Implications of Undocumented Status for Latinx Families During the COVID-19 Pandemic: A Call to Action.

BACKGROUND: A disproportionate number of COVID-19 cases and deaths have been reported among Latinxs in the U.S. Among those most affected by the pandemic are marginalized families, including those that are undocumented and mixed-status, in which some, but not all members are undocumented. Undocumented and mixed-status families face multiple and chronic daily stressors that compromised their health and wellbeing. Salient stressors faced by undocumented Latinx families include poverty, social disadvantage, discrimination, dangerous living and working conditions, and limited access to healthcare. These stressors are frequently compounded with trauma, fear of detention, deportation, and family separation. PURPOSE: Informed by the literature and insights from our community-based work to address the health needs of undocumented and mixed status Latinx families during the pandemic, this paper uses a social determinants of health lens to present a narrative summary that highlights four primary psychosocial stressors faced by these families and their implications for mental health. DISCUSSION: These include stressors pertaining to (a) anti-immigrant rhetoric and actions; (b) family stressors and disruptions in family dynamics; (c) economic changes and financial losses; and (c) limited access to healthcare. Implications of the aforesaid stressors on the mental health of undocumented families and youth are also discussed. In addition, recommendations are provided for the provision of mental health services, best practices, and resources from a strengths-based approach.

Mind the gap: Identifying training needs of community health workers to address mental health in U.S. Latino communities during and beyond the COVID-19 pandemic.

Addressing mental health is an important part of the COVID-19 response among historically underserved communities, which have been disproportionately affected. Community Health Workers (CHWs) are well placed to offer insights about barriers to mental health service use in their communities, and they are well positioned to address mental health gaps by providing education, resources, and assistance to bridging the gap for the use of more traditional mental health services. Using the perspectives of CHWs, this project identified barriers faced by CHWs in assisting community members with their mental health needs, along with relevant training needs to more effectively deliver mental health resources, referrals, and recommendations to community members. Survey data along with data from focus groups were collected among 43 CHWs in communities that have been historically underserved near the U.S.-Mexico border region. Quantitative data were analyzed using descriptive statistics whereas qualitative data were analyzed through systematic methods. Identified barriers to assisting community members with their mental health needs exist at the personal, community, environmental and organizational levels, and ranged from fear and mistrust to limited services, resources, funding and training opportunities. To help address the aforementioned barriers and facilitate access to mental health service use in their communities, CHWs identified and described opportunities for training in core areas including communication, mental illness symptom identification, trauma, self-care and stress reduction, and cultural awareness and sensitivity. Needs-based training programs that incorporate the insights of CHWs are a crucial part of promoting community-based mental health to address existing mental health disparities in access to and use of mental health services.

Vaccination for COVID-19 among historically underserved Latino communities in the United States: Perspectives of community health workers.

A critical step to reduce the spread of COVID-19 is vaccination. We conducted a mixed methods project that used online surveys and focus groups with 64 Community Health Workers and Promotor/as (CHW/Ps) located near the U.S.-Mexico border to identify barriers and facilitators to COVID-19 vaccination among Latino communities that have been historically underrepresented and medically underserved. Overall, personal barriers to vaccination included mistrust of manufacturers and administrators as well as fear of: becoming infected from the vaccine, discrimination/stigmatization from healthcare professionals administering the vaccine, exploitation/manipulation by the government or health authorities, and having personal information mishandled. Environmental and community barriers included being undocumented and fear-inducing myths and beliefs. Additional barriers included limited information and logistics pertaining to vaccination access. Targeted efforts are needed to overcome barriers in a culturally and contextually sensitive manner to prevent harm and reduce risk of infection among communities that have been historically underrepresented.

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).