Commentary

Confronting Immigration Challenges in a Nation of Immigrants: A Call for APA Action

In this commentary, J. Manuel Cases discusses the lack of mental health resources for the immigrant population resulting in part from the overemphasis on immigration as a political and/or economic issue, and provides related recommendations for APA action.

J. Manuel Casas, Professor Emeritus
University of California, Santa Barbara

J. Manuel Casas, PhD To date, immigration, both documented and undocumented, has simplistically been treated as a political and/or economic issue. However, most recently, as the number and visibility of immigrants has increased and as the serious problems faced by immigrants have come to the forefront, the treatment of immigration has evolved to include both social and human issues. Working from this point of view, this article addresses the phenomenon of immigration and the issues associated with it from a variety of social and/or psychological perspectives. However, before addressing these perspectives, immigration is first put into historical and demographic context. The article concludes with selective recommendations on ways to address pertinent problems and issues.

A Historical and General Perspective

The issues and the turmoil associated with immigration have perennially emerged on the American scene. According to Casas (2009), such issues were made most evident by the passage of federal anti-immigration acts and resolutions (e.g., the 1882 Chinese Exclusion Act, the 1965 Immigration Act, the Immigration Reform Act of 1995, the "on" and "off" bracero acts, and California's Proposition 187 in 1994) (Atkinson, 2004). The implementation of "lawful" and unlawful tactics (e.g., immigration and deportation raids) and the commission of racially motivated acts of violence (e.g., lynchings, murders, deprivation of life saving services, etc.) brought the turmoil to the fore (Atkinson, 2004; Falicov, 1998; Gonzalez, 2000).

One could say that all immigration waves produce backlashes of one kind or another, and the latest one is no exception. Illegal immigration, in particular, has become a highly-charged political issue in recent times. It is also a relatively new phenomenon: Past immigration waves did not generate large numbers of illegal immigrants because the U.S. imposed fewer restrictions on immigration flow in the past than it does now.

Some historians have attributed such backlashes to ever-changing economic conditions: When we need cheap labor, "import it", when we don't, "deport it"(Atkinson, 2004). Such simplistic and readily available economic explanations may have been acceptable in the past. However, more recently, social scientists (e.g., Atkinson, 2004) are seeking more comprehensive, and interactive socio-psychological perspectives and hypotheses to better grasp the complexity of issues associated with immigration in the U.S. (e.g., health, education, crime, security, etc.) (Casas, 2009, pp. 13-16).

Concomitant with such perspectives, a belief has surged that immigration is a resonant issue today because it touches so many sensitive nerves: racial anxieties, gnawing questions of national identity, and a generalized sense of traditions under threat (Rutten, 2009). The forcefulness of the issue is such that even in the midst of economic crisis, mass unemployment, war (s), and the healthcare reform debate, it continues to cause turmoil (Rutten, 2009).

Selective Demographic Changes and Data

A major driving force that continues to embroil the prevailing turmoil is the dramatic changes in the immigration demographics that the U.S. is presently confronting. For instance, in 2005, the foreign-born population was nearing 36 million—35% were naturalized citizens, 33% were documented immigrants, and 31% were undocumented. Just a decade earlier, 24 million people in the U.S. were foreign-born, with 30% comprised of naturalized citizens, 47% comprised of documented immigrants, and 20% comprised of undocumented immigrants (King, 2007).

At present, while most undocumented immigrants are young adults, there is also a sizeable childhood population. It is estimated that children constitute a significant portion (16%) of the population. In addition, a growing share (73%) of the children of unauthorized immigrant parents were born in this country and are U.S. citizens. With respect to Latino youth, most are not immigrants. Two-thirds were born in the United States, many of them descendants of the big ongoing wave of Latin American immigrants who began coming to this country around 1965 (Passel, 2006; Pew, 2009).

Measured in raw numbers, the modern Latin American-dominated immigration wave is by far the largest in U.S. history. Nearly 40 million immigrants have come to the United States since 1965. From an ethnic national perspective, most documented and undocumented immigrants are from Mexico: 30% of the documented population and 56% of the undocumented population. Immigrants from other countries in Latin America comprise an additional 35% of the documented population and another 22% of the undocumented population. With respect to immigrants from other parts of the world, King (2007) reports that 26% of the documented immigrant population is from Asia, 14% from Western Europe and another 8% from Africa and other regions. Another 5% of undocumented immigrants come from South Asia and Southeast Asia. The origin of the remaining 17% of undocumented immigrants is unidentified (King, 2007, p. 2).

The prevalent trend of the last decade has been that inflow of undocumented immigrants exceeded arrivals of legal permanent residents. However, the inflow of undocumented immigrants has slowed significantly since 2005 and now trails the pace of legal immigration (Passel & Cohn, 2008). With respect to Hispanics, another emerging trend is that while the majority of undocumented immigrants continue to concentrate in places with existing large immigrant communities, increasingly such immigrants are settling throughout the rest of the country (Passel, 2005).

