Humanitarian crisis on the US–Mexico border: Mental health needs of refugees and asylum seekers

Morales, Frances R.; Nguyen-Finn, Kim L.; Haidar, Makram; Mercado, Alfonso

doi:10.1016/j.copsyc.2022.101452

Cited by 7 publications

(4 citation statements)

References 42 publications

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“…Another study analyzing asylum-seekers’ affidavits after living through the Migrant Protection Protocols (MPP) found that the MPP increased asylum-seekers’ risk of re-traumatization and affected their ability to heal from pre-migration trauma [ 54 ], perpetuating the harms of GBV [ 54 ]. Other studies have highlighted the need for mental health supports in asylum-seekers, given the high levels of trauma exposure, both before and after crossing the border into the U.S [ 6 , 55 – 57 ].…”

Section: Discussionmentioning

confidence: 99%

“When you leave your country, this is what you’re in for”: experiences of structural, legal, and gender-based violence among asylum-seeking women at the Mexico-U.S. border

Ramage,

Stirling-Cameron,

Ramos

et al. 2023

BMC Public Health

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Background Recent U.S. immigration policy has increasingly focused on asylum deterrence and has been used extensively to rapidly deport and deter asylum-seekers, leaving thousands of would-be asylum-seekers waiting indefinitely in Mexican border cities, a large and growing proportion of whom are pregnant and parenting women. In the border city of Tijuana, Mexico, these women are spending unprecedented durations waiting under unsafe humanitarian conditions to seek safety in the U.S, with rising concerns regarding increases in gender-based violence (GBV) among this population during the COVID-19 pandemic. Given existing gaps in evidence, we aimed to describe the lived experiences of GBV in the context of asylum deterrence policies among pregnant and parenting asylum-seeking women at the Mexico-U.S. border. Methods Within the community-based Maternal and Infant Health for Refugee & Asylum-Seeking Women (MIHRA) study, we conducted semi-structured qualitative interviews with 30 asylum-seeking women in Tijuana, Mexico between June and December 2022. Eligible women had been pregnant or postpartum since March 2020, were 18–49 years old, and migrated for the purposes of seeking asylum in the U.S. Drawing on conceptualizations of structural and legal violence, we conducted a thematic analysis of participants’ experiences of GBV in the context of asylum deterrence policies and COVID-19. Results Pregnant and parenting asylum-seeking women routinely faced multiple forms of GBV perpetuated by asylum deterrence policies at all stages of migration (pre-migration, in transit, and in Tijuana). Indefinite wait times to cross the border and inadequate/unsafe shelter exacerbated further vulnerability to GBV. Repeated exposure to GBV contributed to poor mental health among women who reported feelings of fear, isolation, despair, shame, and anxiety. The lack of supports and legal recourse related to GBV in Tijuana highlighted the impact of asylum deterrence policies on this ongoing humanitarian crisis. Conclusion Asylum deterrence policies undermine the health and safety of pregnant and parenting asylum-seeking women at the Mexico-U.S. border. There is an urgent need to end U.S. asylum deterrence policies and to provide respectful, appropriate, and adequately resourced humanitarian supports to pregnant and parenting asylum-seeking women in border cities, to reduce women’s risk of GBV and trauma.

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Section: Discussionmentioning

confidence: 99%

“When you leave your country, this is what you’re in for”: experiences of structural, legal, and gender-based violence among asylum-seeking women at the Mexico-U.S. border

Ramage,

Stirling-Cameron,

Ramos

et al. 2023

BMC Public Health

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“…Recent quantitative and qualitative research on mental health among migrants and refugees in Latin America, including migrants in Ecuador and Panamá, has identified symptoms of depression (Carroll et al, 2020 ; Greene et al, 2022b ), generalized anxiety disorder (Carroll et al, 2020 ), post-traumatic stress disorder (Espinel et al, 2020 ) and general psychological distress, including feelings of fear, anger and stress (Greene et al, 2022b ; Mougenot et al, 2021 ). Migrants and forcibly displaced populations in Latin America face a range of risk factors for mental health problems across the phases of migration, including exposure to potentially traumatic events, discrimination and xenophobia, social isolation, lack of integration and socioeconomic adversity (Keller et al, 2017 ; Carroll et al, 2020 ; Mougenot et al, 2021 ; Morales et al, 2022 ; Salas-Wright et al, 2022 ). There is growing evidence supporting the effectiveness of community-based mental health and psychosocial interventions for alleviating symptoms of common mental disorders and psychological distress among displaced populations (Bangpan et al, 2019 ; Turrini et al, 2019 ; Barbui et al, 2020 ; Haroz et al, 2020 ), including for displaced and emergency-affected populations in Latin America (Bonilla-Escobar et al, 2018 ; 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Strategies to improve the implementation and effectiveness of community-based psychosocial support interventions for displaced, migrant and host community women in Latin America

