Migration denotes a moving process that often involves shifting across a State or an international border. It encompasses the movement of persons despite cause, composition, and length, and results in displaced persons, refugees, uprooted people, and economic migrants (Bailey & Widener, 2022). There has been an increase in migrant populations. The immigrant population has increased by 49% from 2000-2017 (Lanzara, Scipioni, & Conti, 2019). The USA has a longstanding history of immigration since the only originals are Alaska Natives or American Indians. The USA enjoys a high economic strength and soft power that attracts several immigrant populations. The USA approves over one million green cards annually, and California accounts for leading permanent residency approvals. Notably, illegal immigration is a rampant issue with an increasing number of border apprehensions, including 1.87 million cases in 2021 (Ward & Batalova, 2023). Several factors contribute to the movement of people from Central America and Mexico to settle in the USA, such as push factors such as oppression, poverty, and persecution push factors driving people form their countries, while pull factors such as getting reunited with family and improved educational and employment opportunities. Mexico accounts for the highest amount of illegal immigration due to economic disparities and also due to the shared border. A growing population of immigrants and refugees experience significant acculturative stress, pre- and post-immigration trauma, fear of deportation, immigration courts and policies. This paper reviews the psychological impacts of such associated psychological impacts following an increase of immigration to the USA from citizens of Central America and Mexico.
Stressful Events and Psychological Distress Linked to Immigration Processes
The population of USA has undergone high immigration from non-European people resulting in demographic changes such as increased populations of American Indians, Asians, Latinx populations, and African-Americans due to movement of people from Middle East, Asia, East and Southeast Asia, Africa and Latin America. Majority of youth and children in USA in 2025 will be from non-European backgrounds and other minority groups (Ward & Batalova, 2023). The immigrant populations face several problems such as community violence exposure, racism, discrimination, stresses related to immigration and acculturation, poor access to physical and mental healthcare services, lack of access to education, and poverty which result in psychosocial disparities. The resultant impacts include increased mental health comorbidity including substance abuse, stress-related health problems, suicidality, depression, incarceration, disciplinary actions at school, and detention in state custody (Sangalang et al., 2019). The process of migration is often a stressful event that has potential to increase an individual risk to a broad range of adverse mental health outcomes (Lanzara, Scipioni, & Conti, 2019). Exposure to traumatizing and stressful events, migrant or refugee status, abuse by law enforcement officers, racial discrimination, forced separation or forced removal of family members, adaption to new cultures and resultant acculturate stress, predisposes patients to high level of psychological distress, somatization, major depressive disorder, anxiety and post-traumatic stress disorder (Bailey & Widener, 2022).
Pre- and Post-Migration Trauma, Acculturative Stress and Somatization
Many immigrants suffer adverse traumatic experiences, such as trauma during the pre-migration period and stress after resettlement. Pre-migration trauma contributes to acculturative stress and poor mental health (Peña-Sullivan 2020). Immigrant children have higher rates of exposure to trauma in the pre- and post-migration phases. The risk is worse among children who have been separated from their parents (Cohodes et al., 2021; Sidamon‐Eristoff et al., 2022). There is strong consensus in literature that adolescents and children entering the USA as immigrants and refugees are at risk of adverse mental health outcomes following early-life adversity, pre-migration trauma, forced parent separation and traumatic experiences during the migration process and entry into the US.
Pre- and post-migration trauma also poses a significant risk to children who constitute more than 50% of the immigrant and refugee population. Cohodes et al. (2021) focussed on children immigrating to the USA from Central America and Mexico and reveiwed the traumatic experiences before, during, and after migration, underscoring several implications for mental health outcomes in this population. Early adversity has been shown to affect future behavioral problems and is a risk factor for adolescent substabce abuse (Kirsch & Lippard, 2022). Besides, it impacts neurobiological and behavioral sequelae of trauma following migration, attachment, fear learning, emotion regulation, and extinction resulting in externalizied and internalized symptomatology (Cohodes et al., 2021). Undocumented Latinx immigrants from Central America and Mexico suffer high levels of acculturative stress, which is aggravated by early-life adversity in their country of origin, resulting in anxiety and depression in the adolescent stage and early adulthood (Peña-Sullivan, 2020). One study examined the impact of immigration trauma, immigration detention and associated with symptoms of posttraumatic stress. Of 84 children reviewed, 97.4% had at least one traumatic experience before migration and parent-child separation and remigration trauma predicted higher severity of PTSD symptomatology (Sidamon‐Eristoff et al., 2022). Another study that sampled Latinos and Hispanics in the USA revealed that the prevalence of depression and anxiety among documented and undocumented citizens (15% vs. 9%) were higher compared to those of US-born citizens, but undocumented citizens had lower use of antidepressant medications (Ross et al., 2019).
Somatization denotes a psychological response to stressful situations and events. Somatization is linked to migrant status, such as adapting or coping with poor health outcomes. The process of somatization is dependent on cultural, ethnic and religious backgrounds, reason for migration, trauma exposure and individual differences. The impact also varies based on help-seeking behavior, communication/voicing symptoms and perception of illness. Immigrants are predisposed to somatization due to higher accounts of psychological distress, negative emotions and stressful events which leads to poor mental health and diminished quality of life (Bailey & Widener, 2022). The tendency to report physical complaints also reflects overall psychological distress and symptoms of depression among immigrant populations. Lanzara, Scipioni, and Conti (2019) reported that migrant populations with somatization were more likely to report psychological distress, PTSD symptoms and have higher utilization of healthcare services. Thus, the authors hypothesized that somatization is linked to high expsoure to stressful events for migratory individuals and that correlates, and prevalence of somatization varied based on reasons for migration, expsosure to stress, cultural variation, illness, coping, and individual immigrant factors (Lanzara, Scipioni, & Conti, 2019).
