The mental health costs of losing DACA

The New York Times has an article in yesterday’s paper called “The Psychic Toll of Trump’s DACA Decision.” As you may know, DACA refers to the Deferred Action for Childhood Arrival program in the United States. It is an initiative pushed by President Obama with executive action, and thus which can be largely undone with executive action by President Trump. This policy has international implications as it may affect immigration to the US as well as affecting the status of people who were brought to the US from other nations as children without proper documentation and permissions.

The author of the piece, who interviewed immigrants about mental health during their dissertation research, notes:

Some studies have found that the first wave of immigrants has a better mental health outlook than subsequent generations, which researchers say results from traditional family networks and values, as well as “lower expectations for success.” But such conclusions betray a misunderstanding. As a graduate student, I have interviewed dozens of undocumented people, including first-wave adults. Most of them speak of symptoms that we might call anxiety, depression and PTSD, even if the subjects themselves do not use this language, and have less familiarity with diagnostics and less access to treatment than their American-citizen children. These studies are from a more innocent time.

All of the immigrants I have interviewed and known throughout my life seem to accept chronic exhaustion, low self-esteem, fear and panic, low moods and fits of crying as normal for the melancholic migrant struggling to subsist without being arrested. Older immigrants are at the highest riskfor mental health struggles, having aged out of manual labor, with grown children and dead parents, and being unable to receive health care.

People who were covered by DACA must have no criminal background, be doing paid work, pay their taxes, and yet are ineligible for most federal and state benefits including Medicaid and Affordable Care Act (AKA Obamacare) subsidies. This means that DACA Dreamers with disabilities have even less of a safety net than legal residents, though perhaps more than other undocumented immigrants ineligible for DACA. Their access to health care is tenuous at best and dependent on employment. Their need for mental health care is almost certainly inadequately addressed, if acknowledged: “Experts on immigrant mental health say they have already seen a spike in symptoms since President Trump’s inauguration…. It will get only worse, [Roberto Gonzalez, assistant professor of education at Harvard] said, with Mr. Trump’s DACA announcement.”

This article, and the cases the author describes, are worth reading and considering. The conclusion is pointed:

A common Spanish refrain is that dirty laundry is washed at home. But silence equals death. In lieu of comprehensive immigration reform, what can we do? Churches, community health centers and nonprofit organizations can provide referrals to bilingual therapists and conduct workshops on self-care, explaining depression and anxiety from a culturally sensitive perspective. Licensed therapists, psychologists and psychiatrists can offer care for reduced fees to low-income clients, and clinics can hire more bilingual practitioners. Teachers can check in with students from mixed-status families. All of this would be smart from a public health perspective. But it is also a moral imperative.

CODA: In general, people in precarious situations face mental health struggles and trauma. We can expect such phenomena to increase in areas battered by the recent hurricanes just as they are endemic in communities of color facing systemic racism.

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