Immigrant generation, acculturation, and mental health literacy among former Soviet Union immigrants in Israel.

BACKGROUND: Research on Mental Health Literacy (MHL) has been growing in different geographical and cultural contexts. However, little is known about the relationship between immigrant generations, acculturation, stigma, and MHL among immigrant populations. AIMS: This study aims to examine differences in MHL among immigrant generations (first, 1.5, and second) from the former Soviet Union (FSU) in Israel and to assess whether differences are accounted for by immigration generation or acculturation. METHOD: MHL was assessed among 420 participants using a cross-sectional survey adapted from the Australian National Survey. Associations of immigrant generation, socio-demographic characteristics, and acculturation with MHL indices were examined using bivariate and multivariable analyses. RESULTS: First generation immigrants reported poorer identification of mental disorders and higher personal stigma than both 1.5- and second-generation immigrants. Acculturation was positively associated with identification of mental disorders and negatively associated with personal stigma across all immigrants' generations. When all variables were entered into a multivariate model predicting MHL indices, acculturation and gender were associated with personal stigma and only acculturation was associated with better identification of mental disorders. CONCLUSION: Differences in MHL among FSU immigrants in Israel are mainly explained by acculturation rather than by immigrant generation. Implications for policy makers and mental health professionals working with FSU immigrants are discussed.

Cultural competence in multi-family psychoeducation groups: The experiences of Russian-speaking immigrant mothers of adults with severe mental illness.

The successful integration of cultural competence with evidence-based practices in mental health services is still limited for particular cultural populations. The current study explored culturally adapted family psychoeducation intervention for immigrants from the former Soviet Union (FSU) in Israel who care for a family member with severe mental illness (SMI). Semi-structured in-depth interviews were conducted with 18 immigrant mothers about their experience of taking part in Russian-speaking multi-family psychoeducation groups (MFPGs). Qualitative content analysis revealed five salient processes and changes that participants attributed to their engagement in the intervention: 1) from a language barrier to utilization of and satisfaction with services; 2) from a lack of information to acquiring new mental health knowledge; 3) from harboring a family secret to exposure and sharing; 4) from social isolation to cultural belonging and support; 5) from families blurring boundaries to physical and emotional separation. The results showed that these changes-linguistic, cognitive, emotional, socio-cultural and relational-improved family coping and recovery. Implications for cultural adaptation of family psychoeducation for Russian-speaking immigrants are discussed.

Immigrant Caregivers: The Double Burden Experience of Immigrants Caring for a Family Member With Severe Mental Illness.

The aim of this study is to examine the factors that shape the burden experience among immigrants caring for a family member with severe mental illness. In-depth semi-structured interviews were conducted with 32 immigrant caregivers from the former Soviet Union in Israel. The interviews were analyzed using qualitative content analysis. The participants described their burden as an accumulation of economic, linguistic, social, emotional, and health-related adversities that negatively affect their coping and adaptation on the personal and familial level. The results showed that the objective and subjective burdens they experience include dimensions pertaining to their role as family caregivers, dimensions pertaining to their immigrant status, and the circular interaction between these two, which intensifies the overall experience of burden. The study proposes a new term-the "double adaptation burden"-that can help promote the design of research, interventions, and policies suited to the multiple challenges of immigrant caregivers.

Narrative research on mental health recovery: two sister paradigms.

BACKGROUND: Despite the breadth of narrative studies on individuals with severe mental illness, the suitability of narrative inquiry to exploring mental health recovery (MHR) has not been examined. AIMS: (1) Examining the appropriateness of narrative inquiry to studying MHR; (2) assessing the extent to which narrative studies on MHR conform to the unique features of narrative research, as a distinctive form of qualitative inquiry. METHODS: Review of empirical, theoretical and methodological literature on recovery and narrative inquiry. RESULTS: Considering the perspectives of recovery and narrative as paradigms, the similarity between their ontology and epistemology is shown, evident in 10 common emphases: meaning, identity, change and development, agency, holism, culture, uniqueness, context, language and giving voice. The resemblance between these "sister" paradigms makes narrative methodology especially fruitful for accessing the experiences of individuals in recovery. Reviewing narrative studies on MHR suggests that, currently, narrative research's uniqueness, centered on the holistic principle, is blurred on the philosophical, methodological and textual levels. CONCLUSIONS: Well-established narrative research has major implications for practice and policy in recovery-oriented mental health care. The narrative inquiry paradigm offers a possible path to enhancing the distinctive virtues of this research, realizing its potential in understanding and promoting MHR.

Interplay of identities: a narrative study of self-perceptions among immigrants with severe mental illness from the former Soviet Union.

This study explored the self-perceptions of individuals with mental illness who immigrated from the Former Soviet Union (FSU) to Israel. In particular, we examined the double stigma borne by these individuals as new immigrants and psychiatric patients, which may threaten their identity and render them at risk for social marginalization. We interviewed 12 FSU immigrants diagnosed with severe mental illness (SMI), who had been hospitalized in psychiatric facilities in the past and, at the time of the interview, were residing in community rehabilitation centers. Their narratives revealed that they constructed multiple identities for themselves: as bearers of Russian culture, as Soviet Jews, as normative immigrants, and only lastly as consumers of mental health services. In the case of FSU newcomers with mental illness immigration may serve as a normalizing and positive experience. Study findings suggest that stressing patients' identity as mentally ill may be counterproductive in their rehabilitation; instead, clinicians may consider working to mobilize patients' personal and cultural assets and helping them reinstate a more complex self-perception. Further research is needed to explore how immigration may affect self-perceptions of individuals with SMI from other cultural groups.