By Kholiswa Mendes Pepani 

Deciding to leave home and begin again somewhere new is never easy. Stepping out into the abandon of an uncertain beginning takes courage and resilience. 

While prospects of arriving in a new location may offer relief and hope for fresh opportunities, migrating is packed with countless psychological stressors that make adjusting to a new community incredibly challenging. The extensive changes and losses faced are isolating, and when feelings of homesickness and disconnection begin to manifest as an incurable sadness or anxiety, knowing where to turn can be hard. As a result, many refugees and immigrants suffer in silence with feelings of alienation, hopelessness, and depression. But struggling with such a disruptive change is natural, especially when the journey itself is traumatic. 

Refugees and asylum seekers tend to shoulder the burden of a distinct set of hardships, considering that they were forced to leave home, and faced significant stress and trauma before and during their journey. 

Leopold Ndayisabye, former president of the Rwandan Association of Maine and a former caseworker for Preble Street, explained that the most pressing struggles associated with the process of transitioning to the U.S are overcoming war and trauma, loss of community and family support, unemployment and housing stress, racism and discrimination, and the pressure to acculturate.  

“Adjusting to a new lifestyle is very tough. Suddenly you arrive with nothing and it can feel like a loss of identity, like there is no capacity to be yourself. New Mainers are coming from very different communities of support, with distinctive cultural roles. They find themselves totally isolated and alienated from society. This drastic change can create a lack of self-esteem, and when you can’t trust yourself, how can you trust that others want to help you?”   

Leopold Ndayisabye

Ndayisabye went on to say that after undertaking such a physically, mentally, and emotionally taxing journey, refugees can struggle to feel safe and, as a result, harbor a great sense of suspicion and hypervigilance, making it hard to adjust or ask for help. “A lot of the refugees were struggling to get food, struggling to get water, struggling for basic survival before they arrived in Maine. This situation naturally has a huge impact on their mental health,” he said. 

In addition to leaping over various psychological and structural obstacles, one of the greatest barriers to immigrants’ care is the taboo associated with mental illness. Although cross cultural conversations have made significant progress in dismantling stigmas about mental health, many African and South American families continue to struggle with addressing mental illness. A large number of these immigrant families view mental health challenges in a negative light because it is generally linked to weakness or permanent institutionalization. As a consequence, people can receive the mere suggestion of seeking a psychologist can as insulting and a threat to their immigration process. Ndayisabye said, “Because mental health is taboo in most African cultures, a lot of the refugees are unwilling to talk about their trauma. There is a fear to disclose their pain. An unhealthy resilience builds, and when they are alone or feel safe enough, the repressed pain comes out as a breakdown. At that point intervention may be too late.”  

Migrants end up working incredibly hard to survive and, at the end, it takes a piece of them. Their families break apart, their children cannot cope, all because they are too afraid to name that they are having a hard time coping with psychological issues.

Compounding these difficulties is a serious lack of access to resources. When New Mainers arrive, they have limited access to healthcare and means of social support. As most do not speak English, the language barrier becomes an added frustration. While community programs do their best to help, the lack of structure, cultural sensitivity, and funding often falls short in building trust and ensuring that the families are able to thrive long term.  

According to Abusana Micky Bondo, co-founder of In Her Presence, a nonprofit focused on empowering migrant women in Maine, the need for compassion and a sharp sense of cultural competency becomes crucial to embracing New Mainers before they become lost in a community without adequate networks of support. When Bondo first met In Her Presence co-founder Claudette Ndayininahaze, the women talked about the immense struggles they themselves faced as immigrant women of color, and felt compelled to create a space to empower women like themselves. They decided to begin by hosting a yoga class for immigrant women.  

“At first, 12 women came and we began by translating the gestures … As we started to explain things, it became clear that it was only anxiety holding us back from finding out why they had come. Once we started to listen to all the whys, we knew that we needed to build a more robust program of support so that their voices could be heard – a program where we could start building strategies to overcome the challenges we were facing. No one could do it for us. We can build allies, but we needed to stand for our families and ourselves. We are women, mothers, and spouses; we are the pilots of our homes and it was us who needed to do it,” Bondo said. 

Bondo’s ability to help others and bridge a gap that was missing in the community has been a success. At first the organization struggled for funding and recognition, but In Her Presence has now grown to be a pillar of support for many. The organization gives women tools to support their families. Language barriers separate New Mainers from having full autonomy over their intimate lives, so In her Presence created a program called “Find Your Voice,” which works to create a contextual vocabulary for successfully going to the doctor, bank, and school. In addition, they host workshops to help parents better understand their children’s transition into the U.S., and offer career and relationship support.   

Taboos about mental health make it difficult at first for women to share their hardships, Bondo said. “Because of the taboo, we end up walking in denial. It’s hard to recognize that you might have a problem, especially if you don’t know what it looks like.” Many people who struggle turn to substances as a method of coping with anxiety and depression.  

“Migrants end up working incredibly hard to survive and, at the end, it takes a piece of them. Their families break apart, their children cannot cope, all because they are too afraid to name that they are having a hard time coping with psychological issues,” she said. “It’s hard when you come from a place where these things are never talked about.” 

This year, In Her Presence began hosting a workshop with medical providers called “Heal Your Body,” in an attempt to start the conversation about mental health. “When the nurse started talking about the signs, a lot of the women began breaking down. In the stillness, they were able to recognize that this is what they’ve been going through – that it has a name, and treatment,” she said. “They are able to realize that their minds are struggling because of too much stress, trauma, and overworking. We need to start talking about this. We need to name it, so we can find help.”   

In order to provide help to friends and family who might be struggling, recognizing the signs is important, as is finding an approach that incorporates an understanding of cultural backgrounds. Leaning on local churches and communities for support is a helpful first step. 

What are signs and symptoms of declining mental health? 

According to the American Psychiatric Association, the first few warning signs of deteriorating mental health are sleep or appetite changes (dramatic sleep and appetite changes or decline in personal care), mood changes (rapid or dramatic shifts in reactions or depressed feelings), withdrawal (recent social withdrawal and loss of interest in activities previously enjoyed), drop in functioning (unusual drop in functioning at school, work, or social activities, such as quitting sports, failing in school, or difficulty performing familiar tasks), problems thinking (problems with concentration, memory, or logical thought and speech that are hard to explain), apathy (loss of initiative or desire to participate in any activity), feeling disconnected (feeling of being disconnected from oneself or one’s surroundings; a sense of unreality), nervousness (fear or suspicion of others or a strong nervous feeling), and substance abuse (drinking more than usual or using illegal drugs). 

If you, or someone you love is struggling with any of these mental health symptoms, or with thoughts of harming yourself or others, it may be time to reach out for help. Please call the Maine Crisis Line at 1-888-568-1112, or dial 911, or go to the nearest emergency room for help. Talking about mental health is uncomfortable and sometimes unfamiliar, but opening up and leaning on someone else for support can help make a difference in getting through the darkest days. Even when someone is far from home, there is hope, support, and ways to cope. We must take care of our whole selves because home begins in the body.