Iliana Salinas needs to renew her immigration status this year. If the deadline is missed or the application is not approved, there is no telling what will happen to her job, family, and life in the United States. Her mental health is deteriorating as she spends her days in survival mode, and ever-changing immigration policies are exacerbating her problems.
Salinas is eligible for temporary immigration protection under the Obama administration's Deferred Action for Childhood Arrivals (DACA) program in 2012. The program was intended to temporarily alleviate the threat of deportation for hundreds of thousands of undocumented youth who immigrated to the United States. America as a child.
As of September 30, 2023, there are 544,960 active DACA recipients in the United States, 20,750 of whom are in Arizona, according to the latest numbers from U.S. Citizenship and Immigration Services. The states with the highest number of DACA recipients last year were California and Texas, with Arizona ranking seventh among states.
But that may represent only a fraction of those eligible for DACA, with up to 1.16 million people in the U.S. and 44,000 in Arizona eligible for protection, according to the Migration Policy Institute. We estimate that there is a possibility.
“I'm grateful to have had a taste of what the American dream is like,” Salinas said. “But it's also about living your life two years at a time.”
DACA recipients will continue to have to renew their legal status every two years amid a protracted legal challenge that could leave more than 500,000 people without legal status. DACA recipients are allowed to work but are not eligible to participate in federal health programs such as Medicaid, the Children's Health Insurance Program, or the Affordable Care Act Marketplace. According to KFF, a nonprofit foundation that provides health policy research and news, these restrictions lead to high uninsured rates among DACA recipients and create barriers to accessing both general medical and mental health care. It is said that it has become.
Nearly half of respondents who say they have a mental or behavioral health problem say they do not use psychiatric or therapeutic mental health services, according to a fact sheet published by the National Immigration Law Center. did.
For the past 18 years, in Salinas' home state of Arizona, anti-immigrant policies like SB 1070 have fostered a culture of fear and the mentality necessary for undocumented immigrants and DACA recipients to cope with the fear caused by the same policies. Advocates say it prevents people from receiving medical care. . These policies are now being replicated across the country.
Immigration policy “laboratory”
“It's a completely anti-immigrant policy.”
This is how Lydia Guzman described Arizona's SB 1070. Guzman is director of advocacy and civic engagement for Chicanos Por La Causa, an Arizona organization that provides behavioral health and other services to the Latino community and advocates for economic and political empowerment. She said SB 1070, introduced in 2010 as the “Supporting Our Law Enforcement and Safe Communities Act,” allows police to arrest individuals without a warrant if they have suspicions. It became known as the law. Not documented. It also punished American citizens deemed to have supported illegal immigration.
“We wanted to punish immigrants in every way possible,” said Guzman, whose group challenged the law in federal court. “If someone is transporting migrants, if someone is harboring migrants, we asked people to report migrants. We asked police officers to turn migrants over to immigration authorities.”
Provisions of this law were struck down by the U.S. Supreme Court in 2012, but SB 1070 is still being considered in Arizona. The now controversial bill has sparked imitations across the country, including recent anti-immigrant laws in Texas and Florida, Guzman said.
“Arizona is like a laboratory,” Guzman said, referring to the history of Arizona's immigration policies. “Other states are passing this bill and it's coming back.”
It's not just SB 1070. Florida's SB 1718, signed into law in 2023 by Republican Gov. Ron DeSantis, who is currently running for president, includes a provision that would require hospitals to ask patients about their immigration status and report that data to the state. include. This provision is a copy of a bill introduced in the Arizona state legislature in 2013 that failed to pass.
Immigration advocates say this type of bill would deter undocumented immigrants and their families from seeking medical care for fear of reporting them to immigration authorities.
“Many people who want to apply for citizenship are told they can't apply for benefits,” said Brianna Felix, Southern Arizona executive director of the National Alliance on Mental Illness (NAMI). She was “told not to interact as it could affect her citizenship status.”
A culture of fear and uncertainty
Illegal aliens in Arizona are not eligible for Medicaid under the Arizona Health Care Cost Containment System, which handles Medicaid and Medicare in Arizona. However, there are exceptions where there are certain conditions, such as emergencies or medically necessary services such as labor and delivery. This means that people are also not eligible for low-cost behavioral health services until there is a significant risk of self-harm or physical violence against others as a result of their mental health condition.
Some organizations are working to fill the gaps created by people who are left out of care. Chicanos Por La Causa partially funds substance abuse services through federal grants, and NAMI Southern Arizona provides free resources such as support groups and case management to people affected by mental illness and their families. doing. But advocates like Felix say that despite efforts by organizations to provide more culturally appropriate care, a culture of fear and uncertainty can prevent immigrants from accessing this care. claim to have sex.
A 2014 study by researchers at Arizona State University and Harvard University found that after the passage of SB 1070, pregnant women of Mexican origin were “less likely to receive preventive health care, likely as a result of fear of deportation or a perceived lack of safety.” and were less likely to use public assistance.'' ”
In 2019, the Trump administration expanded public charge rules that allow U.S. immigration officials to deny visas or green cards to applicants deemed likely to rely on government aid. This expanded rule included medical benefits such as Medicaid as a public charge.
The court blocked this rule before it took effect. However, this was not the case before overall health care utilization for adult immigrants and their families declined, according to the KFF study. The study found that nearly one-third of health centers surveyed nationwide reported a decrease in immigrants seeking medical care after the new utility rules went into effect. announced.
The policy was abandoned after President Joe Biden took office in 2021, but a coalition of state governments led by former Arizona Attorney General Mark Brnovich argued to uphold the expanded rules before the U.S. Supreme Court in 2022. The justices declined to rule on the case, leaving in place a lower court ruling that blocked the expansion.
“We need to educate the community more about who can still take advantage of a lot of the benefits because they're still available to a lot of people,” Guzman said. “The fear is too great…Everyone in the community needs to be talking about this.”
Build community and take action
For Salinas, the way to heal her feelings of isolation was to organize her community and expand informal mental health care for undocumented immigrants and their families.
Salinas is a program manager at Aliento, a nonprofit that provides resources to undocumented youth and families with mixed immigration status. Cultiva, an outreach program in Salinas, offers informal arts and healing workshops with the goal of building community, liberating immigrant youth from thoughts of isolation, and breaking down cultural stigma surrounding mental health. It offers.
“One of the biggest barriers to mental health access is the stigma surrounding Latino mental health,” Salinas said. “Asking for help is like saying you're a loco or crazy, and that stigma is what prevents people from asking for help.”
Aliento workshops are designed to break down these barriers with cultural awareness, bilingual instruction, and lessons from trauma-informed therapy to create community services specific to the immigrant experience.
Ms. Salinas also works on advocacy campaigns to change policies that indirectly impact the collective mental health of her community, including organizing with Ariento to help Arizona voters pass Proposition 308 in 2022. I started participating. The proposal would restore in-state tuition status to certain groups. It arrested undocumented students and overturned a ban passed in 2006.
“We need to take action to bring about change,” Salinas said. “But an attitude of hope is what really helps build community.”
