Enriching Thinking Through Discourse.

Great effort is invested in identifying ways to change people's minds on an issue. A first priority should perhaps be enriching their thinking about the issue. With a goal of enriching their thinking, we studied the views of community adults on the DACA issue-young adults who entered the United States illegally as children. A dialogic method was employed, offering dual benefits in providing participants the opportunity to further develop their own ideas and to consider differing ideas. Yet, participants engaged in dialog only vicariously by observing the talk of a pair of actors who held opposing positions on DACA. The effect on participants' thinking was greatest in the condition in which they viewed a dialog between the two actors, rather than a comparison condition in which the actors individually expressed their positions. In control conditions, no presentation was observed. Probing questions included in all conditions encouraged a participant to examine and clarify for themselves their own position, potentially enriching it. This condition proved unsuccessful in enriching thinking; participants' justifications for their own positions in fact became simpler and less qualified. In contrast, observing a video of a like-minded and opposing other did enrich observers' thinking, yet to a greater degree in the dialogic than nondialogic condition. The findings thus suggest observed dialog as a promising practical approach in promoting deeper thinking.

Navigating a climate of administrative burden: the perspectives of young adult undocumented immigrants in applying for COVID-19 disaster relief assistance for immigrants in California.

Undocumented immigrants experienced high levels of economic insecurity during the COVID-19 pandemic while being excluded from government-based relief and unemployment benefits. In April 2020, California became the first state to offer financial aid to undocumented immigrants through the innovative Disaster Relief Assistance for Immigrants (DRAI) program in collaboration with several community-based organizations (CBOs). However, the process of applying for aid was marked by many implementation challenges, such as intake and language access; however, little data exists on the direct experiences of the undocumented community. This qualitative study examines the experiences of undocumented Asian and Latinx young adults living in California in applying for DRAI through framework of administrative burden. Themes distilled from participant experiences highlight how administrative burden via learning, psychological, and compliance costs shape the ways in which undocumented immigrants navigate policies and programs, such as DRAI. These experiences highlight the need for policymakers to address structural and programmatic administrative burdens in policy development; failure to do so result in detrimental impacts that outweigh financial benefits or cause communities to forgo needed resources.

"I Can Never Feel Safe": Latinx Youth Voices on Psychosocial Impacts of 287(g) in Georgia.

Increasingly, immigration policies are understood as structural determinants, rooted in racism, nativism, and ethnocentrism, which raise serious public health concerns for Latinx adolescents' mental health. Our objective was to examine how immigration policy enforcement affects mental health of Latinx youth raised in a county with an aggressive interior immigration enforcement program. From 2009 to 2021, Gwinnett County, GA, led the nation in deportations under the 287(g) program as a "universal enforcement model," where local law enforcement were deputized to detain undocumented immigrants, primarily through traffic violations. From June to July 2022, we followed a participatory action research approach with two groups of Latinx youth who grew up in Gwinnett County. In total, 10 youth took photos related to the research question, and engaged in facilitated dialogue using photovoice guide SHOWED/VENCER for four, 2-hour sessions that were audio-recorded and transcribed. Transcripts were analyzed following grounded theory principles to arrive at a conceptual model codeveloped and validated by youth. Youth described how 287(g) led to policing and deportation in their communities, fueling stereotypes, and discrimination that criminalized Latinx immigrants. Youth linked immigration enforcement policies like 287(g) to exclusionary systems that contributed to fear, marginalization, and loss in their communities, bringing experiences of sadness, grief, isolation, hopelessness, and low self-worth. From youth-driven research, we identified mental health implications of the 287(g) program among Latinx youth. The cascading harms of immigration enforcement policies highlight the need to address these policies and identify immediate strategies to promote Latinx youth mental health.

Immigration Enforcement Climate in Georgia and the Mental Health of Latinx Immigrants.