Greene,

Wimer,

Larrea

et al. 2024

Camb. prisms Glob. ment. health

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As evidence supporting the effectiveness of mental health and psychosocial interventions grows, more research is needed to understand optimal strategies for improving their implementation in diverse contexts. We conducted a qualitative process evaluation of a multicomponent psychosocial intervention intended to promote well-being among refugee, migrant and host community women in three diverse contexts in Ecuador and Panamá. The objective of this study is to describe the relationships among implementation determinants, strategies and outcomes of this community-based psychosocial intervention. The five implementation strategies used in this study included stakeholder engagement, promoting intervention adaptability, group and community-based delivery format, task sharing and providing incentives. We identified 10 adaptations to the intervention and its implementation, most of which were made during preimplementation. Participants (n = 77) and facilitators (n = 30) who completed qualitative interviews reported that these strategies largely improved the implementation of the intervention across key outcomes and aligned with the study's intervention and implementation theory of change models. Participants and facilitators also proposed additional strategies for improving reach, implementation and maintenance of this community-based psychosocial intervention.

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“…The disproportionate burden of mental health problems among populations impacted and displaced by humanitarian emergencies is well-documented [4][5][6]. Research on the mental health consequences of forced displacement within Latin America has identified a range of risk factors for mental health problems across the migration trajectory, including exposure to trauma before and during migration as well as discrimination, lack of integration, and socioeconomic adversity following resettlement [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Accessibility and Perceived Impact of a Group Psychosocial Intervention for Women in Ecuador: A Comparative Analysis by Migration Status

Wimer,

Larrea,

Streeter

et al. 2024

IJERPH

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There is increasing guidance promoting the provision of mental health and psychosocial support programs to both migrant and host community members in humanitarian settings. However, there is a lack of information on the respective experiences and benefits for migrant and host community members who are participating in mental health and psychosocial support programming. We evaluated a community-based psychosocial program for migrant and host community women, Entre Nosotras, which was implemented with an international non-governmental organization in Ecuador in 2021. Data on participant characteristics and psychosocial wellbeing were collected via pre/post surveys with 143 participants, and qualitative interviews were conducted with a subset (n = 61) of participants. All quantitative analyses were conducted in STATA, and qualitative analysis was done in NVivo. Attendance was higher for host community members. Specifically, 71.4% of host community members attended 4–5 sessions, whereas only 37.4% of migrants attended 4–5 sessions (p = 0.004). Qualitative analysis shows that the intervention was less accessible for migrants due to a variety of structural barriers. However, this analysis also demonstrated that both groups of women felt a greater sense of social connectedness after participating in the program and expressed gratitude for the bonds they formed with other women. Some migrant women described negative experiences with the host community because they felt as though they could not confide in host community women and speak freely in front of them. These results underscore how the migratory context influences the implementation of mental health and psychosocial support (MHPSS) programs. As humanitarian guidelines continue to emphasize the integration of host community members and displaced persons, it is critical to account for how the same intervention may impact these populations differently.

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Humanitarian crisis on the US–Mexico border: Mental health needs of refugees and asylum seekers

Cited by 7 publications

References 42 publications

“When you leave your country, this is what you’re in for”: experiences of structural, legal, and gender-based violence among asylum-seeking women at the Mexico-U.S. border

“When you leave your country, this is what you’re in for”: experiences of structural, legal, and gender-based violence among asylum-seeking women at the Mexico-U.S. border

Strategies to improve the implementation and effectiveness of community-based psychosocial support interventions for displaced, migrant and host community women in Latin America

Accessibility and Perceived Impact of a Group Psychosocial Intervention for Women in Ecuador: A Comparative Analysis by Migration Status

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