For people who move to the US, no two experiences will be the same. However, many migrants and refugees face or have faced trauma, whether in their home country, while traveling, or after arriving in their host country.
One study suggested that almost half (47%) of migrants experience post-traumatic stress disorder (PTSD)1, while another found that around one-third of adolescents (29%) and parents (34%) experienced trauma during the migration process.2
Stages of Immigration Trauma
First, how do we define trauma? Trauma, as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA), “results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
Often, immigration trauma is thought of in different stages, as follows.
• Pre-migration trauma. People may have experienced trauma before their move—trauma that would likely have influenced their decision to leave their country. This might involve violence, poverty, persecution, or exposure to armed conflict. Money is another factor. There is a USCIS immigrant fee of $220 per person applying, while people might pay the same again for someone to help them apply—and then there’s the wait for an interview date.
• Travel and transit. This involves exposure to trauma during the journey. This might involve violence, detention, forced labor, or lack to access to basic services.
• Post-migration trauma. Migrants and refugees can experience trauma with barriers to accessing basic services like education and health care, as well as financial struggles and poor living conditions, particularly if they’re sending money to loved ones back home.
Children might find it difficult to join a school and they really need trauma-sensitive and identity-informed support to feel safe again so that they can continue their education
Migrants may also find themselves separated from loved ones and support networks, or have difficulties with regard to legal status and work permits.
•Settlement and integration. Challenges with settling and integrating can cause trauma. Migrants might struggle to assimilate into their host culture, with racism, exclusion, isolation and discrimination, and poor living and working conditions.
“Resettlement doesn’t mark the end of these psychological journeys,” explains Amna, an organization that supports the psychosocial well-being of displaced communities, “Adapting to a new country is another challenging step and can add to distress. Refugees will be experiencing loss and grief, even survivor’s guilt, and the normality of the new environment can be a painful reminder of what has been lost.
“Some might be in shock, some can be in a very agitated and anxious state, and others in rapid go-go-go mode. Additionally, hostile policies and discrimination can cause severe anxiety and distress”.
How Does Immigration Cause Trauma?
• Loss of identity and familiarity. When somebody moves to a new culture and loses their familiar culture and social structure, it can cause a form of grief that’s sometimes referred to as cultural bereavement. Migrants might miss the language of their country—particularly regional dialects and colloquialisms – as well as social structures and support networks.3
• Lack of tools or resources to cope in a new environment. When arriving in a host country, migrants may not have access to the tools or resources required to help them cope or adjust to the new environment. This might be because they can’t speak the language, because of financial constraints, or lack of knowledge in terms of what’s available.
• Violence, assault, loss of family members. Migrants and refugees may have experienced assault, abuse, or violence either before the journey or during the process of migration, or lost family friends, or friends—experiences that many people would find traumatic regardless of the wider context of immigration.
“Most asylum seekers who are detained experience a degree of trauma from the process alone and the uncertainty of waiting until their case is reviewed. Unfortunately, asylum seekers have also been known to experience trauma when their children were separated from them or lost in the system, when they receive poor treatment in detention centers, and when women have had hysterectomies without their consent,” says Yolanda Renteria, LPC, a psychotherapist and trauma expert.
• Uncertainty and lack of stability. In terms of post-migration trauma, in particular, uncertainty surrounding immigration policy can be a cause of stress and trauma—some migrants may have a fear of deportation, or experience difficulties in getting work permits, for example. And beforehand, getting the required documentation and seeing if there’s a path to residency can both add to the trauma, as can changes in people’s lives during the immigration process that might impact eligibility. People with student visas might face more anxiety during their stay if they want to remain in the US.
Trauma in Children
For children, racism and discrimination, economic deprivation and a lack of security and stability can be causes of trauma. Children who’ve been separated from their parents or guardians as part of their migration journey have a higher risk of developing depression, anxiety, suicidal ideation, and substance use disorders.4
“Additionally, children might find it difficult to join a school and they really need trauma-sensitive and identity-informed support to feel safe again so that they can continue their education,” say Amna, “Often the symptoms of trauma such as loss of concentration are not recognized and children are labeled as so-called ‘problem children’.”
“For DACA [Deferred Action for Childhood Arrivals] recipients, it’s growing up either knowing they didn’t have papers and being afraid of border patrol/ICE, or not knowing they didn’t have papers when they were children and then finding out once they wanted to apply for college,” says Renteria.
Coping With and Managing Trauma
Consistent access to heritage culture as well as host culture is important for migrants who may be dealing with trauma. The heritage culture offers access to support and resources, while the host culture gives access to institutions that can help migrants adjust.5
Access to employment, basic services, and social support can all help counter the trauma and stress experienced by migrants, as can family reunification and learning the language of the host country.
For children, access to education is important, as are feelings of safety. Strong parental mental health has a knock-on effect too, protecting children from trauma, as does a stable family structure and social network.
The World Health Organization set out ways to overcome barriers to mental health care for migrants and refugees. They include making information on mental health care access clear through schools, religious settings, and community outreach initiatives, and reaching out to at-risk groups like unaccompanied minors and migrants who identify as LGBTQ+.
Person-centered care that’s respectful of religious and cultural differences is also important, as is integrating mental health support through education, social services, and law enforcement.
Amna explain that an “identity-informed and non-pathologizing approach to trauma care is important in helping refugees to begin feeling safer again and rebuild their lives. Refugees (like everyone else) have multiple identities and respecting and recognizing the multiple facets of who they are can help with the healing process, especially as they might face discrimination on their journeys and after settling.
“The grief, stress, and pain that refugees feel as a result of their experiences and displacement are completely normal. Instead of ‘diagnosing’ refugees, recognizing this and that people have different responses to loss and grief, and supporting them to feel safer is important.”
For migrants and refugees looking for support, there are resources out there. A range of charities and organizations work to support refugees and migrants who may have experienced trauma, including The Coalition for Immigrant Mental Health, which offer a directory of services in both English and Spanish. Meanwhile, undocumented immigrants can find mental health support with Immigrants Rising’s Mental Health Connector,
Ultimately, acculturative stress can be overcome if it is understood that ethnic identity, which includes heritage culture and racial identity, and national (i.e. American) identity are not mutually exclusive and can successfully coexist.5
Migrants and refugees need long-term support, with community spaces, mental health care, the right documentation, and stable housing. While it won’t erase trauma, it’ll go a long way to helping them.