INTRODUCTION: Immigrant-related social policies and immigration enforcement contribute to a sociopolitical environment that affects immigrants' health. This exploratory study in six metro-Atlanta counties examined associations among immigrants' perceived vulnerability to harmful immigrant-related social policies and county-level 287(g) agreements (which facilitate cooperation between local law enforcement and federal immigration authorities), county-level immigration enforcement levels (arrests, community arrests, detainers, and removals), and immigrants' mental health. METHODS: Using data from a 2020 study among Latinx parents who were undocumented or members of mixed-status families (N = 140), we merged data on individuals' perceived policy vulnerability and depressive and anxiety symptoms with county 287(g) status and immigration enforcement levels. RESULTS: Perceived policy vulnerability was not associated with county-level 287(g) status or immigration enforcement levels. Greater policy vulnerability and Immigration and Customs Enforcement arrests were associated with higher depressive and anxiety symptoms, but 287(g) status was associated with lower depressive and anxiety symptoms. CONCLUSION: Perceived policy vulnerability, 287(g) status, and immigration enforcement levels do not always align and can have different associations with mental health.

Immigration-Related Discrimination and Mental Health among Latino Undocumented Students and U.S. Citizen Students with Undocumented Parents: A Mixed-Methods Investigation.

Research has consistently linked discrimination and poorer health; however, fewer studies have focused on immigration-related discrimination and mental health outcomes. Drawing on quantitative surveys (N = 1,131) and qualitative interviews (N = 63) with Latino undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine the association between perceived immigration-related discrimination and mental health outcomes and the process through which they are linked. Regression analyses identify an association between immigration-related discrimination and increased levels of depression and anxiety; this relationship did not vary by self and parental immigration status. Interview data shed light on this result as immigration-related discrimination manifested as individual discrimination as well as vicarious discrimination through family and community members. We contend that immigration-related discrimination is not limited to individual experiences but rather is shared within the family and community, with negative implications for the mental health of undocumented immigrants and mixed-status family members.

Cuento de nunca acabar [never-ending story]: Compounding trauma and mental health among undocumented Latinx immigrants.

Research examining the effects of traumatic events on undocumented Latinx immigrants often focuses on assessing posttraumatic stress disorder or general psychological distress, which may obscure the field's understanding of how trauma exposure impacts other common mental health disorders (e.g., anxiety, depression). This study sought to assess the cumulative, individual, and timing effects of immigration-related traumatic events on anxiety and depressive symptoms among undocumented Latinx immigrants. Participants were 253 undocumented Latinx immigrants recruited using respondent-driven sampling who reported their history of immigration-related trauma exposure and symptoms of depression and anxiety. Results suggest that cumulative immigration-related trauma was significantly associated with increases in anxiety and depressive symptoms, τ = .26. Significant positive correlations were found for cumulative trauma at each point in the immigration process (i.e., before immigration, while in transit to the United States, and while living in the United States) such that increases in the number of events were associated with higher anxiety and depressive symptom levels, τ = .11-.29. Trauma frequency differed throughout the immigration process such that some events more commonly occurred before immigration or during transit to the United States, whereas others occurred while an individual resided in the United States. Random forest algorithms uncovered differences in the relative importance of individual traumatic events in explaining the variance of depressive, R2 = .13, and anxiety symptoms, R2 = .14. The findings highlight the importance of providing trauma-informed care when treating anxiety and depression among undocumented Latinx immigrants and considering multidimensional epidemiological approaches in assessing immigration-related trauma.

State and local integrationist policies and the physical and psychological health of undocumented immigrants.

Protracted daily preoccupation with the federal immigration policing infrastructure, restrictive policy, and antagonistic rhetoric take a substantial toll on the psychological and physical health of undocumented immigrants and their families. A growing network of states and municipalities are adopting policies to promote immigrant wellbeing through integration. Recent advances in research suggest subfederal healthcare access, sanctuary, and ID policies increase access to healthcare and health resources and decrease fear and stress. However, health impacts of these policies are modulated by national socio-political forces that spur misinformation, distrust, and fear. To help overcome this, states and municipalities should layer integrationist actions. Critically, more policy impact research is needed to support understanding, uptake, and renewal of state and local policymaking promoting immigrant health.

Everyday Acts of Resistance: Mexican, Undocumented Immigrant Children and Adolescents Navigating Oppression With Mentor Support.

