Mental Health Service Utilization Among Eastern European Immigrants: Armenian and Ukrainian Perspectives

Background and Purpose: The United States hosts one of the world's largest Armenian diaspora populations, with an estimated 1.2 million Armenian Americans primarily living in California and the Northeast. Similarly, over one million Ukrainian-born individuals. These communities have grown significantly in recent years due to new waves of forced displacement: the 2020 Second Nagorno-Karabakh War displaced more than 100,000 ethnic Armenians from their homeland, while the 2022 Russian invasion of Ukraine triggered Europe's largest refugee crisis since World War II, displacing millions. Mental health stigma is strongly present in Armenian and Ukrainian communities, with both immigrant groups utilizing mental health services less often than the general population. Despite this, limited research exists exploring the relationship between cultural stigma and mental health service utilization. Therefore, the purpose of this study is to understand shared and unique culturally specific barriers to mental health services among Armenians and Ukrainians living in the United States.

Methods: A systematic search of peer-reviewed literature was performed across PubMed, Web of Science, CINAHL, and PsycINFO databases using key terms related to immigrant mental health service utilization, stigma, and cultural identity specific to Armenian and Ukrainian populations. Thematic analysis identified recurring patterns and themes across communities, and examined how culturally-embedded values function as barriers to or facilitators to mental health service utilization.

Results: Three culturally-embedded pillars emerged as central to mental health stigma across both communities: (1) family expectations that prioritize collective resilience and strong generational responsibility over individual vulnerability; (2) faith-based perspectives that frame psychological suffering in moral or spiritual terms, positioning mental health challenges as matters of familial or spiritual weakness; and (3) a strong imperative to preserve cultural identity, rooted in historical displacement, that may position formal help-seeking as a departure from communal values. In the Armenian context, diaspora and genocide-related intergenerational trauma reinforced reliance on family, faith, and cultural preservation as primary coping mechanisms. Among Ukrainian immigrants, cultural stigma and mistrust of providers led individuals to turn to family, community, and faith for support or to self-medicate using alcohol, narcotics, and/or other substances rather than seek professional services.

Conclusions and Implications: When immigrant and refugee communities cannot access mental health services, their participation in civic and social life diminishes, weakening the inclusive participation in the community as a whole. These findings highlight the need for culturally-responsive mental health interventions that account for the specific historical and cultural experiences of Armenian and Ukrainian immigrant populations. Social work practitioners can address these barriers by fostering open dialogue within families, challenging faith-based misconceptions, and developing services that align with community values while simultaneously promoting access to care. Findings also have the potential to inform recommendations for community-based outreach and culturally adapted psychoeducation within Armenian and Ukrainian immigrant organizations. Policy advocacy for culturally and linguistically appropriate mental health programming is essential to reduce disparities and ensure that immigrant communities can fully and equitably participate and thrive in the United States.