For years, children brought into the United States by their undocumented immigrant parents have been considered undocumented and subject to deportation, just like their parents. In recognition of their unique status and deep roots in the only country that many of them have ever known, President Obama offered them some relief when he signed the Deferred Action for Childhood Arrivals (DACA) executive action in 2012. This policy granted these children, often referred to as the “Dreamers,” two-year renewable work permits along with freedom from deportation.
So far, the Trump administration has allowed the DACA program to persist. But the recent deportation of Dreamer Juan Manuel Montes-Bojorquez — plus broad new guidelines expanding the scope for detaining and deporting undocumented immigrants — have generated fear among Dreamers and other undocumented individuals seeking to build a future in the United States for themselves and their families.
As physicians, we have been hearing stories from our patients about the stress and anxiety they feel about looming changes to United States immigration policy. We grow increasingly worried that this overwhelming uncertainty may directly undermine their mental health. With stories from concerned patient as a backdrop, we decided to investigate this issue on a national scale.
We asked this question: Could removing the uncertainty around deportation reduce psychological distress among undocumented immigrants? To answer it, we analyzed data from the US National Health Interview Study, comparing mental health outcomes before and after DACA was signed among non-citizen Latinos and Latinas who met the age eligibility criteria for DACA and among those who did not.
Our findings, recently published in Lancet Public Health, were striking. Implementation of the DACA program reduced rates of moderate to severe psychological distress among eligible individuals by nearly 40 percent. This is a remarkable finding, considering that DACA did not grant amnesty for these individuals.
From our perspectives as physicians, the DACA program is a clear win for public mental health.
What do our findings mean for current immigration debates? For starters, they provide medical evidence to corroborate new reports of increasing stress and anxiety among Dreamers who are understandably worried about their futures. Even our new president acknowledged as much in his Time magazine “Person of the Year” interview, in which he said “they’re in never-never land because they don’t know what’s going to happen.”
Our findings may also apply more broadly to others who hold many of the same concerns about escalating anti-immigrant rhetoric, such as refugees and undocumented immigrants not eligible for DACA. Even immigrants who hold valid visas have not been spared anxiety and worry.
Going beyond mental health, our findings complement growing concerns that undocumented immigrants are foregoing needed health care because they fear their interactions with health professionals and health care systems may jeopardize their ability to remain in this country.
The three of us swore an oath to help the sick and care for the suffering. To that end, we urge the Trump administration and other policymakers to carefully weigh the potential health consequences of immigration policy changes, in addition to the perceived economic consequences that now dominate the agenda. Taking this larger view, weakening DACA or repealing it would have untold harmful effects on health.
If the president were to continue deferring action against deportation for the hundreds of thousands of undocumented individuals who contribute every day to the American dream, this could be the signature deal of his early administration — one that Americans on both sides of the political aisle would talk about for years to come.
Atheendar S. Venkataramani, MD, is an assistant professor at Harvard Medical School and a primary care physician at Massachusetts General Hospital. Sachin Shah, MD, is a general medicine fellow and primary care physician at Massachusetts General Hospital. Alexander C. Tsai, MD, is an assistant professor at Harvard Medical School and a staff psychiatrist at Massachusetts General Hospital.