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Tuesday, June 06, 2023

Talking about mental health disparities in undocumented communities

Mental illnesses are colorblind, but the barriers to treatment aren’t. Previously, I wrote about some of the ways that immigrant communities were disproportionately affected by mental illnesses, which made me interested in our undocumented population in the United States. Roughly 10 million strong, they live in perpetual fear and anxiety, often without any sustainable way of getting professional help. Most conversations thus far have been focused on how to eliminate overt barriers to healthcare, but for this community’s sake, more needs to be said about eliminating the underlying psychosocial barriers. 

In a study observing students from the University of California Irvine, researchers found that a person’s undocumented immigration status is often the largest barrier to seeking out counseling services. Participants were quoted as saying that even getting treatment would ultimately be futile because it would not change their status.

This isn’t a sentiment in isolation either. Growing up in one of our nation’s hotspots for immigration, it’s one that I saw frequently. Living in Miami allowed me to grow up with the pleasure of having a third of my friend group be undocumented. Often it was their perspective on modern issues that I valued the most. Today, their viewpoints will contribute to this conversation on what we need to be doing differently to address the mental health needs of vulnerable communities. 

My first friend, we’ll call him Santiago, came to the US by car when he was 8-years-old. In senior year, when we were both due to start applying to universities, his older sister told him that he was undocumented and that he would have to be careful in sending out applications as a result. There was a time when he was pulled over for a broken taillight and faced a terrible panic attack, thinking the officer might report him to Immigration and Customs Enforcement. These attacks became a regular occurrence, but treatment was out of the question.

“In my mind, I wasn’t going to risk everything my parents had been through just to make it easier on me,” he said. 

Carmen is a friend who was able to attend counseling despite her undocumented status, but the process was not easy. Without insurance, she had to pay hundreds of dollars out of pocket for sessions. Even though the sessions were comforting in the beginning, she eventually stopped going.

“My counselor just didn’t get it,” she told me. “He gave me advice that would have been great for anyone else, but in the situation that I was in, with my status, it just wasn’t applicable.”

Having mental health professionals that can provide culturally competent care seems to be one of the most critical points that both friends agreed should be a top priority, and is it supported in undocumented Mexican communities and by research in undocumented student communities as  mentioned above. 

While issues like access to insurance are important to address when considering undocumented access to healthcare, both participants agreed that it was the service structure of the treatment itself that needed to be addressed. To that end, movements like the “Respectful Model,” coined by Dr. D’Andrea and Dr. Daniels, which provide a framework for culturally competent care, serve as useful foundations to build upon for the future. 

Looking at this issue as a student from UF, it’s clear that we need to be doing more, too. An earlier study called for campuses to establish group mental health spaces for their undocumented students. These support groups would be facilitated by professionals, while hopefully relieving some of the psychosocial barriers that come with more formal services. I could not find any that are already around, so if anybody is interested in moving this project forward with me, please feel free to reach out.

Matthew Diaz is the president of the Indigenous-American Student Association


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