The experience of migrant mothers of African origin in Spain: A human rights-based approach to mental health

Received: 16 December 2024 | Revised: 16 December 2024 | Accepted: 27 December 2024 DOI: 10.1002/ajcp.12798 ORIGINAL ARTICLE The experience of migrant mothers of African origin in Spain: A human rights‐based approach to mental health Virginia Paloma 1 |Julia Jiménez‐Ceballos 1,2 |Tatiana Duque 1 | Daniela E. Miranda 1 1 Department of Social Psychology, Universidad de Sevilla, Seville, Spain 2 Spanish Red Cross, Alcorcon, Spain Correspondence Virginia Paloma, Center for Community Research and Action at the Universidad de Sevilla (CESPYD), Departamento de Psicología Social, Facultad de Psicología. C/Camilo José Cela, s/n, 41018‐Sevilla, Spain. Email: [email protected] Funding information MICIU/AEI/10.13039/501100011033/and ERDF/EU; Universidad de Sevilla's Office for Development Cooperation; MICIU/AEI/ 10.13039/501100011033/and ESF+ Abstract Migrant mothers of African origin (MMAO) face multiple situations of vulnerability in receiving societies, with implications for their right to the highest level of mental health. This study examines the intersecting social determinants that shape the experiences of suffering and well‐being expressed by MMAO engaged in transnational motherhood in southern Spain. Sixteen MMAO users of the Spanish Red Cross participated in individual interviews and photovoice‐based group sessions. The qualitative results show the existence of an interconnected web of six key human rights that are often violated, which impact the mental health of the MMAO. Specifically, MMAO frequently refer to their rights to (a) legal status, (b) access to decent work, (c) family reunification with their children, (d) enjoying supportive social networks in terms of transnational relationships as well as relationships with other MMAO in the receiving society, (e) maintaining their cultural and spiritual roots, and (f) self‐ determination as a way to ensure their mental health. This proposal contributes to the literature by offering a human rights‐based approach to the mental health of a population that is particularly sensitive to the intersectionality of oppression and by offering recommendations for ensuring the right to the mental health of MMAO in receiving societies. KEYWORDS Africa, human rights, mental health, migration, motherhood, social determinants of mental health Highlights •The right of migrant mothers to the highest level of mental health must be guaranteed. •The mental health of migrant mothers depends on an interconnected web of six key human rights. •Human rights violations have a negative impact on the mental health of migrant mothers. Immigration status affects mental health through many mechanisms derived from coping with inequitable structural, social, political, and economic forces that create hierarchies of power in receiving societies (Castañeda et al., 2015; Lomax et al., 2022). This social gradient of privilege creates disparities in exposure to risk and protective factors, with implications for mental health (Shim et al., 2014). Thus, people at the bottom suffer disproportionately from poor mental health and common mental disorders (Allen et al., 2014). In particular, migrant mothers of African origin (MMAO) face multiple situations of vulnerability—among stressors of migration and motherhood—during displacement and after arrival at their destination (Benza & Liamputtong, 2014). Several studies have found a high Am J Community Psychol. 2025;75:409–420. wileyonlinelibrary.com/journal/ajcp | 409 This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2025 The Author(s). American Journal of Community Psychology published by Wiley Periodicals LLC on behalf of Society for Community Research and Action. prevalence of anxiety, depression, psychosomatic disorders, or posttraumatic stress disorder among these women in receiving societies (e.g., Kaufmann et al., 2022). In this paper, mental health is defined as “astateofwell‐being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”(WHO, 2021,p.1).Theimportancegranted to MMAO's mental health comes from its influence on one's physical health, relationships with others, productivity achieved at work, and social cohesion within local communities (Friedli, 2009). Faced with this situation, the state is responsible for guaranteeing MMAO their right to the highest possible level of mental health. In this sense, the United Nations (2019)claimsthat“states have a tripartite obligation to respect, protect, and fulfill the right to mental health, […] [it] requires states to ensure policies, laws, and practices that do not hinder the promotion of mental health or well‐being, particularly for those in the most disadvantaged situations”(article 18). The WHO Comprehensive Mental Health Action Plan 2013‐2030 also calls on states to provide comprehensive, integrated, and responsive mental health and social care services in community‐based settings, using a human rights and intersectoral framework (WHO, 2021). However, the MMAO can fall through the cracks, as they are part of the group of migrant mothers coming from the Global South who are largely ignored by mental health programs in the Global North (Trovão et al., 2017). In addition to the multiple challenges they face as migrants (e.g., language barriers), the MMAO also face specific challenges related to being mothers, being racialized, and having low economic resources. Thus, the MMAO face additional stressors such as the lack of support networks for parenting, the difficulty of accessing decent work that allows them to balance family life, the lack of access to community resources that meet their and their children's specific needs, or the difficulty of accessing housing that allows them to provide a stable and safe home for their families (Aubé et al., 2019; Olukotun et al., 2023). Therefore, it is necessary to properly understand the MMAO's psychological experience and guarantee their right to mental health in receiving societies. Although mental health needs to be understood less in terms of individual pathology and more as a response to social injustice (Friedli, 2009), mental health studies and interventions have traditionally placed stress on individual‐ focused issues. This narrow vision “depoliticizes the experience of emotional suffering and fails to address how racism, discrimination, poverty, and inequality profoundly contribute to the development of mental health conditions” (Herrawi et al., 2021,p.52‐53). To overcome this and offer evidence on the benefits of taking a human rights‐based approach to mental health, this study aims to examine (a) the experiences of suffering and well‐being expressed by MMAO and (b) the intersecting social determinants of mental health that shape their experiences of suffering and well‐being as displaced mothers engaged in transnational motherhood in southern Spain. Next, a human rights‐based approach to mental health is introduced, and the literature linking migrant motherhood with mental health is reviewed. Then, the qualitative method used to achieve objectives is described. Finally, the results are presented, and the scientific contributions and social implications to ensure the mental health of MMAO from a human rights‐based approach are discussed. A human rights‐based approach to mental health The dominance of the biomedical model and the industry's influence on the mental health field have led to an over‐emphasis on intra‐individual treatments at the expense of the social determinants of mental health (Cosgrove & Shaughnessy, 2020). In the current context of neoliberal policies, Herrawi et al. (2021) argue that “advocating mainly for the increased provision of psychological services and/or psychotropic medications in response to the dehumanizing conditions that immigrants face is an insufficient response”(p. 56). Understanding the mental health of MMAO through a biomedical model ignores the multiple challenges and inequitable conditions they face at different points in their journey and their destinations, placing the responsibility for their mental health status on the migrant mothers themselves. Based on the above, some authors call for a new approach to address the social determinants of mental health and mental health inequities (Woods‐Jaeger et al., 2020). The social determinants of mental health are “those conditions in which we are born, grow, live, work, and age that have an impact on our mental health and are shaped by the distribution of money, power, and resources in society”(Shim et al., 2014,p.18).Forexample,discrimination, residential segregation, food insecurity, poverty, unemployment, lack of social networks, and poor access to healthcare or education have been identified in the literature as social determinants that need to be addressed to guarantee the human right to mental health (Lomax et al., 2022; Maker & McSherry, 2023; Shim & Compton, 2020). Most social determinants are also identified as matters of human rights, including the right to food, housing, work, education, participation, nondiscrimination, privacy, access to information, or freedom of movement (Drew et al., 2005;Maker & McSherry, 2023). Failure to fulfill these human rights has a detrimental impact on mental health—as a human right in itself, with mental health depending on multiple factors within an interconnected system (Drew et al., 2005; Satcher &Shim,2014). Mahomed (2020) concludes that a human rights‐based approach to mental health is both effective and necessary to address structural violence in receiving societies and its impact on mental health. 410 | AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License Migrant mothers' mental health in receiving societies Several studies have found that migrant mothers are at high risk for mental health problems, with depression, anxiety, psychosomatic disorders, and posttraumatic stress disorder being the main mental health challenges they face in receiving societies (Kaufmann et al., 2022; Mayer et al., 2020; Roze et al., 2020; Stewart et al., 2017; Trovão et al., 2017). In the case of transnational motherhood, the literature has found high levels of guilt, depressive symptoms, and emotional distress among migrant mothers who face long‐term separation from their children, undermining their mental health (Li, 2023; Pineros‐Leano et al., 2021). In addition, there is evidence of how the psychological well‐being of migrant women has decreased more than that of men since the start of the measures adopted to combat the spread of the COVID‐19 pandemic (e.g., closure of schools), which imposed a mental burden specifically on migrant mothers (Garrido et al., 2023). We argue that the negative psychological symptoms found in these studies must be seen as “normal”consequences of living in challenging receiving contexts characterized by multiple human rights violations (Martín‐Baró, 1986). For example, migrant mothers from Haiti who settled in Chile expressed how they suffer discrimination, economic adversity, language barriers, loss of significant networks for parenting, and lack of knowledge about the functioning of the Chilean health system. This affects their mental health as mothers, which is aggravated by the fact that they feel challenged by the expectations that the existing model of motherhood in the destination country—differentfromthatoftheircountry of origin—imposes on them (Carreño et al., 2022). Similar findings were reported by Del Villar‐Toribio et al. (2024) in Spain, where Senegalese migrant mothers expressed how child‐rearing has a stronger collectivist component with extended family care networks in the