Mental Health Outlook Among Central American Migrants

By: Ovidio Vasquez

Central American migration to the United States has been a recent topic of discussion that even U.S. President Donald Trump has commented on. He recently stated that he plans on cutting off financial aid to El Salvador, Honduras, and Guatemala because he believes these countries are not doing enough to limit the number of people migrating to the U.S.

So, what does Central American migration to the U.S. look like? In 2017, the Migration Policy Institute reported that there were 3,527,013 foreign-born Central Americans in the U.S., with 1,401,832 of them coming from El Salvador. The same report highlights that some of the factors pushing Central Americans out of their countries to the U.S. include severe gang violence, droughts affecting agriculture industry, and extortion by gangs. These issues mainly affect the northern triangle which includes El Salvador, Honduras and Guatemala. The southern region (Panama, Costa Rica, Nicaragua) does not factor into U.S. migration as much as the northern triangle countries because there is more intra-regional migration between the three countries for work opportunities. With millions of foreign-born people in the United States from Central America, many of them have experienced violence in their home countries, treacherous journeys to the United States, and difficult living and working conditions in the U.S. These experiences have affected the mental health of many Central American migrants.

In a 2017 study, researchers interviewed 234 Central American migrants from El Salvador (114), Honduras (74), and Guatemala (46) who were seeking shelter in a church in Texas. Many of the migrants spoke of being exposed to murdered family members, sexual and physical assault, death threats, extortion and kidnapping in their home countries. On top of this, the researchers found that nearly one-third of the migrants exhibited clinically significant signs of post-traumatic stress disorder (PTSD) and one quarter exhibited major depressive disorder symptoms.[1] Central American women frequently reported traumatic experiences along the journey to the United States, such as rape, physical assault, and having to engage in transactional sex for protection.[2] Knowing all of this, what sources of help exist for these migrants?

With millions of foreign-born people in the United States from Central America, many of them have experienced violence in their home countries, treacherous journeys to the United States, and difficult living and working conditions in the U.S. These experiences have affected the mental health of many Central American migrants.

There are mental health disparities among Hispanics and non-Hispanics in the U.S. in terms of access to and quality of mental health care.[3] Further, primary factors in determining if Central American migrants will seek mental health services, like the costs for mental health services and uncertainty about what seeking care for a mental health problem entails, deepens disparities.[4] Even still, migrants from Central America reported individual psychotherapy as their preferred treatment and they preferred this treatment from a mental health specialist in a primary care clinic.[4] These findings reveal that this community of migrants recognizes that their migration-related traumatic experiences have lead to conditions such as PTSD, anxiety, and depression. For this reason, it is important to provide more access to mental health services for not only Central American migrants but all immigrant communities in the U.S.

Currently, Doctors Without Borders provides medical services to Central American migrants on their journey through Mexico to the U.S. by means of “psychological first aid” and providing medical kits for sexually transmitted diseases. These services are helpful for Central Americans on their passage to the U.S., but there is still room for improvement in the services available to them in the United States as treatment options like psychotherapy can be long processes lasting 6-12 weeks. Regardless, there is a growing need to mental health care at our border and throughout our immigrant populations and these needs must be addressed sooner rather than later.

References:

1. Keller A, Joscelyne A, Granski M, Rosenfeld B (2017). Pre-Migration Trauma Exposure and Mental Health Functioning among Central American Migrants Arriving at the US Border. PLoS ONE, 12(1).
2. Kaltman, S., Hurtado de Mendoza, A., Gonzales, F. A., Serrano, A., & Guarnaccia, P. J. (2011). Contextualizing the trauma experience of women immigrants from Central America, South America, and Mexico. J Trauma Stress, 24(6), 635-642.
3. Blanco, C., Patel, S., Liu, L., Jiang, H., Lewis-Fernández, R., Schmidt, A., Olfson, M. (2007). National Trends in Ethnic Disparities in Mental Health Care. Medical Care, 45(11), 1012-1019.
4. Kaltman S, Hurtado de Mendoza A, Gonzales FA, Serrano A. (2014). Preferences for trauma-related mental health services among Latina immigrants from Central America, South America, and Mexico. Psychological Trauma: Theory, Research, Practice, and Policy 6(1):83-91.