Luz Garcini, a postdoctoral fellow at Rice University who studies undocumented immigrants' health, made the same journey as many of her research subjects: She fled violence in her native Mexico—without any education or knowledge of the English language—to come to the United States, where she later completed a doctorate in clinical psychology and epidemiology.
But as Garcini soon learned, not all immigrants are so fortunate. In a study published this week, Garcini and her co-authors found that 23 percent of adult undocumented immigrants living near the border are at risk for mental-health disorders, the most common being depression and anxiety.
Research has long linked the immigrant experience to poor health. Acculturation studies show foreign-born people have better mental health than native-born Americans—but the more time they spend in America, the worse off they will be. However, Garcini's work is the first of its kind to establish prevalence, showing disproportionately high rates of mental illness among undocumented people, compared to the general U.S. population.
"This is quite alarming, particularly if we start thinking in terms of, this is a population who lack access to health care, particularly for mental health," Garcini says.
Working in a psychology clinic near the border, Garcini first noticed the need for greater research into the mental health of her undocumented patients, who often showed signs of psychological distress. The symptoms were there, but not the numbers.
So Garcini set out to conduct this study, combining clinical knowledge with statistical methods. The researchers interviewed 248 well-established undocumented immigrants living in the San Diego area and found that 14 percent met criteria for depression, 8 percent for panic disorder, and 7 percent for anxiety. Drug use, however, was at levels consistent with the general population.
From this, the team could make estimates for the area's entire undocumented population of 22,000, concluding that nearly a quarter are at risk for psychological distress.
"You can imagine living under this constant stress, when you know your life could completely change if [authorities] know that you're undocumented—that you could be sent back to a country that is no longer your country," Garcini says. "It's almost like they're trapped in this constant stress and fear, having also to adjust to long work schedules because their undocumented status is not going to allow them to move up in the social ladder. These stressors eventually break their system down."
The majority of Garcini's subjects have lived in the U.S. for more than 10 years, and "made the U.S. their home," she says. But the stress of the undocumented experience—dealing with loss, discrimination, and family separation—still haunts them.
"We're talking about a very resilient population—a population that relies on their work, their spirituality, the social support of families, even though they might not be here, to deal with all this stress," Garcini says. "It's not that they're a weak population, but the stress that they face is so much bigger that I doubt any of us could take it."
In four-hour interviews with subjects, Garcini gathered accounts of chronic stress—"story after story," she says.
There was the young woman who fled an abusive father in Mexico, only to fall prey to traffickers across the border. Or the 22-year-old Dreamer with a heart condition, still waiting for a heart transplant in hospice care, who met criteria for all of the disorders in the study and is now addicted to pain killers.
"They understand that, regardless of having an education and mastering the language, and almost being like their U.S.-born counterparts, they are not," she says. "So they continue to be not second-class citizens, but third-class citizens. At some point, there's no hope for them."
Garcini is currently seeking participants for a confidential online survey through Rice to learn more about the effect of recent anti-immigration policies on Dreamers' mental health. She hopes that these numbers will prompt policy action, demonstrating the need for more health-care providers and trauma-informed systems of care—or at the very least combat dangerous stereotypes.
"The strongest post-migration difficulty that predicts mental disorders is discrimination," Garcini says. "The social political context is fueling that. So, something needs to happen."