Fear of Deportation, Immigration Policies, and Immigration Courts
USA has restrictive immigration policies. Immigrants face the immigration courts, which resemble civil courts that contribute to adverse psychological outcomes. Documented and undocumented immigrants undergo uncertainty regarding immigration policies and fear of getting deported beyond the everyday acculturative stress following immigration into the United States (Ross et al., 2019). Many individuals develop mental health problems following the pre- and post-immigration phases (Cohodes et al., 2021). Immigration courts pose a risk of distress for non-citizen immigrants, which can worsen the pre-existing distress following migration into a new country.
Several culturally relevant protective risks and factors have been captured in the literature. Significantly, cultural protective factors include acculturation, being culturally competent, and cultural conflict. Bailey and Widener (2022) reported challenges individuals encounter in immigration courts, including significant adverse mental health outcomes. The fear and uncertainty of being deported and uncertain futures have mental health impacts on the administration. The authors also addressed linguistic proficiency, economic stability and social support, including religion, as protective factors. Associated risks were legal status, detention, and vilification regarding racial/ethnic composition. Similarly, Bekteshi and Kang’s (2020) systematic review established a relationship between accumulative stress and acculturation among Latinos immigrating to the USA. The risk factors included leaving the family abroad, discrimination, and fear of deportation. These were mitigated by social support, economic stability, and other protective factors such as being married, having English proficiency, and having spent years in the USA. Protective factors such as family values, religious coping, and church attendance were also significant in mental health outcomes. These two studies highlight the distress related to deportation prospects, ever-changing immigration policies, and uncertainty of the future in the new country, which worsen adverse mental health outcomes.
Conclusion
The immigrant population has increased significantly over the years, with illegal immigration developing as a rampant issue with an increasing number of border apprehensions. A growing population of immigrants and refugees experience significant acculturative stress, pre- and post-immigration trauma, fear of deportation, immigration courts and policies. Community violence exposure, exposure to traumatizing/stressful events, migrant or refugee status, abuse by law enforcement officers, racial discrimination, forced separation or forced removal of family members, gang violence, fear of getting deported, facing immigration courts, restrictive immigration policies, adaption to new cultures, acculturation stress, political oppression, sexual or physical abuse, war, poor access to physical and mental healthcare services, lack of access to education, and poverty result in psychosocial disparities. Psychological impacts include increased mental health comorbidity including substance abuse, stress-related health problems, suicidality, depression, incarceration, disciplinary actions at school, and detention in state custody, high level of psychological distress, somatization, major depressive disorder, anxiety and post-traumatic stress disorder, and increased drug trafficking activity.
References
Bailey, C., & Widener, K. (2022). The nexus between immigration status, policy, and proceedings, and mental health. Current Opinion in Psychology, 47, 101411. https://doi.org/10.1016/j.copsyc.2022.101411
Bekteshi, V., & Kang, S. (2020). Contextualizing acculturative stress among Latino immigrants in the United States: A systematic review. Ethnicity & Health, 25(6), 897-914. https://doi.org/10.1080/13557858.2018.1469733
Cohodes, E., Kribakaran, S., Odriozola, P., Bakirci, S., McCauley, S., Hodges, H., & Gee, D. (2021). Migration‐related trauma and mental health among migrant children emigrating from Mexico and Central America to the United States: Effects on developmental neurobiology and implications for policy. Developmental Psychobiology, 63(6), e22158. https://doi.org/10.1002/dev.22158
Kirsch, D., & Lippard, E. (2022). Early life stress and substance use disorders: The critical role of adolescent substance use. Pharmacology Biochemistry and Behavior, 215, 173360. https://doi.org/10.1016/j.pbb.2022.173360
Lanzara, R., Scipioni, M., & Conti, C. (2019). A clinical-psychological perspective on somatization among immigrants: A systematic review. Frontiers in Psychology, 9, 2792. https://doi.org/10.3389/fpsyg.2018.02792
Peña-Sullivan, L. (2020). The “wrong kind” of immigrants: Pre-migration trauma and acculturative stress among the undocumented Latinx community. Clinical Social Work Journal, 48(4), 351-359. https://doi.org/10.1007/s10903-018-0826-2
Ross, J., Hua, S., Perreira, K., Hanna, D., Castañeda, S., Gallo, L., & Smoller-Wassertheil, S. (2019). Association between immigration status and anxiety, depression, and use of anxiolytic and antidepressant medications in the Hispanic Community Health Study/Study of Latinos. Annals of Epidemiology, 37, 17-23.e3. https://doi.org/10.1016/j.annepidem.2019.07.007
Sangalang, C., Becerra, D., Mitchell, F., Lechuga-Peña, S., Lopez, K., & Kim, I. (2019). Trauma, post-migration stress, and mental health: A comparative analysis of refugees and immigrants in the United States. Journal of Immigrant and Minority Health, 21, 909-919. https://doi.org/10.1007/s10903-018-0826-2
Sidamon‐Eristoff, A., Cohodes, E., Gee, D., & Peña, C. (2022). Trauma exposure and mental health outcomes among Central American and Mexican children held in immigration detention at the United States–Mexico border. Developmental Psychobiology, 64(1), e22227. https://doi.org/10.1002/dev.22227
Ward, N., & Batalova, J. (2023, March). Frequently requested statistics on immigrants and immigration in the United States. Migration Policy Institute. https://www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-united-states
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