country of origin compared to its more individualistic nature in the destination country. This loss of involvement in support networks is also accompanied by a loss of social status, as they are no longer recognized as carers of other children, with the authority that this implies in their community. By contrast, in the receiving society, they have to face alone an overload of care that is difficult to reconcile with the precariousness of their work. All this has a negative impact on MMAO's mental health. In any case, migrant mothers often develop resilience in coping with this adversity by building their own supportive networks of family and friends, both locally and back at home; maintaining their cultural and spiritual roots to preserve their sense of identity; cultivating their individual strengths (e.g., agency, hope); and drawing motivation and inspiration from their children to maintain their mental health status (Aubé et al., 2019). Based on the above, this study aims to identify the intersecting social determinants that shape the experiences of suffering and well‐being of MMAO who have left their children behind and who experience family separation in southern Spain from a human rights‐based approach. METHODS Contextualization In 2023, almost 52000 migrants—4% of them women— entered Spanish territory irregularly through its coasts with cayucos or pateras, an increase of 86% over the previous year (Ministerio del Interior, 2024). The migration of women of African origin to Spain by sea—mainly from Senegal, Gambia, Ivory Coast, Morocco, and Algeria—is motivated by the desire to access the European labor market and improve the living conditions of their families. Women may also migrate to Spain to access international protection systems because they have suffered various forms of gender‐based violence in their countries of origin (CEAR, 2024). They may also be victims of human trafficking, which forces them to migrate in conditions of extreme vulnerability and abuse, in one of the main trafficking routes across Sub‐Saharan Africa to Morocco and then to Spain (UNODC, 2022). Once in Spanish territory, these women are characterized by a lack of documentation that would allow them to be identified, or documentation that would allow them to reside in Spain regularly; a low level of education, many of them illiterate; a lack of knowledge of the language of the destination country; a lack of social support networks to assist them; and low self‐esteem and difficulty in recognizing their own strengths (Spanish Red Cross, 2024). Moreover, many of these women are pregnant, caring for children, or engaged in transnational motherhood. Spanish society has historically been open to cultural diversity, but recently, an extreme right‐wing party with a clear anti‐immigration discourse has appeared on the political scene and represents 12.4% of the Spanish government (Iglesias‐Pascual et al., 2021). Despite this, the Government of Spain supports a Humanitarian Care Program to provide first aid to migrants entering Spanish territory by sea (Ministerio de Inclusión, Seguridad Social y Migraciones, 2024). As part of this Humanitarian Care Program, the Spanish Red Cross manages reception centers specifically designed for migrant women who arrive through the coast in a situation of high social vulnerability. These reception centers, located in the south of Spain, carry out a series of actions to offer them a first humanitarian response: (a) housing, providing them with a safe space in a reception center where they can temporarily reside; (b) food, ensuring basic nutritional needs; (c) basic necessities, such as clothing, blankets, personal hygiene kits, or cleaning products; AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY | 411 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License (d) medical care, facilitating access to healthcare to treat possible illnesses or injuries; (e) psychosocial support, providing psychological support to accompany the process of trauma and other mental health conditions; and (f) education, promoting formative learning and personal development (Spanish Red Cross, 2024). Participants Our research group established a collaboration agreement with the Spanish Red Cross for this study. This community partner was key in co‐creating a culturally responsive, community‐based data collection process and gaining access to participants. Sixteen MMAO participated in this study through their involvement in in‐depth interviews and photovoice‐based group sessions. Our community partner selected participants based on the following inclusion criteria: (a) being a migrant woman from Africa, (b) being a mother, and (c) being a user of one of the reception centers managed by the Spanish Red Cross in southern Spain. Six migrant mothers were from Senegal, three from Ivory Coast, two from Morocco, two from Gambia, two from Nigeria, and one from Algeria. Their ages ranged from 21 to 52 years old (M= 34). Fourteen of the participants reported having been victims of some form of gender‐based violence: seven had suffered violence at the hands of their ex‐partners, four had suffered female genital mutilation, one had suffered forced marriage, one had suffered vicarious violence, and one had suffered persecution. All had left between one and four children in their country of origin and were currently engaged in transnational motherhood. When they participated in this study, they had been residing in the reception center for one to 5 months. To protect the participants' identities, their names were replaced by pseudonyms with the names of African gemstones. Instrument The data collection for this study was based on two complementary qualitative techniques to approach the mental health of the MMAO during the exercise of their transnational motherhood in the receiving