Race and Identity Race and Mental Health Mental Health Challenges Experienced by Undocumented Immigrants By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on January 08, 2021 Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Adah Chung Fact checked by Adah Chung LinkedIn Adah Chung is a fact checker, writer, researcher, and occupational therapist. Learn about our editorial process Print FG Trade / Getty Images Table of Contents View All Table of Contents Who Is an Undocumented Immigrant? Factors Affecting Mental Health Mental Health Challenges Ecological Systems Theory Mental Health Improvements Overcoming Language Barriers Coping as an Undocumented Immigrant Why This Is Important Undocumented immigrants face unique mental health challenges as a result of the barriers that they face every day living in the United States. It's important to learn the causes of their mental health concerns, the kinds of mental health challenges that they face, and ways to help improve their mental well-being. Who Is an Undocumented Immigrant? Undocumented Immigrant An undocumented immigrant is a person who leaves their country of origin to move to another country without legal documentation. Immigrants differ from refugees, who are persons who are escaping their home countries due to war, natural disaster, or persecution. The United Nations classifies refugees as a protected group. If the country that is entered offers asylum, then these persons gain automatic legal status in their new country. While immigrants can apply to enter the United States under temporary legal status such as a work visa or student visa, there are limited numbers of opportunities for these special permits. Furthermore, some people are eligible for residency if they have a family member who is a United States citizen. Deferred Action for Childhood Arrivals (DACA) is a special program that gives temporary permission to people who arrived in the United States as children to work. However, this program can be revoked by executive action, something that was threatened by the Trump administration. Undocumented Immigrants in the U.S. There are more than 10 million undocumented immigrants living in the United States and more than 16.7 million people have an undocumented immigrant living in their household and many arrive from Mexico, Central American, and Asia. Traveling to and taking up residence in the United States involves numerous challenges that can threaten their mental health. Furthermore, due to structural barriers and other factors, many will never receive help or treatment. The anti-immigrant rhetoric that has become the norm within the Trump administration (e.g., threatening to build a wall and making Mexico pay for it or calling Latin Americans "bad hombres") has caused many undocumented immigrants to feel that they are viewed as criminals. Consequently, many endure consistent mental stress as they fear deportation. All of this, without question, has taken its toll on the mental health of this population. Factors Affecting Mental Health Undocumented immigrants face a number of unique challenges that can make them susceptible to mental health challenges. Below are some of the most common stressors that can lead to or worsen mental health problems—especially for those with pre-existing vulnerabilities. Outside Factors Harassment: Many face discrimination in the workplace and at schoolLanguage barriers: This affects their ability to speak to doctors, teachers and other professionalsLack of access to healthcare: Without benefits or documentation most cannot seek any kind of healthcareLack of education about mental health: Many grow up in a country where mental health or there is a stigma. Consequently, mental health is not discussed or is dismissed (e.g., praying might be offered as an alternative). Men, especially, are less inclined to seek help.Working in low paying jobs: These jobs often have unsafe working conditions and hard manual laborPast trauma prior to immigration: Some immigrants are escaping violence, war, and oppression in their home countriesInability to experience typical life milestones: Undocumented immigrants cannot obtain a driver's license or go to collegePoverty: Many immigrants are impoverished and have to work multiple jobs to make ends meetFamily separation: It's typical for some family members to go to the U.S. while others have to stay behind Internal Factors Living in constant fear: Undocumented immigrants fear deportation regularly even when doing routine things like going shopping or going to work. Additionally, people fear they will be shamed if they admit to needing helpFeeling isolated: Some parents may feel they are losing their children if they decide to become part of the larger American community.Loss of identity: It's not uncommon for undocumented immigrants to feel that they don't fit in with any communityFeelings of mistrust: Undocumented immigrants don't trust doctors, therapists, and other professionalsStress: Culture shock, poverty, harassment, isolation, and pressure to support family members all contribute to extreme stress Understanding Xenophobia, the Fear of Strangers Mental Health Challenges While anyone who has a pre-existing risk for mental illness may be affected, a systematic review of 40 papers showed that undocumented immigrants were particularly impacted by three mental health outcomes: depression, anxiety, and post-traumatic stress disorder. It was also shown that there was a direct relationship between immigration policies and poor access to healthcare services. Undocumented immigrants may also experience a range of other mental health effects as a result of their undocumented status, including the following: Disillusionment, despair, helplessness, fear, or hopelessnessSubstance abuseDestructive behavior (e.g., joining a gang) Children, in particular, may show the following mental health effects as undocumented immigrants: Sleep problemsLoss of appetiteLowered self-esteem and confidenceFailure to thrive How You Can Help Boost Your Child's Self-Esteem