Amplify mental health resources for immigrants.
Happy Thursday and welcome back! A new Gallup survey found that "Americans’ assessment of our mental health is 'worse than it has been at any point in the last two decades'" (NYTimes). Although we covered the intersection of COVID-19 and systemic oppression frequently, we haven't discussed its impact on our mental health. Kayla joins us today with her perspective on how we can amplify mental health resources for immigrants, who are disproportionately impacted by the pandemic.
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TAKE ACTION
Learn more about mental health resources for immigrants and refer immigrants to the resources from the Immigrant Learning Center’s list
Share this curated list of diverse and inclusive therapists (from InclusiveTherapists.com) that can meet the needs of immigrants
Check your local mental health organization for ways you can support and/or spread the word about their resources.
Have conversations with family members to destigmatize mental health. First, educate yourself about your own mental health situation. Second, explore what support systems you have, and lastly, if you feel comfortable, share with loved ones what you are experiencing.
GET EDUCATED
By Kayla Hui (she/her)
While every administration has dealt with immigration differently, the Trump Administration has gained its notorious reputation for separating kids at the border. A few weeks ago, Trump blocked the Justice Department from paying for mental health services for migrant families who had been separated at the border especially amid a global pandemic (NBC News).
The COVID-19 pandemic and economic downturn has affected people globally, immigrants are especially vulnerable. As they grapple with job loss, family death, stacking bills, eviction, health issues, and remote schooling and caregiving, immigrants’ mental health is being impacted by these conditions caused by the COVID-19 pandemic.
For example, 14.3% of immigrant workers live in overcrowded housing, making it difficult to practice social distancing (Center for Immigration Studies). Immigrants and children born from immigrant parents are also more likely to experience food insecurity (PubMed). Coupled with COVID-19 stress, they are dealing with job and health insurance loss, hampering mental health access.
Common mental health issues include depression, anxiety, post-traumatic stress disorder, and psychiatric disorders related to exposure to war, violence, and torture (PubMed). A study found that immigrants were much less likely than nonimmigrants to utilize mental health services, especially among communities of color.
There are two types of barriers that hamper mental health access for immigrants, cultural and structural (PubMed). Cultural barriers include stigma, norms, and attitudes whereas structural barriers include factors such as costs, transportation, and discrimination.
When trying to seek mental health care, my sisters and I were always met with the same response: “You don’t need it. There’s nothing wrong with you.” Growing up in an uninsured immigrant household, stigmatization was just one of the barriers that prevented my family and I from seeking mental health services. When the pandemic hit, our mental health was hit hard. Some of my family members had lost their jobs, experienced stress from surmounting bills, and were socially isolated. I witnessed the repercussions of the pandemic on my family and knew that we weren't alone in experiencing these barriers to mental health access.
Oftentimes, access to mental health services can be seen as an extra or unnecessary expense especially in communities where stigma is prevalent, making it hard to justify its need to family members (The University of Chicago Press Journals). When mental health is left unmanaged, it can lead to physical health problems, homelessness, job instability, and suicide (Psychology Today).
In addition to the lack of health and mental health coverage for immigrants, language barriers persist in the mental health space. A study found an association between the under-utilization of psychiatric services with language proficiency (Psychiatry Online).
“What does this mean?” was a common question my grandmother would ask whenever we visited the doctors. Because English was my grandmother’s second language, I translated healthcare information in the doctor’s office from Cantonese to English so that she could understand. For many immigrants where English is not their Native language, understanding health information can be daunting. Therefore, there is a need for multilingual mental health providers who are culturally competent and can understand the mental health needs of immigrants.
Beyond cultural barriers, there are structural roadblocks including the lack of access to health insurance. Unfortunately, health insurance coverage for immigrants is a complex issue that predates the pandemic. Back in the 1940s, the United States federal government tied health insurance to employment by incentivizing employers to start offering health insurance to workers. As health insurance industry grew, the Internal Revenue Service (IRS) began chipping away at the tax-exempt status. To save the tax-exemption for employer-based insurance, the Eisenhower administration secured tax-exemption permanently. Thus, employer-based health insurance was born. (The Observer).
Health insurance access is even harder for undocumented immigrants, many of whom are not eligible to work jobs due to the racist and discriminatory nature of our employment and health system. Under federal programs such as the Affordable Care Act (ACA) and Medicaid, undocumented immigrants are not eligible to receive those benefits, leaving the state of their mental health vulnerable (Health Insurance). Of the 44.8 million immigrants living in the United States, nearly 20% were uninsured in 2018 (Pew Research Center).
And this issue was exacerbated because of COVID-19. Between February and March, the number of unemployed immigrants increased by 30%, doubling the unemployment rate of U.S. born workers. (Migration Policy Institute). Because health insurance coverage is tied to employment, immigrants lost their health insurance and mental health coverage.
Federal programs are fueled by taxpayer dollars. It is disheartening to see how immigrants are not covered under some federal programs, despite undocumented immigrants paying a total of $11.7 billion in state and local taxes, according to the Institute on Taxation and Economic Policy (Vox). Due to the 1996 welfare law, it categorized immigrants for eligibility for federal programs such as “qualified” and “not qualified” (National Immigration Law Center). The “qualified immigrant category includes people with green cards, refugees granted asylum, certain survivors of sex trafficking and abuse. For the “not qualified” category, those include undocumented individuals. Many federal benefit programs such as the Supplemental Nutrition Assistance Program, non-emergency Medicaid, and Supplemental Security Income (SSI) leave immigrants out. And because health insurance coverage is not distributed equally, the health system was designed to only benefit a select few, leaving immigrants with worser mental health outcomes. Sadly, the United States does not provide universal healthcare for all.
When members of our community thrive, we all thrive. Immigrants are members of our community and their health should be a priority. We can support their mental health by destigmatizing it, supporting policies that shape health insurance access for immigrants, and support community organizations that are amplifying their mental health needs.
Mental health impacts every facet of our lives. It governs our daily actions and shapes our behavior. Therefore, access to affordable mental health should be prioritized and made available. Mental health is a human right.
KEY TAKEAWAYS
COVID-19 is disproportionately impacting immigrants' mental health.
Cultural and structural barriers hamper immigrants mental health access (PubMed).
Albeit undocumented immigrants pay taxes, they aren’t protected or covered under federal programs like the Affordable Care Act and Medicaid programs
RELATED ISSUES
12/1/2020 | Fight inhumane medical care at ICE facilities.
10/5/2020 | Protect undocumented Americans.
9/17/2020 | Abolish ICE.
8/10/2020 | Respect the relationship between name and identity.
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