Unsurprisingly, as immigrants settle in non-traditional demographic pockets, the U.S. finds itself confronting new complex social, cultural, and political issues (e.g., greater economic and power disparities across groups, the need to provide vital information and services in languages other than English, increase in the number of persons who cannot afford health insurance, and increased reliance on emergency services). These issues will continue to emerge as the U.S. population grows by 120 million people by 2050, of whom about 80 million will be here as the direct or indirect effect of immigration (King, 2007).

Socio-Psychological Problems and Issues of Mental Health Services

Such problems and issues can occur prior to, during, and after their arrival in their host country (Lustig, et al., 2004) and to persons of all ages. Incurring such problems can have immediate and long-term implications for the psychological and social well being of individuals and families (Espin, 1999). The implications can be especially traumatic for undocumented children and families (Cooper et al., 2007). 

With respect to children and youth, the immigrant experience may negatively affect their growth, development, acculturation, health, education and, more specifically, their self-concept and self-esteem; positive racial ethnic identity development; sense of security; ability to trust others; and capacity to dream of, plan, and work for a brighter future (Capps et al., 2007; Communiqué, 2007; Morgan & Gonzales, 2009; Passel, 2006).

Frequently, undocumented immigrant children and youth are subject to traumatic experiences (Capps, et al., 2007) such as racial profiling, ongoing discrimination (Para-Cardona, et al, 2006), exposure to gangs (Pew, 2010), immigration raids in their community, being forcibly taken or separated from their family for an indeterminate period of time (Capps, et al., 2007), returning home to find their family has been taken away, violation of their home by authorities, placement in detention camps or in child welfare, and deportation to their country of origin. Needless to say, such traumatic and challenging experiences can produce a range of psychological problems (Capps et al., 2007) including post-traumatic stress disorder, acculturation stress, and intergenerational conflict (Kohatsu, Concepción, & Perez, 2010), feelings of persecution, high distrust of institutions and authority figures, fear of school, inability to concentrate, acting out behaviors, eating disorders, loss of motivation, depression, anxiety, difficulties in school performance and matriculation (Suárez-Orozco, 2007), and finally dropping out of school (Capps et al., 2007).

The risk for so many potential problems for these immigrant youth can significantly impact the socio-political future of the U.S. More specifically: "By force of numbers alone, the kinds of adults these young Latinos become will help shape the kind of society America becomes in the 21st century" (Pew Hispanic Center, 2009). This fact should provide a strong impetus for governmental and social institutional action.

Social, Therapeutic, and Systemic Issues

Psychological problems aside, there are numerous social, therapeutic, and systemic problems that continue to negatively impact the provision of mental health services to low-income immigrants. These include inaccessibility to appropriate mental health services; the inability to pay for services; a lack of health insurance; misdiagnosis of presenting problems; cultural and linguistic barriers; contextual factors (e.g., lack of child care, time conflicts, lack of transportation); providers ''treatment of mental disorders" rather than placing their clients within a broader ecological context (Sue, Bingham, Porché- Burke, & Vasquez, 1999); clinician bias; and most importantly, the persistence of anti-immigrant prejudice (Casas, Vasquez, & Ruiz de Esparza, 2002; Ponterotto, Casas, Suzuki, & Alexander, 1995).

Selective Recommendations to APA for Addressing Problems and Issues Associated with Immigration

Given the information provided above, it is evident that immigration (documented and undocumented) has provoked ongoing political and social turmoil, while immigrants themselves have continuously been subject to a great deal of health and socio-psychological problems and systemic challenges and issues that continue to this day. While the need to address such problems and challenges has frequently been ignored, the demography of the U.S. and the pervasiveness of problems are such that continuing to ignore them is no longer a viable option. To this end, short of bringing about comprehensive immigration reform, which for "political" reasons may not be feasible at this time, there are innumerable intermediary and foundation-building actions that can be taken (see CYF News, Fall, 2009 (PDF, 1.4MB)). Because of limited space, I solely address two such actions.

From an institutional perspective, APA needs to revisit its Resolution on Immigrant Children, Youth and Families (American Psychological Association, 1998). This Resolution reflected increased sensitivity towards the unjust and contradictory treatment of the growing number of documented and undocumented immigrants in the United States. The Resolution emphasized the socio-psychological experiences associated with immigration for children and families. While somewhat dated, the Resolution is still pertinent and necessary. In particular, the necessity exists for action to be taken that focuses on implementing the Resolution with a force consisting of comprehensive and well-planned strategies that enable the psychological profession to move persistently and methodically towards decisive actions that seek to provide social justice, safety and security for all persons and, in this case, immigrant children, youth, and families.

