Legal, illegal immigrants face slew of mental health issues

TUSCON, ARIZ. - He rode from Guatemala stacked like lumber with other human slabs in a van.

He was along for the ride as passengers were crushed by the weight of others and trapped women were raped.

Dehydration knocked him out in the desert. He awoke horrified and full of tubes in Arizona, where he was wired to a dialysis machine.

"He thought he was being tortured," said Sarah Roberts, a Tucson nurse, about the traumatized minor, an illegal immigrant. Roberts belongs to the Samaritans, a humanitarian group that delivers food, water and emergency aid and rescue to migrants traveling along the southern border.

Around Christmas, the minor from Guatemala was in a psychiatric ward, full of trust issues and burdened by pressure from family in South America who told him to buck up, start working and pay them back for the ticket price of his crossing.

But work would make him ineligible for the abandoned children's visa he applied for.

The desperation that makes some leave their native countries, the dangerous journeys they take and the culture shock they experience upon arrival make for high rates of post-traumatic stress, anxiety and depression among immigrants.

A late 1980s study of 7,000 Southeast Asian refugees showed subjects had three times the rate of psychological stress than the general American population, said Jeannine Chapelle, prevention supervisor at La Frontera Center, Inc. in Tucson.

Many of the refugees she encounters likewise exhibit signs of anxiety, depression and post-traumatic stress.

Unhealed wounds

Neither the scars of homeland hardships nor memories of atrocities en route fade once immigrants reach the United States, where they encounter an array of new stressors and, sometimes, discrimination.

"It's a land of opportunity, but the circumstances we provide them create stress and more anxiety than what they already had," Chapelle said.

Being immersed in a new place with an unfamiliar language and different cultural norms is trying by itself, but the adaptation process also depends on where immigrants are from and the level of education and urbanization they have.

People who lived in refugee camps where their lives were organized by others have a particularly hard time getting settled into the independent American lifestyle, Chapelle said.

It also depends on one's nationality, said Ferdinand Lossou, director of migration and refugee services for Catholic Social Services in Tucson.

He described the adjustments of people from well-educated, Western-exposed Lebanon, Jordan and Syria as easy compared to people from remote areas in Somali with less access to education.

Lossou, who is from West Africa, said his transition to the U.S. was simple because he had lived in Europe previously.

For some, "it's really hard to understand, and they will ask the question 100 million times," said Irena Aksel, a clinician for adult outpatient therapy services at La Frontera. Aksel is a refugee from Russia. She learned English upon arrival in the U.S. from the children she supervised as a day care assistant.

Matching new arrivals with more assimilated, bilingual immigrants from the same culture makes the transitional processes easier, she said, but can backfire if they isolate themselves within their own ethnic communities, slowing adaptation to the American lifestyle.

Lossou said his agency provides networks for refugees, including welcome picnics and ethnic councils, but it tries not to place refugees of the same ethnicities in the same neighborhoods, hoping to force some assimilation.

Hardships of the American Dream

Immigrants feel pressure to "make it" in the U.S., but jobs are hard to come by in a place that doesn't always recognize foreign degrees and scoffs at accents.

The professional failure that can result cripples immigrants' self-esteem.

"We are a country of idiots in our inability to understand an accent," Chapelle said, explaining that immigrants who speak good English are often dismissed by potential employers who don't want to deal with foreign pronunciation.

Aksel had degrees in psychology and speech-language pathology in Russia; neither is considered valid in the U.S., so she had to duplicate her post-secondary education in Arizona.

"We have people with tremendous skills not able to find jobs here," Chapelle said. "They left what they knew and are unable to be the people they were before, here. It's a tremendous pressure we put on people."

A widened generational gap

While working-age immigrants may have trouble adapting to the U.S., teenagers and children learn English and absorb American culture all day long at school. They tend to outstrip their parents in assimilation, sometimes rupturing family structures.

"Kids are called upon to translate. They know how America works," Chapelle said. "It's easy for them to begin to take on responsibilities beyond their years."

The upturned family order and new culture can make parental discipline difficult, and social workers here aren't always sure how to balance respect of one culture with realities of another.

Closely monitoring older boys isn't stressed in African culture, Chapelle said, but the lack of supervision worried the Tucson Police Department because immigrant children are more at risk to join gangs than children born here.

Criminal activity sometimes looks like economic opportunity to these children, she said, and they're desperate to fit in.