Ecological Systems Theory One way of understanding the impacts of being an undocumented immigrant on mental health is to examine the situation in the context of a theoretical framework. Urie Bronfenbrenner was a Russian-born American scientist. He is best known for the development of human ecological theory also known as the ecological systems theory. He argued that there are five different layers or levels within social or ecological environments: micro, meso, exo, macro, and chrono. Below are definitions of each of these levels and how they relate to the mental health of undocumented immigrants. Micro Level The micro level system refers to the children, parents, siblings, teachers, friends, etc. in the environment of the undocumented immigrant. Meso Level The meso level refers to interaction among the individuals within the micro level. For example, at the meso level there would be interactions between children and parents, parents and teachers, children and teachers, etc. In other words, these are relations among the undocumented immigrant and the persons immediately surrounding them. Undocumented immigrants would be affected at this level by having fewer connections than U.S. citizens. For example, a child may have fewer chances to participate in team sports and thus not make friends with other children or have other adults to look up to for advice. Exo Level The exo level refers to interactions that occur outside the meso level. For example, for a child, this might mean their parent's relationship with their boss, or teacher's relationship with the school principal. In other words, it is the relationships of someone connected to the child with someone not directly connected to the child. Interactions at the exo level can affect undocumented immigrants. For example, if a parent has a bad relationship with someone at their workplace, they might then take out their frustration at home. Interactions can also shift from one level to another. For example, a parent who must leave their child behind to go to the United States would shift from the meso level to the exo level. As a result, the relationship may shift and require repairing or rebuilding when they are eventually reunited. Macro Level The macro level is the largest and refers to the greater context of the person, including economic, political, and cultural factors. Factors at the macro level might include language barriers, discrimination or bullying, being exploited at work, financial stress, etc. as well as effects of policy change or political climate in general. For example, in 2010, those affected by DACA anxiously awaited a new policy that would remove barriers for them. However, when it did not pass, they experienced negative effects. Chrono Level Finally, the chrono level refers to changes over time. This might include leaving one's home country, being deported, etc. Understanding the impacts on the mental health of undocumented immigrants at all of these levels will help make changes to benefit this group going forward. Mental Health Improvements Considering the challenges that undocumented immigrants face living in the U.S., in regard to their mental health and well-being, change has to occur individually and at the policy level. Access to Care Access to care is a significant problem impeding the mental health of undocumented immigrants. As a result, there needs to be a system and policy level response to ensure equal access to support programs for these individuals. Overcoming Language Barriers Language barriers create a hurdle for undocumented immigrants to access care. Even if they are able to access care for mental health, their ability to express themselves in English may be limited. Given that the nature of most psychological therapy is talk-based, this presents a serious problem. Solutions include training therapists who speak their native language or offering translators or interpreters. Culturally Sensitive Care Perhaps of most critical importance to healing the mental health issues of undocumented immigrants is the promotion of culturally sensitive mental health care. This means that therapists must be aware of the unique challenges faced by undocumented immigrants, and should be willing to incorporate that knowledge into the care that is provided. Otherwise, undocumented immigrants may spend a large part of therapy trying to explain their specific situation or the challenges that they have faced. Many undocumented immigrants come to the United States in a state of distress, which is only worsened by the obstacles that they face once they enter the country. They may deal with very basic survival challenges such as earning enough money to survive or being able to go out into society without fear of deportation. In addition, they may have faced traumatic events prior to entering the United States, like violence and persecution. Understanding their mental health symptoms in the context of their larger situation will be critical to teasing out the differences between underlying mental health disorders and stress-induced symptoms. Awareness and Outreach In order for undocumented immigrants to receive access to mental health care, they need to be aware that it exists in the first place. They also need to be made aware of mental health struggles through education. There are various ways that this can be approached. One method might involve spreading awareness through religious institutions attended by undocumented immigrants. Faith leaders could provide free information and resources to help increase awareness. In addition, media campaigns could be launched in the native language of undocumented immigrants to make them aware of the services available to them. This might include passing out flyers, taking out radio advertisements, or other channels of media awareness. Undocumented immigrants also are in need of advocates who can identify them in the community to provide access and resources for care. Given that these individuals are not likely to self identify, advocates would need to look for signs such