Improving Mental Health Among Haitian Immigrants in the United States

Introduction

Mental health has become a hot topic in recent years. Some mental health disorders include PTSD, depression, anxiety, schizophrenia, and eating disorders. According to the National Institute of Mental Health, about one out of every five US adults today live with mental illness (National Institute of Mental Health, 2024). Yet, despite its prevalence, the services that treat mental illnesses are still very limited, especially for minority groups. For example, based on data in 2021, only 39% of African Americans with mental health needs sought out and received treatments (Dixson, 2024). This can be dangerous as without early detection and effective treatments, some minor mental health issues can develop into very serious mental illnesses, leading to tragical episodes such as suicide.

How is the Haitian community doing? Have there been enough effective intervention programs and services that address various mental health concerns? How can we do better to support this community? It seems like there is scarce data available online that specifically discusses the mental health picture among Haitian immigrants. In this policy brief, we hope to provide some background information, outline the problem, and propose several solutions that will help to address this problem better. We hope to draw attention from policymakers, advocacy groups, educational institutions, and the general public to stimulate positive changes.

Background

According to 2022 data, there are currently around 731,000 Haitian immigrants living in the US, comprising around 2% of all US immigrants (Dain & Batalova, 2023). Even though Haitians are present in almost every state, they are highly concentrated in Florida, New York, and New Jersey. Actually, it is estimated that around 49% of them live in Florida alone (Dain & Batalova, 2023). This population is expected to continue growing in the coming years, as more Haitians move to the US seeking for greater political and economic stability.

The Haitian immigration wave started around the 1980s due to violent uprisings and economic hardship in Haiti. The intermittent violence following nationwide demonstrations against poor living conditions and high unemployment prompted more people to move to the US in the coming decades (Congressional Research Service, 2024). Specifically, there are three aspects people usually cite when they mention the reasons why they moved to the US. First is the security crisis caused by the relations between Haitian gangs and political elites. There has always existed a close tie between gangs and well-known political elites in Haiti. Gang members often contribute to political campaigns using illegitimate means, such as bribing governors and intimidating voters. This situation has posed many security concerns for normal Haitian people. Second, Haiti’s geographical location makes it relatively prone to natural disasters. With climate change and the continued human destruction of natural environments, this problem is exacerbating. Third is poverty and uneven economic development. According to the World Bank, in 2023, the GDP per capita in Haiti was $1,694.1, and the growth continued to be slow due to political instability and gang violences (World Bank Group, 2024). Making the problem worse is the fact that there is a big discrepancy in income levels among different groups. Low-income groups in Haiti face a series of problems, such as food insecurity, inadequate access to healthcare, gender-based violence, and more.

Difficulties Faced by Haitians in the US

Haitian immigrants in the US face many difficulties, from language barrier to lack of trust in the system. When not being addressed properly, these problems can lead to mental health issues. It’s irresponsible to look at mental health issues without understanding their causes. Below we outline two major hardships faced by Haitians living in the US and how they can lead to mental health disorders.

1. Language Barrier

A 2022 survey showed that around 44% of Haitians aged more than 5 years old speak English less than “very well” and only around 10% of Haitians spoke English at home (Schumacher et al., 2023). As many Haitian immigrants moved to the US as adults, studying English can be a both time- and energy- consuming process. As understanding English is often, if not always, a prerequisite for finding a job, this language barrier can prevent them from finding jobs that can support themselves. With relatively low English language proficiency, they can have trouble finding employment and earning enough income to support the household. In fact, in 2022, the median income of Haitian households was at $65,000, well below that of the overall foreign-born populations (Dain & Batalova, 2023)

This language barrier can lead to mental health issues in two ways. First, limited English proficiency prevents many Haitian immigrants from fully participating in American society, which can cause a range of mental strains. Whether going to a game, restaurant, theater show, or school, it can all seem super intimidating if one doesn’t speak English very well. Even though there is a big Haitian population in the US, not being able to fully assimilate into mainstream society can cause additional mental and emotional strain (Degerville, 2023). The stress of going into public spaces and having to communicate with others in English, when accumulated overtime and not being treated properly, can lead to depression or even suicidal thoughts (Blanc et al., 2024).

Second, limited English proficiency makes it harder to find jobs and have a financially stable life, making it easy to be stressed and anxious (Carson et al., 2010). As mentioned in the previous paragraph, with English being a prerequisite in many jobs, limited proficiency can close doors to many jobs. Based on my personal ESL teaching experience, many of my students held very prestigious and highly-skilled jobs back in Haiti. But after moving here, they are switching into more labor-intensive roles. These jobs often pay less and require more physical effort. The lower incomes make it harder to support families and can lead to many stress and anxious emotions.