society. First, an in‐ depth individual interview was conducted with each participant, lasting approximately 1 h. The interview explored aspects related to (a) the participants' mental health (e.g., How do you feel?), (b) the social determinants of their mental health (e.g., What difficulties do you encounter in having a satisfying motherhood? What do you rely on to cope with adversity, what helps you to keep going as a mother?), and (c) their proposals for improvement (e.g., What could be done to make you feel better as a woman and as a mother?). Second, 8 weekly photovoice‐based group sessions were held with all the participants (each lasting two to 3 h). The first six photovoice‐based group sessions started with a reference question: (a) What does it mean to you to be a mother? (b) What are the biggest challenges to raising your children as you want? (c) What do you rely on in your day‐ to‐day life to make you feel better as a mother? (d) How would you describe your mental health? (e) What future do you want for yourself and your children? and (f) What would help you raise your children and feel better? Participants then took photos to answer the question based on their own experiences. Back in the group, each participant shared her personal story through the photos she had taken. Finally, an exercise was conducted to select the photos that best represented the feelings of the group, creating a space for group dialogue on the issues raised. Thus, photovoice allowed us to stimulate group dialogue based on photographs taken by the participants themselves (Pearce et al., 2017;Wang&Burris,1997). The last two photovoice‐ based group sessions were dedicated to the coproduction of an informative video led by the participants to make their situation visible. Both techniques—in‐depth individual interviews and photovoice‐based group sessions—were facilitated by Arabic, French, English, and Wolof interpreters as needed. The presence of interpreters was particularly important to ensure an adequate dialogue among the participants in the photovoice‐based group sessions, as they communicated in different native languages. Procedure In‐depth interviews and photovoice‐based group sessions were conducted in a psychologically safe and confidential space within one of the reception centers managed by the Spanish Red Cross, where the participants reside. Participants were informed of the study's objective, the voluntary nature of their participation, and their right to withdraw whenever they wished, without any repercussions for them. Informed consent was obtained from all participants. Ethical approval for this study was obtained from the Human Research Ethics Committee of the University of Seville (0568‐N‐23). This study focuses on capturing the narratives that emerged in the context of the in‐depth individual interviews and photovoice‐based group sessions—focusing specifically on the narratives shared by the participants rather than the photos they took. Individual interviews and group dialogues were recorded and later transcribed in their entirety. To analyze the narratives that emerged from these two qualitative techniques, we performed a hybrid thematic analysis. This analysis combines inductive coding and deductive thematization, allowing us to apply theory‐driven concepts to data‐driven themes (Fereday & Muir‐Cochrane, 2006). For this purpose, we first followed the phases Braun and Clarke (2006) suggested to analyze the narratives inductively. In this way, through a process of iterative coding of the transcribed material and by grouping narratives into similar themes, afinal list of themes was generated that captured the most representative contents expressed by the MMAO 412 | AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License concerning their mental health, their social determinants, and the connections between them. We then followed a deductive approach to place the previously identified themes under the umbrella of a theoretical framework for reasons of conceptual adjustment. Specifically, the themes identified were embedded in three pre‐existing categories (i.e., structural integration, social and cultural inclusion, and individual strengths). These categories were adapted from the proposals of the European Foundation for the Improvement of Living and Working Conditions (Bosswick & Heckmann, 2006) and the European Commission (Huddleston et al., 2013) and have been used successfully to study the mental health of migrants (Paloma et al., 2021). Research team positionality This research was based in the Center for Community Research and Action at the University of Seville (CESPYD, www.cespyd.es/en), which seeks to improve the health and well‐being of minoritized communities in southern Spain. The research team includes four women, two of them mothers (V.P. and J.J.). Two researchers were born in Spain, in an environment characterized by intellectual restlessness and concern for people in socially vulnerable situations (V.P. and J.J.), while two researchers are of Latin American origin and have experienced migration phenomena themselves (T.D. and D.M.). During the last decade, the research team has played an active role in supporting community‐driven initiatives and defending the well‐being and social justice of minoritized groups in Colombia, the United States, and Spain. This experience has promoted researchers' empathy with MMAO, to position themselves as allies in their liberation processes, and to develop a critical approach to mental health as a human right. This may have influenced how this study was designed and thus, the findings generated and presented in this manuscript. RESULTS Experiences of suffering and well‐being expressed by MMAO In general, the narratives state that being a mother is associated with experiencing feelings of well‐being. As