The Intertwining of Politics and Medicine: DACA and its Effects on Mental Health

Illustration by Nancy Yang

Illustration by Nancy Yang

Through hard work, determination and initiative, every resident in the United States should have the equal opportunity to achieve success and prosperity: the very core of the American Dream.  While it seems plausible in theory, many struggle to achieve this idealized version of the American life, as is the case for many undocumented immigrants.  With an estimated 11.1 million undocumented immigrants living in the United States, the issue of immigration has become an increasingly controversial topic in today’s world of politics.  Recently, on Tuesday, Sept. 5, 2017, President Trump issued an executive order to begin phasing out an Obama-era program in March 2018, urging Congress to replace it before these actions take place.

The program, Deferred Action for Childhood Arrivals (DACA), protects undocumented children who were brought to the U.S. before 16 years of age from deportation and grants them work permits, allowing temporary access to limited rights and protections.  Participants are also required to submit their current school attendance, proof of completion of high school or the high school equivalency certification (GED), or military service.  More than 800,000 people—mainly from South Korea, Guatemala, Mexico, El Salvador and Honduras—have participated in this program and will now be eligible for deportation once the program begins to be phased out. The program does not provide a pathway to citizenship; as a result, the Development, Relief and Education for Alien Minors Act, Dreamers, was a bill granted to participants to allow access to opportunities in socio-economic growth.  However, many think DACA should be replaced with definitive citizenship status.  Washington University in St. Louis (WUSTL) assistant professor in sociology Ariela Schachter says she agrees; however, Schacter finds it unlikely that such legislation will pass.

Most unauthorized immigrants in the U.S. have lived in the U.S. for over 10 years, one-third have at least one US-citizen child under age 18 and the longer we have a substantial proportion of our population living in the shadows, unable to participate in the formal economy or political system, the worse off we all are,” Schachter said.  “However, given the current political climate, I fear that getting rid of DACA is a bad idea because Congress is unlikely to pass comprehensive legislation that provides a formal pathway to citizenship.”

In response to the Trump Administration’s announcement, many groups and organizations have expressed their concerns and criticism.  In regards to WUSTL’s response, Chancellor Mark S. Wrighton sent an email to all faculty and staff, stating on behalf of WUSTL that they believe in the continuance of DACA.  Many WUSTL students have participated in this program and are recognized as members of the community.  WUSTL strongly believes that every student, regardless of social categorization, should have the same opportunities for success.

“DACA is not only a moral imperative, but it also benefits the United States as a whole,” Wrighton said. “We should be embracing them, not abandoning them.”

Although debates about DACA have focused mostly on economic consequences, research shows that it has a profound effect on mental health as well, according to Penn Medical Researchers, Atheendar S. Venkataramani and Alexander C. Tsai.  Venkataramani predicts that ending the policy will have a significant negative impact on the mental health of undocumented children, which as a result, could cause a massive public health crisis in the U.S.  In their recent quasi-experimental study, when comparing the relative changes in mental and physical health results in those who were eligible for DACA and those who were ineligible in at least one of the criteria, rates of moderate or severe psychological distress in the DACA-eligible group decreased about 40% compared to the DACA-ineligible group after DACA was enacted.  In addition, other studies of DACA participants showed significant improvement in their psychological state.  A recent study conducted using the data of Oregon Emergency Medicaid beneficiaries, demonstrated that the mental health benefits not only was advantageous to the individual but lasted beyond their generation as well.  The probabilities of DACA-eligible mothers that were U.S. citizens by birth affected by anxiety disorders and adjustment rates fell more than half due to the enactment of DACA.  A Co-Heritage Chair on the Executive Board of American Association for Latin American Students (ALAS) at WUSTL, sophomore Maria Cortez Lopez, explains why DACA has such a profound impact on mental health in undocumented immigrants.

“For a long time, the undocumented community had to suffer in silence.  The struggles and challenges that were unique to them were kept a secret because of how vulnerable they would be if they came out as undocumented,” Lopez said.  “With DACA, part of the undocumented community was able to come out of the shadows and give a human face to the 11 million undocumented immigrants living in the U.S.  DACA was able to show that undocumented people in the US are friends, teachers, doctors, not criminals.”

In place of DACA, the Trump administration’s immigration platform includes strengthening authority and border security, and banning or significantly reducing immigration, which, in return, would only reinforce negative health consequences.  In addition, Dreamers will be less likely to seek help from social workers, educators, physicians or nurses as a result of the removal of legal protections incorporated in DACA, making it increasingly difficult to deploy treatment and health resources where they may be needed most.  These results could even appear in states that provide generous resources to undocumented immigrants due to federal authorities enforcing harsher laws such as raids to identify and deport any undocumented immigrants in these particular areas.  Furthermore, they would have immense difficulty finding organizations to aid them, as the loss of work permits may result in unemployment, loss of financial aid or health insurance, and withdrawal from school.

If no solution is provided to allow DACA’s former participants a definitive legal status, collaboration between health care and public health institutions will become all the more critical. These organizations will need to actively reaching out to undocumented immigrants with open communication and reassurance.  Physicians will have to continue accepting patients despite immigration status and provide the health care needed in addition to informing them about mental health resources.  In the upcoming months, health care and public health professionals will need to aid in patient care, engage in public advocacy, and prevent factors that negatively impact public health.

Those who initially came to the United States as children were allowed the opportunity to pursue the American Dream through this program, reflective of America’s core ideals.  Although DACA was intended to provide economic relief to its beneficiaries, studies show that DACA also became important as a public health program.  Its significant impact on mental health is proven through various studies, and by repealing DACA, public health is greatly threatened.  Health care providers and health officials must make it their priority to take a front-line role in pre-empting the crisis that lies ahead.  As the situation grows more complex, Lopez emphasizes the importance of unity and that taking action is more crucial now than ever.

They are American in all but name,” Lopez said, “and it is the duty of the government to give them a permanent solution.”

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