The Mental Health of Undocumented Immigrants & Refugees

Moving to a new country is, in itself, a major life change. But adjusting to a new culture, language, and setting is further impacted when such a move is brought on by an urgent, and at times life-threatening, necessity. Such is the case for the millions undocumented immigrants, refugees, and other displaced individuals across the globe, who have uprooted themselves from their homeland in the hope of making a better life for themselves and their loved ones. 

Their journey, however, often includes physical, emotional, and financial hardships, which build up on one another. The following article aims to describe the mental health issues that more commonly arise due to the realities faced by undocumented immigrants and refugees. Read on to find out more about the complex issues that can affect their well-being.

Refugees, Asylum Seekers, Undocumented Immigrants, and the Displaced

The journey of many refugees and other displaced individuals tends to include periods of preflight, flight, and resettlement. They also often face a serious threat of violence in their country of origin, which had initially caused them to seek security elsewhere. Labor or sexual exploitation, contact with military populations, prolonged detainment in internment camps, the separation of children from their parents, and a loss of community or language are also common experiences for refugees the world over. On a more positive note, research has also shown that refugees who settle in places where they feel a sense of security are generally able to adjust well to their new surroundings. 

According to the World Health Organization (WHO), at present there are roughly 272 million migrant individuals who have left their homes across the globe. Within this larger population, more specific groups of migrants have gained attention:

• Undocumented Immigrants: Individuals who have left their homeland and are residing in another country, without the legal documentation necessary to permit their stay, are defined as undocumented immigrants. This group includes:
• Refugees: Individuals whose lives or freedom are threatened, and who have crossed an international border in an effort to flee war, violence or similar forms of conflicts in their homeland, may apply for refugee status under the United Nations (UN) 1951 Refugee Convention. The countries adhering to the decisions of this convention have agreed to provide safe harbor to refugees who manage to reach their borders and ask to be let in.
• Asylum Seekers: Asylum seekers are individuals fleeing their homeland due to persecution, whose refugee status has yet to be determined. 
• Illegal Immigrants: Individuals seeking better work opportunities or a greater quality of life for themselves or their loved ones, but without legal status in a new country.
• Internally Displaced Individuals: Those who have been displaced have fled their homes, mainly due to prosecution, but remain within the borders of their own country. Individuals who cross the border to flee persecution are usually referred to as asylum seekers or refugees.

Common Mental Health Problems Among Displaced Immigrants and Refugees

The following mental health conditions have been shown to appear at a higher rate among undocumented immigrants and the displaced:

• Depression. Often exhibited through symptoms of helplessness, hopelessness, or a feeling of loss, 5-15% of those displaced develop depression. Children and adolescent refugees have been shown to suffer from higher rates of this condition, with certain studies finding up to 40% of this subgroup to contend with depression.
• Anxiety. Stemming from an overflowing fear of threats to the survival of the individual or their loved ones, 4-40% of refugees have been shown to suffer from some form of anxiety.
• Post-Traumatic Stress Disorder. A diagnosis primarily based on experiencing or witnessing a horrendous or deeply destabilizing event, studies have found that 10-40% of refugees contend with PTSD. Additional research has pointed to 50-90% of children and adolescent refugees suffering from this condition.
• Adjustment Disorder. Somewhat less severe than the above-mentioned conditions, adjustment disorder describes a prolonged inability to accept a stress-inducing event and continue with one’s life with a regained sense of stability and relative calm. Studies have found that 20% of refugees contend with adjustment disorder.

Common Obstacles for Those Displaced Seeking Mental Health Support

For individuals and families fleeing their homes, arriving at a safe harbor does not necessarily translate into receiving proper care and support. This is particularly true in regard to mental healthcare. When seeking treatment for their mental health, refugees undocumented immigrants, and others experiencing displacement often face the following impediments, even after they manage to escape persecution:

Lack of Funding. Reacting to an emergency so extreme it would propel you to escape your country with little-to-no planning can create a reality of severe poverty for refugees on the run. Even those who do manage to take with them a certain amount of savings or valuables would first need to secure the immediate, physical demands of their new life, with their mental healthcare viewed as an issue that may need to be postponed, until they are back on their feet.

Lack of  Mental Health Care for Illegal Immigrants. Global initiatives, charities, and the governments of countries who accept refugees do not divert the same amount of resources to the mental health of displaced individuals as they do to the mental health of their citizens. As a result, the mental health of displaced immigrants and refugees continues to suffer, as they try to balance the emotional, financial, and physical demands of their present lives.

Scarcity of Treatment in Their Mother Tongue. A further obstacle for many undocumented and legal immigrants is their inability to fluently speak the language. Describing the turmoil, trauma, and stressors they have gone through frequently requires a nuanced knowledge of the language used both with a psychotherapist, and a doctor trying to understand any psychiatric symptoms from which they are suffering. Having a rudimentary grasp of the commonly spoken language in their new place of living, if any, makes it exceedingly more challenging to find a therapeutic setting in which they would be able to properly express themselves, and work through their pain.

Compacted Vulnerability of Sub-Populations. Certain groups within the refugees and the displaced populations are particularly vulnerable to abuse, ill-treatment, and as a result—to developing mental health issues. These include children, the elderly, those contending with a physical disability, and members of the LGBTQ community. 

What Can Be Done

The WHO has highlighted certain steps governments can take to more comprehensively address the mental health needs of displaced individuals. These include:

• Incorporating mental healthcare into primary care.
• Promoting a continuity of care, with the same treatment provider and facility.
• Encouraging social integration, with government programs offering vocational training, and social case managers charged with addressing individual and familial social needs.