one participant expressed, “I'm happy to be a mother, very happy. I love children; I learned to love them when I took care of my siblings' children. I felt good when I became a mother”(Turquesa, 35 years old, one child in Nigeria, 1 month in Spain; individual interview). However, the participants show how these positive feelings are altered by multiple factors related to the lack of guaranteed rights in society. This has a negative impact on the well‐being of MMAO: The change of country has affected me a lot. I'm scared, and I feel sad. I have problems in Morocco, and I can't go back to see my daughter, but I can't have her here with me either. Right now, I'm very upset inside, thinking I don't have the means to pay for my daughter's studies and her education. (Zafiro, 31 years old, one child in Morocco, 3 months in Spain; individual interview) In many cases, the negative effects on their well‐being are so profound that they cannot find the words to define what they feel, as Rubí says: “I can't express what I feel, I have no words to tell you what I feel about the distance and separation from my children. I feel devastated” (52 years old, two children in Algeria, 5 months in Spain; individual interview). Thus, transnational motherhood evokes mixed emotions in the MMAO. On the one hand, the mothers express some sense of well‐being related to reaching their destination, where they expect to have access to better living conditions for themselves and their children. On the other hand, they are overwhelmed by the sadness of not being able to share this destiny with their children. This is how Ópalo puts it: “I'm happy to be here and have a different life, but knowing that [my son] isn't here is very difficult. I feel sad that I don't have him with me”(33 years old, one child in Gambia, 1 month in Spain; individual interview). Similarly, this ambivalent experience linked to their own mental health as mothers can be seen in the following fragment: “Being a mom is difficult, but it's also tender or sweet; it's two things inside. On the one hand, it's hard because it's a lot of stress, but on the other hand, it's really lovely to be a mom”(Citrino, 32 years old, one child in Nigeria, 4 months in Spain; individual interview). This perception of ambivalence—between experiences of suffering and well‐being—is compounded when considering how MMAO must navigate receiving societies where multiple social determinants converge to impact the exercise of their motherhood. Specifically, the results show the existence of an interconnected web of six key human rights, placed at three different levels of analysis, that impact the mental health of the MMAO (see Figure 1): structural integration (legal status and decent work), social and cultural inclusion (family reunification and supportive social networks), and individual strengths (cultural and spiritual roots and self‐determination). These results are explained in detail below. Intersecting social determinants of the mental health of MMAO Structural integration This category refers to the social determinants of mental health related to acquiring rights as citizens in the AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY | 413 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License receiving society. Participants' narratives often refer to their right to (a) legal status and (b) access to decent work in the receiving society as ways to ensure their mental health. References to enjoying legal status in the receiving society as a prerequisite for having a higher level of mental health are very common. As stated by Rubí: My situation is very difficult at the administrative level; I don't have papers; for me, the main thing is to fix my legal situation, to be able to travel to see my children, to leave the country; I have lost my son on the way, but without papers, I can't do anything. (52 years old, two children in Algeria, 5 months in Spain; individual interview) It should be noted that most of the participants are in the process of formalizing their administrative situation, having applied for a residence visa or international protection with the legal assistance of the Spanish Red Cross (in the latter case, if they can claim a well‐founded fear of persecution in their countries of origin). In the first case, the competent authorities carry out a process of verification of the information provided; in the second case, individual interviews are also conducted to assess the credibility of the applicant's account. Both processes are complex and can take more than a year to complete. This means that during this waiting period, these women could not access other community resources to meet their needs and/or enter scenarios (such as the labor market) that would allow them to develop their autonomy. For this reason, access to legal status becomes a key objective for MMAO, which would also allow them to access other rights (such as housing) and improve their mental health: “If I had my documents, [my children and I] could have a house and do things for ourselves and not [receive] everything from the government. That would make me happy and help me feel better”(Citrino, 32 years old, one child in Nigeria, 4 months in Spain; individual interview). Respondents also mentioned the importance for their mental health of having access to decent work that allows them to support themselves in the destination country and to contribute financially to raising their children in their country of origin. In this regard, Tanzanita expresses: “While I'm here, I only think about getting a job so I can earn money, and with that money, I can support my children in Senegal”(43 years old, three children in Senegal, 2 months in Spain; photovoice‐based group session). Turquesa also mentions: “All I need is to get a job. If I have a job, I can feed them and buy them the things they need. If I eat, they eat. If I drink, they drink” (35 years old, one child in Nigeria, 1 month in Spain; individual interview). The participants agree that this would help to increase their well‐being: “I think I could feel calmer, easier, if I could improve my work situation over time”(Zafiro, 31 years old, one child in Morocco, 3 months in Spain; individual interview). In the same line, Agate also mentions: The step I want to take to feel better as a mother and a woman is to start working and cooking, working in the kitchen as a chef or cooking for others, and then I will be able to provide a home and a house to my family and earn money for it. (26 years old, one child in Gambia, 4 months in Spain; photovoice‐based group session) FIGURE 1 A human rights‐based approach to mental health of migrant mothers of African origin in Spain. 