as adults without a driver's license, those who finish school but don't apply to college, or a student who has many absences from school. Mental Health Services Existing mental health services are in the best position to offer support to undocumented immigrants. Psychologists, social workers, and other mental health professionals can provide a safe space for undocumented immigrants to share their frustration and struggles. Beyond licensed mental health professionals, coaches or support groups might be a helpful avenue to address the mental health concerns of undocumented immigrants. These groups could be involved in solving the specific problems faced by undocumented immigrants that psychologists or social workers might not address in their more narrow focus on specific mental health issues. This might include help for problem-solving issues at school, issues in the workplace, etc. In addition, undocumented immigrants might feel more comfortable speaking to a coach or small group outside the typical mental health care system, for fear of being identified or deported. Legal and Policy Changes In order to protect the mental health of undocumented immigrants, legal and policy changes need to happen. These include pathways to citizenship to make it easier for undocumented immigrants to live without fear in the community, as well as policies and rhetoric that address stigma and make undocumented immigrants feel more comfortable coming forward. Community Programs Also, community resources can be put in place to help undocumented immigrants manage their mental health. These might include community programs to help connect children to mentors such as sports programs or after school programs. They might include community groups that help to validate the feelings of undocumented immigrants, such as peer support groups. In the most basic sense, community programs should be aimed at both maintaining connections among undocumented immigrants, but also providing the opportunity for undocumented immigrants to assimilate with the larger culture and feel less fear doing things that others take for granted. Coping as an Undocumented Immigrant At the same time, it needs to be recognized that undocumented immigrants will have a sense of fear living within a system that does not afford them protection or a general sense of safety. If you are living as an undocumented immigrant and struggling with your mental health, you may wonder how to cope with the chronic stress that you experience in your life. If you or someone you know is documented, below are some coping tips that can help. Acceptance It's okay to feel as though things are very hard for you. This doesn't mean that you are giving up on your situation, but rather that you will focus on the things in your life that you can control and you can change. In this way, you can feel less like a victim and more as someone who has control over their life. Be Kind to Yourself Given that you are going through an extremely difficult period in your life, it's especially important to be kind to yourself and expect that you will have times when you don't feel like trying. You are probably grieving the loss of support in many areas of your life. It's okay not to be functioning at full capacity while you are struggling. Maintain Social Connections While it might feel easier to withdraw, it's important to maintain some sort of social connections who can offer you support. That might mean your immediate family, friends, or community. It could mean joining a group or organization where you can meet other people. Social connections are important to building resilience, especially when you are under chronic stress. Build Resilience Other ways that you can build resilience are by focusing on basic survival aspects of your life, such as eating healthy food, getting regular exercise, getting enough sleep, etc. Doing the most you can to build your strength will also build your resilience. Why This Is Important The mental health challenges faced by undocumented immigrants can range from stress caused by their unique set of circumstances to diagnosable mental illness. Regardless of the specific type of mental health challenge, it is critically important that this vulnerable group receives more support and attention. Actions that can help undocumented immigrants manage their mental health will include policy changes that reduce the chronic stress associated with fear of deportation, programs to remove barriers to accessing mental health care, as well as community-level supports to provide social connection. A Word From Verywell There is a need for mental health professionals who understand the unique cultural challenges faced by this group. There is a need for psychologists and social workers who not only speak Spanish and other dialects, but also those who understand the contextual factors that affect undocumented immigrants. It's not as simple as opening up more access to care; rather, there is a need for cultural competency and sensitivity for this particularly vulnerable group. Ideally, individuals arriving as immigrants might eventually train in the mental health field, and go on to help others facing the struggles they once faced. One example of this already happening is the story of Liliana Campos, who came to the United States from Mexico at the age of 7 and later became a health educator for those falling under the Dreamers act. Campos is a member of the California Psychological Association's Immigrant Task Force and works with immigration attorneys, social workers, and other mental health professionals who are in direct contact with immigrants and refugees. Campos also works as a mental health advocate for Immigrants Rising, an organization to empower undocumented immigrants to achieve their goals. Her goal is to help these individuals understand their own issues and develop trust for healthcare professionals. 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. United Nations Refugee Agency. Protection. 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