Study aims were to examine oppression in education among Mexican immigrant youth with undocumented status and how mentors and other adults helped them resist oppression. Qualitative, narrative one-on-one interviews were conducted with 17 Mexican immigrant young adults with undocumented or DACA status in the U.S. Participants provided retrospective accounts from childhood through older adolescence. Analyses revealed critical junctures in which participants experienced oppression: (1) developmental milestones and school events, (2) college application process, (3) unforeseen life events, and (4) incidents of racial discrimination. Mentors and other adults helped participants to resist oppression through advocacy, social capital efforts, role modeling, and emotional, instrumental, and financial support. This study fills gaps in the literature on mentoring and immigrant youth who are undocumented.

Using Occupational Histories to Assess Heat Exposure in Undocumented Workers Receiving Emergent Renal Dialysis in Georgia.

BACKGROUND: Immigrants often work in jobs that are known as dirty, demanding, and dangerous. Globally, the agricultural occupations have been associated with the emergence of chronic kidney disease of unknown etiology (CKDu) primarily in outdoor worker populations. The disease has also been reported in immigrants in the United States who work in agricultural occupations, but little research has been done outside of agricultural workers to determine whether immigrants who work other occupations are at risk for developing CKDu. METHODS: This study assessed the self-reported occupational histories of undocumented immigrants receiving frequent, emergent-only dialysis in Atlanta, GA. We assessed demographics, employment status, and work history, using the Grady Dialysis Questionnaire and the Occupational/Environmental Health History Form. RESULTS: Fifty undocumented immigrants receiving frequent, emergent-only hemodialysis were recruited for this study. The average age was 49.5 years (SD ± 11.5), and the majority (52%) were female and originated from Mexico (66%). A majority (74%) reported having worked in the past 5 years and 28% reported currently working. A total of 68 unique jobs were reported. In decreasing order of frequency, our sample worked in occupations with documented renal toxicant exposures, such as applying pesticides in landscaping, heat exposure in agriculture, construction, landscaping, and dry cleaning, and lead paint fumes in construction. DISCUSSION: Occupational histories provide a greater understanding of the exposures and working conditions of those receiving frequent, emergent-only hemodialysis. This exploratory study suggests that further research is needed to investigate and assess whether renal toxicants are associated with occupations with high numbers of undocumented workers. APPLICATION TO PRACTICE: A detailed and thorough occupational history should be conducted from those receiving frequent, emergent-only hemodialysis. Developing continuing education for nursing and medical staff in dialysis centers on taking an occupational history, mandatory State reporting requirements, and hazard communication training for workers should be considered. Collaborations between occupational health professionals, public health authorities, employers, dialysis providers, and clinicians who see undocumented workers is required to understand and develop appropriate prevention measures for this population.

Familias Divididas [divided families]: Transnational family separation and undocumented Latinx immigrant health.

Undocumented Latinx immigrants (ULIs) comprise a large segment of the U.S. population, yet they remain at high risk for diminished health outcomes due to increased exposure to adverse experiences and context. Transnational family separation and the distress that accompanies it is an example of a common adverse experience that is chronic and that impacts the lives of many ULIs. However, despite how chronic and central transnationalism is to the lives of ULIs, little is known about its relation to the health outcomes of ULIs. To that end, this study examined the relation between distress due to transnational family separation and the physical and mental health of ULIs. To do so, the study utilized respondent-driven sampling and path analysis methodologies to cross-sectionally examine how distress from transnational separation was related to the physical and mental health of ULIs (n = 229). Results revealed that as distress from transnational family separation increased so too did participant's depressive (ß = .25, p < .001), anxiety (ß = .18, p = .006), and physical symptoms (ß = .24, p < .0001). Distress from transnational family separation was also more strongly related to physical and depressive symptoms than to anxiety symptoms. Considering these results, important systemic changes to our approach to healthcare delivery and access among ULIs communities are needed to promote the well-being of this at-risk population. Recommendations for doing so are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

One more wall to cross: The role of psychologists in addressing integrated health among undocumented Latinx immigrants in inpatient medical settings.

