Through interview and focus group results, this section explores Eritrean and Ethiopians’ understanding of mental health including general causes, signs/ triggers, how they address it, and what is needed moving forward.

Causes of mental health issues in Eritrean and Ethiopian communities.

Although the respondents failed to define mental health or explain which ones are prevalent in the community, they provided numerous themes for the causes of mental health issues in Eritrean and Ethiopian immigrants. As discussed by each respondent, the most prevalent issue causing mental health issues concerns the strenuous and often risky immigration process. This is especially evident for immigrants who immediately entered the workforce and/or created a family in which they failed to process their experiences (Nahom, 57). This is reiterated by Steel et al., (2009) who finds that Eritrean and Ethiopian immigrants deal with high levels of depression and PTSD due to their migration process, and with limited support, immigrants continue to work two-three jobs while limiting sleep and proper nutrition, consequently exacerbating their symptoms (Nahom, 57). 

In addition, rapid and forced cultural assimilation in post-migration life continues to amplify mental health issues for Eritrean and Ethiopian immigrants. For example, Nahom (57) described American culture as overall talkative and slightly aggressive due to the incandescent displays of public affection, further mentioning how he’d wish there were a book to teach him on what to expect when first arriving. Subsequently, these differences in culture appear in severe forms including impacting family dynamics and increasing familial violence and tension. For Leila (53) “America isn’t what people thought it would be,” rather, the expectation of simplicity and wealth is false and many immigrants are forced to work even harder, fostering sentiments of regret (Sabrina, 32). These sentiments are further exacerbated for immigrant parents who fail to reach their cultural and self imposed expectations including, for example, expecting their children to achieve certain academic or career titles or expecting to live in certain neighborhoods (Nahom, 57). Consequently, failing to achieve these expectations results in increased marital issues or divorce as couples are oftentimes unable to reconcile. This is especially evident as Eritrean and Ethiopian cultures are community oriented, and failing to meet cultural expectations or losing community exacerbates mental health issues. This is especially evident for women whose kids have passed away in which many mothers will pass away shortly following as their lives completely concern their children (Leila, 53).

How Eritrean and Ethiopian communities distinguish signs of mental health issues

The second emerging trend concerns the consequences accompanying the communities’ limited access to resources and knowledge on mental health. Men dealing with mental health issues are known to isolate themselves by overworking or avoiding the home in order to avoid confrontation or their problems (Nahom, 57). This is heightened for low-income, sole providers men who work 16+ hours to ensure their family’s stability. For men without mental health issues, working two-three jobs and avoiding the home is a tactic used to avoid their depressed wives, as explained by Nahom (57) working allows men to ignore household tension. The second emerging trend following this discussion concerns domestic abuse and marital paranoia stemming from men’s unresolved mental health issues. In order to gain control, men physically or psychologically abuse their wives (Kevin (56) and Nahom (57)), cheat, or even accuse their partner of cheating (Nahom, 57). Lastly, men display signs of increased interest in illicit activities including gambling or addiction (Kevin (56) and Liela (53)) or adopting extreme religious or political ideologies (Nahom, 57) as a means of distraction. 

For women, the female respondents described signs of mental health issues as increased distance from their family or community and/or refusing to get ready (Sabrina, 32). From the male perspective, however, men view increased household ‘nagging’ as a clear sign their partner is dealing with depression or anxiety. Temesgen iterates this idea by saying “as a man you get annoyed because you don’t realize its’ mental health so you lock yourself out, but if we knew differently we would deal with it differently.” This contradicts the female perspective in which ‘nagging’ is believed to be a last resort to increase their husband's household support (focus group one).  

Communal solutions

This section discusses the actions deployed by Eritrean and Ethiopians to address mental health concerns, individually and communally. General trends, as discussed by Nahom (57) and Kevin (56), include increased faith in religious beliefs, ignoring signs and persevering through trauma, increased substance abuse or gambling and escaping through children/ caretaking or work. These trends are largely explained by the communities unwillingness to receive professional support through therapy or similar resources (Kevin (57) and Leila (53)). Overall, we can see however that the solutions of self-regulation and support reveal the effects of limited knowledge and resources as their solutions offer temporary, insufficient, or outdated means. For example, when providing a hypothetical scenario about a woman (Sabrina) displaying signs of depression, the women in focus groups one, two, and three advised Sabrina to go shopping, spend more time with family and friends, exercise, or take medication. And although these solutions offer relief, women dealing with (postpartum) depression, anxiety, and PTSD need more than community involvement. As discussed in literature, Eritrean migrants with limited access to mental health support are victims of violent systems exacerbating their oppression. And although each group further responded with "get professional help" (focus group one, two, and three), the participants were unable to offer additional advice as they were unaware of what professional help entailed, further stating they had never received professional mental health services (focus group three). 

Moving Forward

These respondents highlight three components to address the limited knowledge and awareness of mental health issues plaguing the Eritrean and Ethiopian community in Colorado. First, the communities need to address the fear and taboo associated with mental health as well as creating culturally safe avenues to receiving therapy. Second, the communities need confidential and credentialed support from specialists who understand the cultural nuances of Eritrean and Ethiopian people while also being able to offer support outside of religious ideology. Lastly, the communities need to understand the basic foundations (signs, strategies, triggers, etc.) of mental health which includes avenues to support their children.