Sunday, 19 August 2018

The Negative Health Impact of Migration Policies

The Negative Health Impact of Migration Policies
21 Apr

In a paper currently in press in American Psychologist, Torres et al. discuss the impact of immigration policies on the mental health needs of Latino immigrants, and make recommendations for improving the current situation.1

Of the 15 million immigrants from Mexico and Central America residing in the U.S., many have experienced trauma. This is not surprising, given that political, community, and domestic violence are prevalent in both Central America and Mexico.

According to a 2016 study, about “half of all Latino immigrants have experienced at least one form of trauma before arriving to US.”2

But people do not experience trauma only during the pre-migration phase (i.e. in their home country). Some are exposed to dangers on the way to the new country. For instance, many women from Mexico and Central America are kidnapped and sexually assaulted during their journey to the U.S.

Once in U.S., some might experience additional traumas, but more importantly, as this paper argues, the majority will experience conditions that worsen their previous traumas, conditions in part created by biased immigration policies.

Impact of U.S. immigration policies

Some US policies create a “hostile and discriminatory environment” for Latino/a migrants—many of whom have already experienced traumas—but in general, for all Latino/a individuals regardless of their documentation status.

Torres et al. review various immigration policies—starting with the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, all the way to policies laid out by the current administration, finding that many of them support hostile and discriminatory treatment of immigrants.

Discrimination (or perceived discrimination) is one of the main reasons that longer residence in U.S. is linked with increased mental health problems among immigrants.3

Discrimination also contributes to poverty. Presently, 20% of all immigrants live in poverty, but the percentage of Latino/a immigrants residing in poverty is 30%—almost 60% live in “near poverty.”1

Discrimination and poverty are exacerbated by the mistrust of government, and by fears and uncertainties regarding potential deportation.

Deportation “significantly damages long-term mental health among children, many of whom are U.S. citizens, and is undoubtedly traumatic across the family.”

Lastly, immigrants also face obstacles to accessing care. Even assuming that an immigrant is eligible for services and is willing to trust government service providers, her access to care could still be limited by numerous barriers such as cost, stigma, lack of knowledge of resources, language barriers, unavailability of culturally sensitive services, etc.

In summary, Torres and colleagues claim that a number of US policies have “significant negative mental health-related implications” for immigrants. That “Discrimination, limited access to services, poverty, fear and distrust, detention and deportation, and family separation increase the risk for poor mental health functioning among immigrants who may have already experienced traumas before and/or during the migration process.”

Implications for clinicians, researchers, and advocates

Torres et al. argue that there is need for certain community services, such as additional bilingual providers, culturally sensitive assessments, and treatments informed by evidence and adapted for use in migrant populations.

The authors believe that clinicians who treat migrants need to take on additional roles, such as helping immigrants learn how to access health services or locate needed support resources (e.g., family and youth programs, legal services), etc.

Mental health providers can also get involved with schools—which are sometimes yet another setting where immigrants are discriminated against—helping to turn schools into welcoming and supportive environments.

In what way can research contribute to improving the current situation?  Research that evaluates the “cumulative impact of the many policies that lead to discrimination, fear, poverty, family separation, and a lack of services, can make strong claims about policy changes needed to improve mental health and well-being for immigrant parents and children.”

Research on supportive policies is important too. We need to learn more about positive policies that help immigrants integrate into the society, and how they impact immigrants and their communities.

Advocacy is another area that requires a greater involvement of psychologists.

For example, psychologists can assist in translating psychological findings into better training of the “front line” people working with immigrants (e.g., school staff, physicians, etc).

Furthermore, psychologists can help shape public policies, policies that provide additional legal routes to migration and permit “authorized employment, protection from workplace discrimination and other abuses, and broader access to public benefits.”

Such policies would reduce discrimination and fear, and improve the well-being of immigrant families.


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