414 | AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License Social and cultural inclusion This category corresponds to the social determinants of mental health associated with supportive community settings in the receiving society. In the participants' narratives, common references are linked to their rights to (a) family reunification with their children and (b) the enjoyment of supportive social networks as ways to ensure their mental health. Being able to enjoy family reunification in the receiving society is a right frequently cited by participants as a prerequisite for their mental health. The negative impact of separation from children on mothers' well‐being is evidenced by the fact that many mothers burst into tears or became silent for a few minutes to calm themselves when remembering their children during the data collection process. The following excerpt captures some of these emotions: The distance is hard [to bear] because they are far away from me, and I can't take care of them. I think about how to bring them over all the time. I'm worried, and I'm always taking sleeping pills. […] They only have me, and I think a lot about when I can bring my children here to Spain. (Tanzanita, 43 years old, three children in Senegal, 2 months in Spain; individual interview) During the group sessions, one of the participants also mentioned: “What would make me feel good is to have my children together and take care of them. That's what would make me happy”(Amaranta, 34 years old, three children in Senegal, 4 months in Spain; photovoice‐based group session). While having legal status and a decent job is important and meaningful, for most participants, it is only a precondition for moving in the direction they really want to go: reuniting with their children and immediate family. It is important to emphasize that the MMAO's strategy of migrating without their children is based on careful family planning that allows them to: (a) first settle more easily in the receiving society, ensuring the sending of regular remittances that improve their children's living conditions before they can join them; (b) minimize the risks associated with a dangerous, complex, and costly migration route; and (c) familiarize themselves with the norms of the receiving society, establishing support networks and resources before facing the challenges of integrating their children into a new cultural and educational environment. The following excerpt summarizes this desire of the participants to exercise their right to family reunification, linking it to the rights mentioned earlier—legal status and access to decent work—as a way to improve their mental health: Obviously, it's a situation that worries me a lot. It makes me sad because they [my daughters] are not with me. Someday, we'll meet again. I want to feel like I have a family and feel the warmth of my family. The only solution I'm thinking about is to work, regularize my papers, and be able to regroup them here with me. (Coral, 34 years old, two children in Morocco, 4 months in Spain; individual interview). Another participant expressed this same idea in these terms: “I cannot sleep some days thinking about my children; it hurts me not to have them with me […] The problem is that I don't have the documents, and I can't bring my son here to educate him”(Espinela, 43 years old, four children in Senegal, 4 months in Spain; individual interview). In addition, supportive social networks are very important for the participants' mental health, especially in terms of maintaining a transnational relationship with their children's caregivers in the country of origin, as well as establishing relationships with other MMAO in the receiving society. First, the narratives repeatedly mention the importance to their mental health—as a buffer—of feeling that their children are cared for by their own mothers—or other close relatives—in their countries of origin. This is how Jade expresses it: “I feel reassured because my mother is taking care of my son. I'm happy because I know he's well cared for. He goes to school with my siblings and lives a good life”(29 years old, one child in Ivory Coast, 4 months in Spain; individual interview). On the other hand, it is also a source of concern when they cannot send financial support for their children and their caregivers in the country of origin: But I have to keep helping by sending money for their education and food. That's my problem now. My daughter and my mother need money to live on, and I can't afford it. My mother is the one who pays for everything. And now I'm trying to figure out what I can do. I'm worried about them. (Turquesa, 35 years old, one child in Nigeria, 1 month in Spain; individual interview) Second, the opportunity to interact with other MMAO in the receiving community provides participants with an important source of emotional support that positively impacts their mental health. As Granate says: “When I feel lonely and