitian immigrants living in the southeast region of Florida. Descriptive statistics, ANOVA, chi-square, Pearson correlations and multiple linear regression were used to assess MRS (Demands of Immigration), depression (Center for Epidemiological Studies Depression (CESD) and Zanmi Lasante Depression Symptom Inventory (ZLDSI)) and relationships with demographic variables.

Factors associated with MRS included older age, rarely speaking English at home, higher number of children, and marginally significant suggestions of female gender and being directly affected by the 2010 earthquake. Findings showed a strong positive linear relationship between migration-related stress and depression (CESD (r =.606, p <.0001) and ZLDSI (r = .624, p < .0001)) and between CESD and ZLDSI (r =.738, p <.0001). MRS remained the strongest predictor of depression when controlling for all other significant predictors of depression (CESD: gender, income, education, and direct 2010 earthquake impact; ZLDSI: in Haiti for 2010 earthquake and moving to the U.S. during first visit). Being in Haiti during the 2010 earthquake moderated the relationship between MRS and depression (ZLDSI), showing an amplifying effect for depression between MRS and earthquake exposure.

When diagnosing and treating depression, clinicians and nurses should consider both the unique migration stressors and risk factors Haitian migrants may face, and the ethnic differences in their expression of depression. The use of a culturally appropriate and validated instrument is instrumental to better capture depression among Haitians.