First-generation immigrants

Many adults arrive with years of experience and suddenly feel like beginners. Even simple tasks, like a phone call or a form, can take great effort in a new system and a new language.

The APA notes that immigrants with low incomes or no status often have to choose between long, low-paid jobs and chances to study or learn English. Housing, money and legal worries can stack up.

Signs you may be running on empty

• Feeling numb or always tired
• Getting sick more often
• No time for anything that brings you joy
• Snapping at people you love

Many first-generation parents feel they must make the sacrifice “worth it”. That can turn into pressure on themselves, and on their children, to succeed no matter what.

Gentle questions to ask yourself

• What did I hope for when I came?
• What have I already achieved, even if no one sees it?
• What would “enough” look like?
• Who can I share the load with?

• A call with someone who knows you well
• A meal from home, cooked slowly
• A short walk outside in daylight
• Music or prayer in your own language
• Time with your community, not only work

• Feeling unsure is part of discovering who you are, not a failure
• You can keep some traditions and let others go
• You don’t need one neat answer to “Where are you from?”
• Your identity can grow as you grow

Places to ask

• A local library, which often has free classes and help with forms
• A place of worship or cultural centre
• Call or text 211 for local services
• Neighbours or coworkers who arrived a few years before you

Many people feel excited at first, then tired and lost, then slowly more at home. The World Health Organization (WHO) says that for most people, distress after migration gets better over time.

USA Learns is a free website for learning English, with lessons in speaking, listening, reading, writing and grammar, plus a course for the U.S. citizenship interview. It is run by the Sacramento County Office of Education, and USA.gov lists it among ways to learn English.

A 2024 review found that being comfortable in the new language, and speaking more than one language, were linked with less acculturation stress.

1. When you book, say: “I need an interpreter in (your language).”
2. At check-in, say it again, or point to your language on a language card
3. If they suggest your child interpret, say: “I would like a professional interpreter, please.”
4. Speak to the provider, not the interpreter, and ask them to slow down if needed
5. If you were refused, write down the date and name, and ask how to make a complaint

The APA notes that, in general, research finds no difference in outcomes when trauma-focused therapy is done through an interpreter compared with therapy in a person’s own language.

Under a federal rule that carries out Section 1557 of the Affordable Care Act, health programs that receive federal money from the U.S. Department of Health and Human Services must follow these rules for people with limited English:

• Language help must be free, accurate and timely
• They must offer a qualified interpreter when one is needed
• They cannot make you bring your own interpreter
• They cannot rely on a child to interpret, except briefly in an emergency while they find a qualified interpreter
• An adult friend or relative can interpret only if you ask for that privately, with a qualified interpreter present, and it is appropriate

U.S. national standards for culturally and linguistically appropriate services (CLAS) also say health organisations should tell you, in writing and out loud, that language help is available.

In a 2024 study of 1,738 undocumented migrants at a clinic in Milan, Italy, two in three workers had lost job status after moving, and those who had were more likely to have a mental health condition.

The APA notes that many U.S. immigrants who start in low-status jobs struggle to move up, and that limited English is linked with fewer chances to do so.

The U.S. Department of Education does not evaluate foreign degrees. Schools, employers and state licensing boards each decide whether to accept them, often asking for a report from a private credential evaluation service, which charges a fee.

Before you pay for an evaluation

• Ask exactly which evaluation services they accept
• Ask if they need a course-by-course report
• Ask the school, employer or licensing board what they need
• Keep certified copies of your diplomas and transcripts

• Join a professional group for people in your field
• Look for a related job that uses some of your skills
• Take English classes for your profession
• Volunteer where it is allowed, to build local experience
• Write down every skill you have, not only your title

The APA notes that immigrants with low incomes or no status often face a choice between long, low-paid jobs and chances to study. Night shifts and physical work can wear down sleep and health.

Words you could try

• “Can we plan together what the money is for?”
• “I love you and I want to help. This month I can send this much.”
• “I need to keep some savings here in case I get sick or lose work.”

• Family back home may not know how expensive life is here
• Hiding money struggles from family can be lonely
• Saving for your own emergencies may feel selfish
• You may feel you can’t say no without being ungrateful

The U.S. Consumer Financial Protection Bureau (CFPB) says money transfer companies generally must show you the fees, taxes and exchange rate before you pay, and give a receipt showing how much should arrive. That lets you compare companies.

• You can generally cancel for free within 30 minutes, unless the money has been picked up or deposited
• You can report a problem up to 180 days after the money was due to arrive
• The company must investigate within 90 days

The APA notes that both immigrants and people born in a country need to adjust to live well together. Welcoming attitudes protect immigrant health.

The APA notes that it is often helpful to lean on your heritage culture at home and with people from your community, and on the new culture’s skills at school or work.

Some people blend cultures into something new. Others switch between them depending on where they are. Researchers are studying how both styles can protect mental health.

A 2024 review of 53 studies of immigrant youth found that stress can come from both directions: pressure to adapt to the new culture, and pressure from family or community not to.

Other sources of stress it found

• Family duties
• Gaps between how fast parents and children adapt
• Language barriers
• Not knowing where you fit (identity stress)
• Racism and religious stereotypes

The 2024 review found that strong ties to heritage culture were protective when stress was high. Support from family and friends, family warmth and speaking more than one language were also linked with less stress.

In the review of U.S. studies, stigma was the cultural barrier mentioned most often. Cost, language, lack of insurance, fear about legal status and not knowing what help exists also kept people away.

The World Health Organization (WHO) adds that racism and discrimination can make people slower to ask for help.

Many immigrants turn first to family, friends or faith leaders. In one study of Latino immigrants, 36% had talked to a religious leader about emotional problems.

The APA describes peer support specialists, culture brokers and community health workers, often called promotores, who come from the communities they serve. Evidence suggests they help more people get care and understand mental health.

• Ask for an interpreter so you can speak in your own words
• Start with your regular doctor, and talk about sleep, stress or pain
• Look for a therapist who shares or understands your culture
• Use words that feel right to you, like stress, worry or a heavy heart

In a 2026 study of 16 older migrants in the U.S., many described feeling “half and half”: not fully from their birth country, and not fully American. Some felt a growing distance from friends and family back home.

Researchers describe loss of status within the family, more dependence on others, and missed or changed mourning rituals as part of “ambiguous loss” for older migrants.

One older migrant said that when feelings run high, the words that come out are not English. Others described children laughing at their accent.

In the study of older migrants, volunteering, weekly routines and community involvement helped. One person said that feeling needed helped more than anything else.

What seems to help

• “Both/and” thinking: “I lost something real, and I am building something new”
• Cultural and faith practices that feel like home
• Regular contact with people back home
• Strong ties with your own community here

• Cultural festivals and heritage-language schools
• Hometown or regional associations
• Places of worship and faith groups
• Student cultural clubs
• Volunteering with newer arrivals

The APA notes that people who blend their heritage culture with their new culture tend to do better. Friends from your own community and friends from your new one can both help.

• Invite a coworker for a meal from home
• Join a class, sport or hobby group
• Say yes to one local event a month

Older migrants in one study said that volunteering and feeling needed helped their wellbeing.

WHO recommends care that fits a person’s language and culture. The Immigration & mental health guide lists therapist directories you can search by language and culture, and a worksheet for checking if a therapist is a good fit.

211 connects people with local community services, including legal aid and counseling. You can call or text 211, or visit 211.org.

Find A Helpline (findahelpline.com) lists free, confidential crisis lines in many countries. You can search by country and by topic.