sad, and I think about my son, my roommates athometalktometogivemeadvice,theytellmethat 1 day, all this will end and that I have their support” (21 years old, one child in Senegal, 2 months in Spain; individual interview). In this sense, some MMAO mentioned the importance of participating in the photovoice‐ based group sessions for their mental health by connecting with other mothers in the same situation: On Fridays, when we meet with other mothers, it helps me realize that I am not the AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY | 415 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License only mother going through these situations alone. Before, I always thought about all the bad things I had, and now I try to see the good things I have, like this center and the meetings. So I'm better off than before, and I really appreciate Fridays because I feel that [the meetings] help me a lot. (Amaranta, 34 years old, three children in Senegal, 4 months in Spain; individual interview). In some cases, building relationships with other MMAO has led to forming mutual support networks in response to the structural oppressions that hinder realizing their rights. These networks have strengthened the women's self‐determination and improved their mental health. As the following excerpt illustrates: Being a mother has given me responsibility. I've always been able to meet my kids' needs. That motivated me to be part of a women's association. It's a support network made up of mothers to save money. Every ten days, we save an amount of money, and we take turns distributing it among the associates. (Espinela, 43 years old, four children in Senegal, 4 months in Spain; individual interview) Individual strengths This category refers to migrants' personal resources for coping with adversities in the new society that affect their mental health. The participants' narratives contain common references to their right to (a) maintain their cultural and spiritual roots and (b) self‐determination. The participants state that it is very important for their mental health to be able to maintain their cultural and spiritual roots in a non‐discriminatory receiving society. Thus, the possibility of deploying their cultural and spiritual practices in the destination country is a factor that positively affects the mental health of the MMAO. In the narratives, this element is presented as an important coping strategy: When I'm anxious and stressed, I try to go out, go for a walk, and, because I'm a Muslim, I pray and meditate to find the faith I need. When I'm not feeling well, I do those little things that I know can change that inner pain. (Rodolita, 42 years old, two children in Ivory Coast, 3 months in Spain; individual interview) Participants recognize that the spiritual education received at home provides them with some tools to face the challenging situations they experience in the receiving society: “My strength is my faith. I was born into a family of believers, so believing in God makes you strong”(Amaranta, 34 years old, three children in Senegal, 4 months in Spain; individual interview). At the same time, these spiritual roots help them to understand and make sense of what is happening to them, as Granate mentions: “What strengthens me nowadays is that I have faith, I believe in God. Everything that happens in my life is for some purpose”(21 years old, one child in Senegal, 2 months in Spain; individual interview). This practice is also transmitted transnationally to their children, which makes them feel psychologically good by maintaining an active parenting role despite the distance and providing them with spiritual guidance: “It makes me feel good that my children have a good religious orientation […] What I do from here is call them up in the mornings, and we pray over the phone”(Espinela, 43 years old, four children in Senegal, 4 months in Spain; individual interview). In addition, the perception of being able—or not—to exercise their right to self‐determination affects the participants' mental health. Some MMAO demonstrate a high capacity for self‐determination, clearly articulating what they want to achieve for themselves and their children, which helps them to resist oppression and fight for the fulfillment of their rights: “Yes, I don't just think [that my kids and I will have a good future], I know it. I'll make that happen; they're very smart. I just need to work hard for them to make that happen”(Turquesa, 35 years old, one child in Nigeria, 1 month in Spain; individual interview). In the same direction, Zafiro expresses: The future I want for my daughter is for her to be great, to flourish, and to be a lawyer in the future. I am going to work hard to achieve her dreams and mine because I believe that I have the strength to do so. (31 years old, one child in Morocco, 3 months in Spain; photovoice‐based group session) However, participants often find their right to self‐ determination limited over time, as it is closely linked to the violation of other rights, such as lack of access to legal status,decent work,orfamily reunification. These conditions lead MMAO to feel trapped in an interconnected web of human rights violations and unable to act to improve their current situation and that of their children, which negatively impacts their mental health. As Rubí states: It's just that my situation [lack of legal status] doesn't allow me to contribute anything or improve anything. On the contrary, [my children] are the ones who are trying to help me; they are very worried about me. I wish I 416 | AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License had my papers to give them a hand […]I can't do anything to take care of them […], and that affects me because I'm the mother. It's very hard [crying]. (52 years old, two children in Algeria, 5 months in