Over the past decade, there has been increased attention to the benefits of an integrated health-care care model in which psychologists play a vital role collaborating with other health providers to deliver services in inpatient medical settings, such as emergency departments and acute care medical units. Psychologists working in inpatient medical settings can facilitate access to mental health services and referrals, reduce mental health stigma, improve health outcomes associated with insight into psychosocial factors that affect health and illness, improve communication between patients and providers, and increase sensitivity in addressing the health needs of diverse patients. Psychological services in inpatient medical units can be particularly valuable for marginalized populations, such as undocumented Latinx immigrants, who may not otherwise have access to services that can address the compounded effect that psychosocial stressors may have on their physical health. We illustrate the critical role that psychologists can play in inpatient medical settings to address the complex health needs of Latinx immigrants. In this case study, an undocumented young woman presented to an emergency department with acute liver failure. We focus on psychologists' specific contributions as part of the integrated medical team and how it may have impacted treatment effectiveness. We also provide practical assessment and treatment recommendations, along with proposing advocacy efforts to facilitate access to culture and context sensitive treatments for undocumented immigrants with complex health issues. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Lessons learned from undocumented Latinx immigrants: How to build resilience and overcome distress in the face of adversity.

Living under chronic uncertainty, fear, and isolation is the experience of many undocumented immigrants particularly under the recent sociopolitical climate. Yet, despite facing chronic adversity and an uncertain future, undocumented immigrants are highly resilient. This paper draws upon the clinical and research expertise of leading Latinx psychologists working with diverse undocumented communities across the United States. Qualitative data from seven focus groups with undocumented Latinxs and 15 in-depth interviews with key informants were used to complement clinical insights to identify and highlight strategies of undocumented Latinxs that promote their resilience. Overall, six primary strategies emerged including cognitive reframing, behavioral adaptability, acceptance, sociability, courage, and ancestral or cultural pride. Within each of these primary strategies, two-to-five additional facets emerged. We also identified the positive effects of the aforementioned strategies, including the fostering of meaning, purpose, and hope. Our findings are essential to address biases and stigmatization against undocumented immigrants, as well as to inform strength-based interventions and services, as well as culturally and contextually sensitive resources. Health services providers working with undocumented Latinxs can identify and build on strengths in their patients to demonstrate accurate cultural understanding and also to support resilience. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Comparison of Psychological Stress and Sleep Problems in Undocumented Students, DACA Recipients, and U.S. Citizens.

Amidst the uncertainty of a shifting political landscape, our study examined stress and sleep problems experienced by both Deferred Action for Childhood Arrivals (DACA) undergraduates and non-DACA undocumented immigrants in an undergraduate population, in relation to students who were US citizens. We surveyed 969 students (93% Hispanic; 69% female) in 2017 or 2019 using established measures of stress, sleep quality, and insomnia. Collapsed across years, undocumented students reported significantly greater stress than citizens and DACA students, but DACA students did not differ from citizens. No differences were found in sleep for either quality or insomnia. Additionally, DACA student stress was significantly higher in 2019 than 2017, rising to a level similar to that of undocumented students and that differed significantly from citizens. Undocumented students appear to experience greater stress than students who are U.S. citizens, but these differences do not extend to sleep quality or insomnia.

Designing and assessing of an art-based intervention for undocumented migrants.

BACKGROUND: Undocumented immigrants and refugees are more likely to suffer from psychosocial disorders. METHODOLOGY: In this pilot study, an art-based intervention is described and assessed, with a sample of 11undocumented immigrants who recently came to southern Spain on a small boat. The art-based intervention is assessed using a pre-post design and four questionnaires, which consist of The General Health Questionnaire, Beck's Depression Inventory, the Barcelona Immigrant Stress Scale and Carol Ryff's Psychological Well Being Scale. Furthermore, five participants were interviewed before and after the intervention and a thematic analysis of the transcriptions was carried out. RESULTS: A significant reduction of depressive symptoms with a large effect size was found. An increase of reflexive discourse and the feeling of belonging after the intervention was also observed. CONCLUSIONS: The study suggests that the art-based intervention decreased depressive symptoms and stress, redirecting the narratives of the participants towards the future and increasing the sense of community.

