Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Immigrants and Workers’ Compensation

An injured worker who is a refugee from South America, Mexico or Africa, there are often factors influencing recovery that are not anticipated; especially true Bosnia and similar settings. This is not solely a language barrier or difference.

These patients often carry trauma from their past lives. For example, about half of Latino immigrants to Los Angeles have post-traumatic stress disorder (PTSD), depression and chronic pain upon arrival. This high prevalence of symptoms is caused by political violence and torture prior to their arrival in the US. They enter the workforce in the U.S. with these pre-existing problems.

There is a similarly high prevalence of psychological disorder among Guatemalan refugees living in camps in Mexico. In contrast, Israeli citizens exposed to terrorism appear to exhibit relatively low rates of mental illness.

The difference between populations is due in large part to the breakdown of social support systems among refugees, who often flee to “an environment that is hostile to them.

The association between political violence and chronic pain, functional impairment and decreased health-related quality of life is substantial. Only 3% of those exposed to political violence had discussed their experiences with a healthcare provider after their arrival in the US.

JAMA 2003;290:612-620,627-642.

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