Spain; individual interview) DISCUSSION This study aimed to examine the mental health experienced by the MMAO and the intersecting social determinants that shape their experiences of suffering and well‐being as migrant mothers engaged in transnational motherhood in southern Spain. The MMAO in our study experienced an ambivalent perception of suffering and well‐being, often shaped by being between two places at once—living in a receiving context struggling to fulfill their basic human rights, but with the expectation of being able to access better living conditions for themselves and their children, along with the pain of being physically separated from their children and their country of origin. This aligns with other studies finding significant emotional distress—sadness, hopelessness, difficulty sleeping, and sense of loss—among migrant mothers in receiving societies (e.g., Pineros‐Leano et al., 2021). Despite the diversity of motherhood experiences, we found common patterns that allow us to identify an interconnected web of six key human rights that are often violated and that help explain the experiences of suffering and well‐being found in the MMAO in southern Spain: structural integration (legal status and decent work), social and cultural inclusion (family reunification and supportive social networks), and individual strengths (cultural and spiritual roots and self‐ determination). Understanding the mental health of the MMAO through this human rights‐based approach allows us to identify the multiple challenges and inequitable conditions they face at their destinations and to highlight the responsibilities of receiving societies concerning their mental health status. Thus, this study provides evidence of how the level of social (in)justice of receiving societies is closely related to the mental health of MMAO, highlighting the fundamental role of social determinants in mental health (Paloma et al., 2014,2021). From this approach, our findings also recognize the active role that MMAO develop in their relationship with the challenging environment, especially in cultivating their supportive social networks and cultural and spiritual roots. These factors appear in the literature as important strategies of resistance to oppression among migrants in receiving societies (Buckingham et al., 2021; Del Villar‐Toribio et al., 2024). The nature of MMAO networks provides them with a source of psychological well‐being by sharing their individual struggles and aspirations with peers who find solace in mutual recognition and a source of strength in imagining a better life for their children, which justifies their migrant journey. The importance of having transnational family ties for MMAO's mental health, along with supportive connections with other migrant women in the receiving society, was also found in the context of Latina mothers in the United States (Rios‐Casas et al., 2020) and migrant mothers with diverse cultural backgrounds in Australia (Renzaho & Oldroyd, 2014). Other studies also revealed these supportive spaces' role as “affective sanctuaries”in the receiving society (Biglin, 2021). Regarding cultural and spiritual roots, our findings are consistent with other studies, such as that of Trovão et al. (2017), which emphasizes that most migrant mothers mobilize their own spiritual coping resources to address their high levels of psychological distress in the receiving society, rather than turning to mental health professionals. The results found in this study suggest that guidelines for promoting the positive mental health of MMAO require multilevel, systemic, innovative strategies to overcome the dominant individualistic view in mental health care and to address the nonfulfillment of human rights closely linked to mental health. That is, it is important to consider the structural factors that are the root causes of suffering among the MMAO, adopting “an integrated approach to mental health care that moves away from psychiatric care only”(Carta et al., 2005, p. 12). In particular, the adequate provision of services aimed at improving the MMAO's mental health requires the development of flexible community‐ based care models that maximize the strengths, resources, and advocacy capacity of the MMAO themselves to fight for their rights and the rights of their children. In our study, the Spanish Red Cross has played an important mediating role in creating spaces for the MMAO to enhance their individual strengths and supportive social networks to review their current circumstances in the receiving contexts, extending to a broader rights‐based scenario—as this study evidence. Future considerations should explore the organization's role in connecting MMAO users to other empowering community settings in receiving contexts, as this can support their right to mental health. In addition, support for realizing civil, political, economic, social, and cultural rights must be considered a mental health intervention (Mahomed, 2020). This requires establishing a collaborative intersectoral partnership for the sustainable promotion of mental health in society (Walker et al., 2005; WHO, 2022). Intersectoral partnerships that instigate processes that cocreate evidence to advocate for a just receiving context can address the multifaceted, interconnected nature of the MMAO's experiences as the existing structures become increasingly responsive to their needs (Miranda et al., 2020). Strengthening mutual recognition among peers, researchers, and care providers can support the coproduction of dissemination materials to promote the right AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY | 417 15732770, 2025, 3-4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12798 by Readcube (Labtiva Inc.), Wiley Online Library on [04/07/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License