While waiting for comprehensive reform, two humanely focused Congressional bills that merit the immediate attention and support of APA are: H.R. 3531 (U.S. representative Lynn Woolsey-D-CA) and H.R. 1215 (U.S. representative Lucille Roybal-Allard-D-CA). H.R. 3531 aims to prevent separation of children from their parents during immigration enforcement by facilitating access to family court proceedings, travel documents, and communication between parents and children. H.R. 1215 seeks to institute standards for treatment of detainees ranging from basic necessities (adequate food, blankets, clothing, medical care) to access to legal counsel. This legislation also addresses the needs of unaccompanied children by mandating better training of border personnel. These bills have been sent to committee and could benefit from the support of our respective representatives.

In conclusion and based on the information contained herein, I leave you with the thought that there is no longer anytime to waste if we are to fulfill America's destiny as a nation of immigrants. More extensive coverage of the material contained herein can be found on line (see CYF News, Fall, 2009 (PDF, 1.4MB)).

References

American Psychological Association (1998). Resolution on immigrant children, youth, and families. Washington, DC: Author. 

Atkinson, D. R. (2004). Counseling American minorities (6th edition). New York: McGraw-Hill.

Capps, R., Castañeda, R. M., Chaudry, A., & Santos, R. (2007). Paying the price: The impact of immigration raids on America's children. Washington, DC: Urban Institute.

Casas, J. M. (2009). The 1998 APA Resolution on Children, Youth, and Families: A time to revisit and revitalize. In CYF News. Washington, DC: American Psychological Association.

Casas, J. M., Vasquez, M. J. T., & Ruiz de Esparza, C. A. (2002). Counseling the Latina(o): A guiding framework for a diverse population. In P.B. Pedersen, J. G. Draguns, W. J. Lonner, & J. E. Trimble (Eds.), Counseling across cultures (5th ed., pp. 133-160). Honolulu, HI: University of Hawaii Press.

Communiqué (2007, March). [Special section] Psychological perspectives on immigration. Washington, DC: American Psychological Association.

Cooper, J., Masi, R., Dababnah, S., Aratani, Y., & Knitzer, J. (2007). Strengthening policies to support children, youth, and families who experience trauma. New York, NY: National Center for Children in Poverty.

Espin, O. (1999). Women crossing boundaries: The psychology of immigration and the transformations of sexuality. Florence, K. Y: Taylor & Frances/Routledge.

Falicov, C. J. (1998). Latino families in therapy: A guide to multicultural practice. New York, NY: Guilford Press.

Gonzalez, J. (2000). Harvest of empire: A history of Latinos in America. New York, NY: Penguin Press.

King, M .L. (2007) Immigrants in the U. S. health system: Five myths that misinform the American public. Washington, DC: Center for American Progress.

Kohatsu, E. L., Concepción, W. R., & Perez, P. (2010). Incorporating levels of acculturation in counseling practice. In J. G., Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of Multicultural Counseling (3rd ed.), pps. 343-356. Thousand Oaks, CA: Sage.

Lustig, S., Kia-Keating, M., Knight, W.G., Geltman, P., Ellis, H., Kinzie, J.D., Keana, T., & Saxe, G. N. (2004). Review of child and adolescent refugee mental health. Journal of the American Academy of Child and Adolescent Psychiatry, 43,24-36.

Morgan, M., & Gonzales, R. (2009). Strength in the face of adversity: Latino/a resilience. In CYF News. Washington, DC: American Psychological Association.

Passel, J. S. (2005). Unauthorized migrants: Numbers and characteristics. Washington, DC: Pew Hispanic Center.

Passel, J.S. (2006). The size and characteristics of the unauthorized migrant population in the United States: Estimates based on the March 2005 current population survey. Washington, DC: Pew Hispanic Center.

Passel, J. S. & Cohn, D. (2008). Trends in unauthorized immigration: Undocumented inflow now trails legal inflow. Washington, DC: Pew Hispanic Center.

Pew Hispanic Center (2009). Between two worlds: How young Latinos come of age in America. Washington DC: Pew Hispanic Center.

Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C.M. (1995). Handbook of multicultural counseling (2nd ed.). Thousand Oaks, CA: Sage.

Suárez-Orozco, C. (2007, March). Commentary: The challenges of immigrant families. [Special section] Communiqué, 6-14. Washington, DC: American Psychological Association.

Rutten, T. (2009, September 29). The voices behind Joe Wilson. Los Angeles Times, p. A29.

Sue, D. W., Bingham, R. P., Porché-Burke, L., & Vasquez, M. (1999). The diversification of psychology: A multicultural revolution. American Psychologist, 54, 1061-1069.

Dr. J. Manuel Casas is Professor Emeritus at the University of California, Santa Barbara, and a member of the APA Committee on Children, Youth, and Families. He has published over 140 articles and his research interests include resiliency in Latino families and the identification and implementation of culturally appropriate mental health services to such families.