Prior to even leaving her country of origin, Mila was worried about how her children would be affected after seeing their father killed in the civil war. Their impoverished background made it difficult to migrate to the U.S., and Mila herself was twice assaulted when she tried to bargain deals. She hoped their arrival to the U.S. would bring peace and stability, but their inability to afford mental health treatment, undocumented status, and lack of community left them without support. Mila watched her kids tumble into depression and anxiety, and she herself constantly feared men in the facility. Scared and alone, they were left vulnerable and helpless.
Around 51 million people in the U.S. experience mental illness each year. Refugees, immigrants (especially those undocumented), and people of color face increased exposure to unique stressors that can result in a higher incidence of mental illness: migrants are 42% more likely to have depressive or anxiety disorders as compared to non-migrants. Many of these stressors are associated with resettlement, acculturation, social isolation, racism, poverty, trauma, and more.
Children, being in their biologically and psychologically formative years, may be especially vulnerable to these stressors. For example, young migrants may face difficulties in school, in adjusting socially and linguistically, even in experiencing discrimination. This can lead to low self-esteem and poor coping mechanisms, and often, suicide and depression. Harmful immigration policies have exacerbated these traumas. From the Trump administration’s “Zero Tolerance Policy” that separated almost 2000 children from their parents to rampant sexual abuse in ICE detention and immigrant youth facilities (over 4500 children reported sexual abuse between in these facilities 2015 and 2019), the government’s inhumane treatment of migrants has directly exacerbated trauma and mental illness.
Additionally, child poverty (faced by 25% of immigrant children as opposed to 17% of non-immigrant children) is so severe that it’s considered a disease due to its deleterious effects on cognitive development, doubling the chances of developing a mental illness by adulthood.
Furthermore, the multitude of reasons that may have caused immigrants to leave their native country may also be traumatic and linked to PTSD, anxiety, and depression. At the California-Mexico border, around 1 in 4 migrants met the diagnostic criteria for a mental health disorder.
There is limited data published regarding the extent to which immigrants have access to mental health services; however, federal policies have increased obstacles to accessibility. The Public Charge rule (which allowed the government to reject green card applications from immigrants who relied on public benefits, and has only recently been revoked by the Biden administration), left 1 in 4 immigrants avoiding public programs, including (mental) health resources. Additionally, an estimated 4.1 million people are ineligible for the Affordable Care Act (healthcare reform that extended insurance coverage) solely due to their immigration status.
Additionally, immigrants often face linguistic and cultural challenges to obtaining treatment. Some patients may avoid treatment due to negative cultural stigma regarding mental illness. Many require the access to interpreters and value providers’ respect for traditional health beliefs and social services during their visits. If these requests prove unattainable, patients may not follow through with their appointments or seek treatment at all.
Keipo Hui, a Chinese semi driver from NYC, faces additional barriers to seeking mental health care from his occupation. Driving his truck around 14 hours a day leaves him in constant isolation, with only one day a month at home with his family. His depression has been addressed and he’s been prescribed medication, but he is unable to take it because it could cause him to fall asleep as he’s driving. The stigmatization around mental health in Asian communities adds an additional barrier to immigrants like Keipo in seeking psychological treatment.
Not only do these untreated mental health issues create suffering for these individuals, but they also cause many immigrants to cycle through the criminal justice system. In some states, the criminal justice system offers mental health services (more than 50% of inmates have a mental health issue), but it is not guaranteed. Moreover, abuse and trauma faced by individuals in prison/detention exacerbates mental illness. Then, as soon as an individual is back on the streets, they often fall back again into adverse situations (often due to their untreated illnesses), where resources are unattainable and the risk for deportation is high.
The COVID Compounding Effect
Mental health awareness is important now more than ever due to the continuing challenges with the COVID-19 pandemic. In the past year, 4 in 10 Americans reported symptoms of anxiety or depressive disorder compared to the 2 in 10 experiencing mental illness in 2019. As the pandemic wears on, the prior list of mental health challenges only grows.
Social isolation may have exacerbated prior feelings of loneliness, especially for new immigrants who may not have sufficient social support and are away from their family, friends, and native cultures. Nearly 3 in 10 immigrant households lacked access to personal broadband internet at home in 2018. The percentages were higher for low-income immigrant households with around 4 in 10 households having no internet connection at home. While it might be easy for some to use video calls to stay in touch with family and friends, many immigrants could not.
Adding to the increased stress and trauma caused by the pandemic, discrimination and racial violence have also increased. Hate crimes targeting the Asian-American community in major U.S. cities rose by over 150%.
The long term psychological effects of the pandemic will remain unknown until time progresses and the opportunity for greater studies are available. All we can do for now is to increase access to resources for those in need. The Biden administration has notably introduced a pathway to citizenship for 11 million people in the U.S. and continues to work on changing law around family separation and the border policy. Uncertainty in bipartisan support and greater demands to address the growing migrant populations on the border are only two of the challenges that the administration faces. Immigrant advocates continue to pressure President Biden and Congress to accomplish more on border detention facilities, unaccompanied minors, and expanding COVID relief bills to include immigrants as benefits recipients.
Resources
CIANA can help connect you with health resources and public benefits available to you, regardless of your financial need or immigration status. Please call or email us at (718) 545-4040 or info@cianainc.org if you need assistance.
Here’s a list of resources that might be helpful to you:
New York Affiliations:
National Suicide Prevention Lifeline: 800-273-8255
NY Project Hope: Crisis Services Hotline (English and Spanish).
Mental Health Resources for Immigrants in New York: This compilation is provided by DocumentedNY and includes agencies that offer low cost options to mental health services. (Many are offered in English and Spanish).
Mental Health Resources by Region: Provided by the Center for Human Rights at Weill Cornell Medicine.
General Resources:
Immigrant Child Health Toolkit: Offers general questions for trauma screening and mental health assessment factors, treatment strategies.
Mental Health America: Staying Mentally Healthy: MHA offers interactive assessments to get personal insight on your mental health, they also offer a number of guides for bringing healthy living into various aspects of your life.
Psychology Help Center: The American Psychological Association provides both COVD-19 mental health resources as well as numerous advocacy plans to champion future campaigns.
Informed Immigrant: Search for different resources and therapists near you.
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