"Land of Milk and Honey” Expectations and Mental Health Meaning-Making Among Sub-Saharan African Immigrants

Background:

Despite rapid growth of sub-Saharan African immigration in the United States, reaching approximately 2.5 million in 2024, limited research has examined culturally grounded understandings of mental health. This study explores how sub-Saharan African immigrants construct meaning around mental health within their cultural and social contexts.

Methods:

This study used an inductive qualitative approach to explore sub-Saharan African immigrants’ understandings of mental and psychological health. Participants were recruited through purposive and snowball sampling via community networks. Semi-structured interviews were conducted with sub-Saharan African immigrant adults (n = 10) in the United States via Zoom or telephone; interviews were audio-recorded and transcribed verbatim. Data were analyzed using Braun and Clarke’s six-phase thematic analysis. Data saturation was reached across interviews.

Results:

Five themes emerged from the analysis: (1) stigma-driven nondisclosure, (2) negative perceptions of the term “mental health,” (3) reliance on family and faith-based supports, (4) the “land of milk and honey” expectation, and (5) recommendations for community outreach and education.

Participants described stigma as a barrier to disclosing mental health concerns, often leading to concealment of distress. The term “mental health” was frequently perceived as stigmatizing and was described as needing reframing or avoidance in conversation.

Participants reported primarily using family members, community leaders, and faith-based supports rather than formal mental health services. Many described pre-migration expectations of the United States as a “land of milk and honey,” which shaped expectations of success and influenced willingness to disclose distress when experiences did not align with these expectations.

Participants also identified a need for community-based outreach and education, including culturally relevant messaging and use of social media to improve awareness and engagement with mental health resources.

Discussion/Conclusions:

Findings highlight how stigma, language, cultural expectations, and reliance on informal support systems shape mental health perceptions and help-seeking behaviors among sub-Saharan African immigrants. Mental health is often understood through culturally embedded frameworks that differ from dominant Western clinical models.

Stigma contributes to silence and delayed help-seeking, reflecting cultural norms that associate mental health concerns with shame and social judgment. Participants also expressed discomfort with the term “mental health,” suggesting that clinical language may function as a barrier to care. These findings point to the need for culturally and linguistically responsive approaches that reduce stigma and improve accessibility.

Reliance on family, faith, and community-based supports reflects cultural preference and strong trust in informal systems, underscoring the importance of integrating these networks into mental health outreach.

The “land of milk and honey” narrative illustrates how migration expectations shape emotional experiences post-migration. When lived realities do not align with expectations of success in the United States, individuals may feel increased pressure to suppress distress, limiting help-seeking and highlighting the need for early post-migration psychoeducation.

Overall, improving mental health engagement among sub-Saharan African immigrants requires culturally grounded, community-engaged approaches that reduce stigma, use accessible language, and strengthen partnerships with trusted community and faith-based organizations.