People living in the United States with undocumented status often face higher rates of mental health problems but are unable to access appropriate formal care. We have spoken to experts and undocumented individuals to find out why — and what the best solutions might be.
Trigger warning: This feature mentions experiences of trauma and sexual abuse. Please read at your own discretion.
According to Migration Policy Institute estimates, there are around 11,300,000 migrants with undocumented status living in the U.S.
The institute report that about 5,944,000 undocumented migrants were born in Mexico, while 1,774,000 were born in Asian countries.
Research shows that there are many reasons why people migrate to the U.S. without going through the typical legal channels and thus wind up with undocumented status.
Past studies suggest that migrants may choose to cross borders illegally because they are unable to find gainful employment in their home countries or because they hope to be reunited with family members who have already emigrated.
Other migrants cross borders illegally to flee areas saturated in crime and violence, and some are survivors of human trafficking. These are only a few of the many reasons for illegal migration.
Many undocumented migrants live with this status for decades, trapped in a complex legal web that makes it difficult for them to obtain documentation.
This situation means that the undocumented U.S. population faces huge difficulties in accessing healthcare, including appropriate mental healthcare.
In this Special Feature, we look at the evidence surrounding mental health risks for undocumented migrants. We also explore what prevents people in this situation from accessing mental healthcare and what kinds of policy changes might help.
To enhance our understanding, we have spoken to two people who have lived in undocumented communities in the U.S.
Additionally, we have also spoken to two experts: Prof. Luz Maria Garcini, a specialist in trauma, loss, and grief among Latino immigrants at Rice University’s Baker Institute for Public Policy, in Houston, TX, and Prof. Margarita Alegría, from the Department of Psychiatry at Harvard Medical School, in Boston, MA.
Disclaimer: We have changed some contributors’ names to protect their identities.
Recent studies have shown that in the U.S., immigrants — and particularly people without documentation — face disproportionately high rates of mental health issues, compared with the general population.
In a study published in the Journal of Consulting and Clinical Psychology in 2017, Prof. Garcini and colleagues found that undocumented Mexican migrants have a significantly higher risk of developing symptoms of anxiety and depression, compared with the general population.
Data from clinical interviews with 248 people in this situation who lived close to the California-Mexico border revealed that as many as 23% met the diagnostic criteria for a mental health disorder: 14% met the criteria for major depressive disorder, while 8% and 7% reported symptoms consistent with panic disorder and generalized anxiety disorder, respectively.
Another study from Prof. Garcini and colleagues — this time published in the Journal of Traumatic Stress in 2017 — indicated that 82.7% of 248 undocumented Mexican migrants living near the border reported a history of trauma.
Traumatic events included experiencing violence, witnessing violence, or living in a context of poverty. Many participants had experienced six or more traumatic events.
Forty-seven percent of the participants met the criteria for clinically significant psychological distress. Of these, 59% had experienced domestic violence or another form of bodily injury, 56% had witnessed violence, 55% had lived in poverty, and 53% had witnessed violence toward a loved one.
Prof. Garcini emphasizes that these findings are “alarming,” adding, “The prevalence of traumatic events among undocumented immigrants in our study is much higher, compared with estimates for other U.S. populations.”
Other investigations, such as a study featured in the Journal of Social Service Research in 2019, suggest that undocumented Latina migrants have much higher rates of post-traumatic stress disorder (PTSD) than the general population.
The study, conducted with the participation of 62 Latina migrants, concluded that this group experiences an incidence of PTSD almost four times higher than that faced by women in the U.S. in general: 34% versus 9.7%.
According to one of the study authors, Carol Cleaveland, Ph.D., from George Mason University, in Fairfax, VA, the effect of trauma on these women does not appear to lessen over time, even after they have lived in the U.S. for a significant period.
“We found that time in the U.S did not lessen trauma symptoms among the women studied, a fact that is concerning, given that they typically came here to escape violence and severe poverty in their countries of origin,” says Cleaveland.
These issues extend beyond first-generation migrants. Research published in JAMA Pediatrics in 2019 found that, among 397 U.S.-born Latinx adolescents with at least one immigrant parent, around half expressed a persistent worry about whether or not U.S. immigration policy might lead to the deportation of a family member
Such concerns were associated with heightened anxiety, poor sleep, and fluctuations in blood pressure.
Why is mental distress so common among undocumented migrants and their families? The answer, specialists say, is complex.
Prof. Garcini explained to Medical News Today that people in this situation face many internal and external stressors that make it hard to cope mentally and emotionally.
There are, Prof. Garcini told us, “constant chronic stressors that [undocumented migrants] face in their everyday lives across multiple domains, including work, family (e.g., separation from family), discrimination, stigmatization, exploitation, socioeconomic adversity, and limited healthcare, among many others.”
One of our contributors, Marcela, explained how her mental health has been severely affected by factors within and outside of the undocumented community that she is a part of.
“What first comes to mind for me, regarding mental health, is the stigma that exists within the undocumented and immigrant community,” Marcela told MNT.
“When I was younger, I struggled with mental health in my family because I went to a counselor for depression and self-harm at a really young age, but at the time, my family wasn’t supportive at all. They viewed mental health as a privileged illness because, in their view, only the wealthy could afford going to therapists and counseling, while everyone else had to work for a living.”
– Marcela
“Immigration policies that came after didn’t help with this,” she continued. “When policies around DACA [Deferred Action for Childhood Arrivals] come up, my automatic sentiment is to panic for my family.”
DACA is an immigration policy that allows undocumented U.S. residents who entered the country as children to access a renewable 2-year deferment of deportation, which can allow them to apply for an official work permit.
Earlier this year, U.S. President Donald Trump challenged DACA in the S