2. Lack of Access to US Healthcare System

The healthcare system in the US works very differently from the one in Haiti. As a result, Haitian immigrants can find it challenging to navigate and have an intrinsic distrust of the treatment methods. Research shows that in 2022, around 17% of Haitian immigrants didn’t have health insurance and many were not aware of programs such as Medicaid (Dain & Batalova, 2023). It is estimated that around 37% of Haitian immigrants don’t do annual physical exams (Pierre, 2012). This lack of access to healthcare is even more prevalent when it’s a mental health-related issue. Many have reported fears of reaching out to mental health facilities for help or engaging in long- term psychotherapeutic treatments. Some cited reasons include lack of trust in the healthcare system, different cultural beliefs, financial burdens, and lack of information.

This lack of trust in the US healthcare system has significant influences on Haitian immigrants’ mental health. Without timely diagnosis and treatment, minor mental health issues can develop into chronic illnesses, affecting patients’ life quality in the long-term (Canadian Mental Health Association). This is an especially important implication for Haitian youths and adolescents. As mental disorders usually start showing signs in youth, failure to notice them can lead to worse education outcomes, unemployment, and lower socioeconomic development later in life. It’s also worth mentioning that female-headed households tend to have higher ratios of mental health illnesses, as these households usually have a lower median income and less spare money to spend on “not immediate” illnesses (Carson et al., 2010).

Recommendations

The path towards greater mental health among Haitian immigrants is a long one, but also a promising one. We believe that with effort from policymakers, advocacy groups, institutions, and many other parties, Haitian immigrants can have greater access to mental health resources and live a high-quality life. Below we propose three solutions that can be adapted:

1. Collect More Data on the Haitian Population

As mentioned at the start of this policy brief, the statistics on Haitian immigrants’ mental health landscape is scarce. While there is much research that looks at specific racial groups, it’s important to collect more data on specifically the Haitian community to better understand and address the group’s needs. For example, in the research process, I read about a Haitian-American psychologist mentioning that the problems that most affect Haitians are depression and schizophrenia (Joseph, 2022). I was very curious whether or not that’s the case, but was unable to find any other data to back it up. If we have more data available on the Haitian population, we can make more informed and targeted plans to address specific issues.

2. Create Culturally Responsive Treatment Programs

It’s important to design mental health treatment programs that are tailored to Haitians in the US. This is especially important for non-Haitian practitioners who have Haitian patients (Moreau et al., 2024). There should be short courses online that are available to them to help them learn about the culture and religion in Haiti. For example, many non-Haitian practitioners might not understand the influence of Voodoo and the violent history on their Haitian patients (Krause, 1996). Without the knowledge, it can be very hard for them to truly understand the patients’ needs and provide effective treatments Joseph, 2022). Structured brief online or in-person educational programs would be very helpful in this case. Policymakers and community groups should distribute funding and resources to design such courses and make them available to health care practitioners. As these practitioners gain  a greater understanding of Haitian culture and history, they can give patients a better experience, and thus instill confidence in them to access this unfamiliar healthcare system (Desrosiers & Fleurose).

3. Promote Mental Health Awareness among the Haitian Community

Another important part is to promote mental health awareness among the Haitian community. There should be regular local community classes designed to promote the importance of mental health. For example, some people might see receiving treatment as a sign of weakness and thus only reach out when they face a serious issue (Dupiche, 2024). Communities can offer classes that debunk such myths and provide them with resources to get help. An advantage of offering such community classes is people can attend those with people they are familiar with. They don’t have to feel like they are doing it on their own, but rather there is a support net in which they can rely on. Another aspect of promoting mental health awareness is to share stories from famous Haitian-Americans like Karine Jean-Pierre. Karine suffered from many mental health struggles when she was younger, and she has written a book on how she found a way out (PBS News, 2019). It’s a good idea to let community members learn about such stories and gain strength from them.

Summary

We hope this policy brief provides a little clarity and insights on how to improve mental health among Haitian immigrants. As we step into another Trump era, we should be more proactive and vocal in speaking up on immigrants’ rights and debunking fake news. With greater emphasis on working across cultural, language, and economic barriers, policymakers and advocacy groups can help Haitian immigrants navigate the US healthcare system and improve health conditions dramatically. Let’s work together in this difficult time and fight for a better life for people in our community!