WHAT S AT STAKE: IMMIGRANT MENTAL HEALTH

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WHAT S AT STAKE: IMMIGRANT MENTAL HEALTH Betzabel Estudillo Senior Policy Manager, Health and Public Benefits California Immigrant Policy Center April 10, 2018

ABOUT THE CALIFORNIA IMMIGRANT POLICY CENTER Founded in 1996, CIPC is a non-partisan, non-profit statewide organization that seeks to inform public debate and policy decisions on issues affecting the state s immigrants and their families in order to improve the quality of life for all Californians. CIPC engages in policy advocacy, and provides technical assistance, training and education on immigrant issues.

Key Demographics In CA there are an estimated 10.3M immigrants -- 2.9M are undocumented Californians 1 in 6 of all CA children have at least one undocumented parent 1 in 10 workers is an undocumented Californian. They are integral to a range of industries Undocumented Californians contribute $180 billion/year to our economy More than half of undocumented Californians have lived in the U.S. for at least a decade Source: PEW, USC, and USC

Anti-Immigrant Climate These are challenging times for immigrant families Administration targeting of immigrants, scare tactics, and draconian detention and deportation machine have caused increased fear and anxiety in immigrant families. Immigrant families are fearful of enrolling and utilizing health and public benefits Missing appointments, or doctor visits Asking to be disenroll from health and public benefit programs Confusion about administrative actions and changes to public charge

Anti-Immigrant Policies and Actions Under 45 Decision to terminate TPS for Caribbean and several Central American immigrant groups Border Security & Immigration Enforcement Improvements Enhancing Public Safety in the Interior of the United States "Protecting the Nation From Foreign Terrorist Entry into the United States Decision to terminate DACA & the fight for a clean DREAM Act Leaked Executive Order & NPRM on Public Charge

IMMIGRATION STATUS: A SOCIAL DETERMINANT OF HEALTH Hostile immigration policy creates a climate of fear and paralysis in communities. People are afraid to drive afraid to use parks and exercise outdoors afraid to use public services like clinics and afraid to get involved in their communities

People who don t have a history of anxiety and depression are coming forward with symptoms they ve never had before. And people who had those symptoms already are getting much worse. - Mimi Lind from Venice Family Clinic in Los Angeles

Mental Health Barriers Faced by Immigrant Communities Personal/Community (Micro) Fleeing from violence/persecution Anxiety, stress, depression due to uncertainty, detention, deportation Trauma from having experienced detention/deportation Secondary trauma from seeing/knowing someone in family/community that experienced detention/deportation Stigma/shame Administrative (Macro) Fear of seeking services Personal information sharing with state/federal agencies Lack of culturally competent providers Navigating U.S. health care system Lack of in-language services Geographic isolation

Addressing the Mental Health Needs of Immigrants Immigrants with mental health needs often seek primary care to present with physical complaints, but the underlying problem can be mental health. Studies on survivors of traumatic events have suggested that exposure to stress and trauma may have long lasting effects on future generations. Mental health problems Cardiovascular disease Obesity and other eating disorders Menstrual problems Sexual dysfunction Skin and hair problems Gastrointestinal problems

Intergenerational/Transgenerational Trauma 1996 OHS Study by Dr. Vivian Rakoff - Holocaust survivors and their children Studies on survivors of traumatic events have suggested that exposure to stress may indeed have lasting effects on subsequent generations. Studies have shown that the trauma of a Holocaust has psychological impacts on the children of survivors such as higher levels of childhood trauma, depression, PTSD and other psychiatric disorders. Children learn coping mechanisms Long-term effects: self-protection, mistrust of police/those with authority, fear of legal system, substance abuse, intergenerational poverty This is the key moment to address the mental health of immigrants, as it may have long term effects.

Contact Information Betzabel Estudillo Senior Policy Manager, Health and Public Benefits California Immigrant Policy Center bestudillo@caimmigrant.org California Immigrant Policy Center Sacramento Oakland Los Angeles San Diego www.caimmigrant.org