Why we dehumanize illegal immigrants: A US mixed-methods study.

Dehumanization is a topic of significant interest for academia and society at large. Empirical studies often have people rate the evolved nature of outgroups and prior work suggests immigrants are common victims of less-than-human treatment. Despite existing work that suggests who dehumanizes particular outgroups and who is often dehumanized, the extant literature knows less about why people dehumanize outgroups such as immigrants. The current work takes up this opportunity by examining why people dehumanize immigrants said to be illegal and how measurement format affects dehumanization ratings. Participants (N = 672) dehumanized such immigrants more if their ratings were made on a slider versus clicking images of hominids, an effect most pronounced for Republicans. Dehumanization was negatively associated with warmth toward illegal immigrants and the perceived unhappiness felt by illegal immigrants from U.S. immigration policies. Finally, most dehumanization is not entirely blatant but instead, captured by virtuous violence and affect as well, suggesting the many ways that dehumanization can manifest as predicted by theory. This work offers a mechanistic account for why people dehumanize immigrants and addresses how survey measurement artifacts (e.g., clicking on images of hominids vs. using a slider) affect dehumanization rates. We discuss how these data extend dehumanization theory and inform empirical research.

Perspectives on Kidney Disease Education and Recommendations for Improvement Among Latinx Patients Receiving Emergency-Only Hemodialysis.

Importance: In most states, undocumented Latinx immigrants with kidney failure receive dialysis in acute care settings on an emergency-only basis. How much kidney disease education Latinx immigrants receive and how to improve kidney disease education and outreach among Latinx populations are unknown. Objective: To understand the kidney disease educational gaps of Latinx individuals who need but lack access to scheduled outpatient dialysis. Design, Setting, and Participants: This qualitative study used semistructured interviews in a Texas hospital system from March 2020 to January 2021 with 15 individuals who received emergency-only dialysis when they were first diagnosed with kidney failure. Demographic information was collected, and a thematic analysis was performed using the constant comparative method on interviews after they were audio-recorded, translated, and transcribed verbatim. Data analysis was performed from April 2020 to February 2021. Main Outcomes and Measures: Subthemes and themes from semistructured interviews. Results: All 15 persons interviewed (9 male individuals [60%]; mean [SD] age, 51 [17] years) identified as Hispanic, 11 (73%) were born in Mexico, and none reported knowing about their kidney disease more than 6 months before starting dialysis. The themes identified were (1) lack of kidney disease awareness, (2) education provided was incomplete and poor quality, (3) lack of culturally concordant communication and care, (4) elements that Latinx patients receiving emergency-only dialysis want in their education, (5) facilitators of patient activation and coping, and (6) Latinx patient recommendations to improve community outreach. Conclusions and Relevance: Latinx adults receiving emergency-only dialysis are usually unaware of their kidney disease until shortly before or after they start dialysis, and the education they receive is poor quality and often not culturally tailored. Participants made feasible recommendations on how to improve education and outreach among Latinx communities.

Risk and protective markers for well-being in Latinx immigrants in removal proceedings.

OBJECTIVES: There are currently 1,308,327 immigrants in removal proceedings, over 80% of whom are Latinx (TRAC, 2021b). This study examined the relation among putative protective markers (i.e. social support, religious support, and legal support) and the emotional and physical well-being of Latinx individuals facing removal proceedings. HYPOTHESES: We hypothesized that increased social support, religious support, and legal support would buffer the negative relations between hopelessness, poor self-efficacy, and well-being measures (depression, anxiety, stress, mental well-being, somatic symptoms, and physical well-being). METHOD: Participants (N = 157; 31.2% men, M age = 33.4 years) had an active immigration court case in Texas and completed a demographic questionnaire, the Beck Hopelessness Scale, General Self-Efficacy Scale, Multidimensional Scale of Perceived Social Support, Multi-Faith Religious Support Scale, Depression, Anxiety, Stress Scale-21, Patient Health Questionnaire-15, and Short Form Health Survey-12. RESULTS: Higher levels of hopelessness and poor self-efficacy were associated with more negative well-being outcomes, while social support was associated with more positive well-being outcomes. Contrary to hypotheses, religious support and legal support served as risk markers independently, while legal support interacted with hopelessness, such that decreased legal support was associated with higher mental well-being at lower levels of hopelessness and interacted with poor self-efficacy, such that increased legal support was associated with poorer mental well-being at lower levels of self-efficacy. All effect sizes were small (rsp2 = .04 to .16). CONCLUSIONS: Targeting hopelessness and poor self-efficacy while promoting social support may help mental health professionals improve the well-being of immigrants in removal proceedings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Anti-immigrant Rhetoric and the Experiences of Latino Immigrants in the Emergency Department.

INTRODUCTION: Anti-immigrant rhetoric and increased enforcement of immigration laws have induced worry and safety concerns among undocumented Latino immigrants (UDLI) and legal Latino residents/citizens (LLRC), with some delaying the time to care. In this study, we conducted a qualitative analysis of statements made by emergency department (ED) patients - a majority of whom were UDLI and LLRC - participating in a study to better understand their experiences and fears with regard to anti-immigrant rhetoric, immigration enforcement, and ED utilization. METHODS: We conducted a multi-site study, surveying patients in three California safety-net EDs serving large immigrant populations from June 2017-December 2018. Of 1684 patients approached, 1337 (79.4%) agreed to participate; when given the option to provide open-ended comments, 260 participants provided perspectives about their experiences during the years immediately following the 2016 United States presidential election. We analyzed these qualitative data using constructivist grounded theory. RESULTS: We analyzed comments from 260 individuals. Among ED patients who provided qualitative data, 59% were women and their median age was 45 years (Interquartile range 33-57 years). Undocumented Latino immigrants comprised 49%, 31% were LLRC, and 20% were non-Latino legal residents. As their primary language, 68% spoke Spanish. We identified six themes: fear as a barrier to care (especially for UDLI); the negative impact of fear on health and wellness (physical and mental health, delays in care); factors influencing fear (eg, media coverage); and future solutions, including the need for increased communication about rights. CONCLUSION: Anti-immigrant rhetoric during the 2016 US presidential campaign contributed to fear and safety concerns among UDLI and LLRC accessing healthcare. This is one of the few studies that captured firsthand experiences of UDLI in the ED. Our findings revealed fear-based barriers to accessing emergency care, protective and contributing factors to fear, and the negative impact of fear. There is a need for increased culturally informed patient communication about rights and resources, strategic media campaigns, and improved access to healthcare for undocumented individuals.

Public Benefit Use and Social Needs in Hospitalized Children With Undocumented Parents.

BACKGROUND AND OBJECTIVES: Studies supporta recent decline in public benefit enrollment among immigrant families. We aimed to describe health and resource use, barriers to use, and immigration-related fear in families with undocumented parents compared with families without undocumented parents. We also aimed to assess associations with discontinuation of public benefits and fear of deportation. METHODS: We assessed immigration concerns and enrollment in Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with an 89-item anonymous, cross-sectional survey of English- and Spanish-speaking caregivers of hospitalized children. Multivariable logistic regression was used to assess associations with discontinuation of public benefits and fear of deportation. RESULTS: Of 527 families approached, 399 enrolled (105 with 1 or more undocumented parent, 275 with no undocumented parent, and 19 with undisclosed immigration status). Compared with families without undocumented parents, families with undocumented parents had higher levels of poverty and food insecurity. Controlling for perceived eligibility, public benefit use was similar across groups. Of families with undocumented parents, 29% reported public benefit discontinuation because of immigration concerns, and 71% reported fear of deportation. Having an undocumented parent was associated with public benefit disenrollment (odds ratio: 46.7; 95% confidence interval: 5.9-370.4) and fear of deportation (odds ratio: 24.3; 95% confidence interval: 9.6-61.9). CONCLUSIONS: Although families with undocumented parents had higher levels of poverty and food insecurity compared with families without undocumented parents, public benefit use was similar between groups. Immigration-related fear may be a barrier to public benefit use in this population.