Mental Health and Immigration Policy: A Conversation With Germán Cadenas

Overview

During the first Trump administration (2017–21), immigration policies shifted rapidly, creating significant challenges for immigrants and their broader communities. These changes led to increased psychological stress and health concerns among migrants, largely due to the pressures of new immigration restrictions. While immigrants were most directly affected, spillover effects extended to connected communities, such as mixed-status families or workplaces. For instance, young U.S. citizens experienced fear upon witnessing the effects of these restrictions on their immigrant peers.

Researchers have identified key features of immigrant communities that may help improve conditions in response to these challenges. Activism, particularly in response to restrictive immigrant policies, has emerged as a valuable coping strategy. Other responses to such policies, however, also exist among populations under stress. Alternative coping strategies include strengthening social ties with their communities, leveraging resources, and maintaining future aspirations.

This brief is based on a conversation with Germán A. Cadenas, an associate professor of clinical psychology at Rutgers University Graduate School of Applied and Professional Psychology. On Dec. 4, 2024, Cadenas met with members of the Baker Institute Migration Initiative to discuss the effects of U.S. immigration policies and the potential of activism in promoting immigrants’ health and well-being.

Four main themes were explored:

1. Federal and state immigration policy changes.
2. Impact on immigrant health and well-being.
3. Community activism as a resilience strategy.
4. Community and policy responses.

Federal and State Immigration Policy Changes

Even before 2017, a series of federal policy changes had begun to limit immigrants’ access to social support systems, creating growing challenges for migrant families. Between 2017 and 2021, more than 470 federal policy changes affecting immigrants were implemented, according to the Migration Policy Institute. These included increased raids and enforcement, expedited deportation through immigration courts, and a stricter interpretation of the public charge rule, which deemed that noncitizens who rely on long-term public assistance can be denied admission to the United States and deemed ineligible for visas or permanent residency.

The impacts of these changes have been far-reaching, contributing to detrimental public perceptions of immigrants, rising deportations, and broader efforts to deter migration. These included policies such as sanctuary city bans, travel bans, and the termination of programs that informed immigrants about their rights while in detention.

Cadenas noted that recent research used the Immigration Policy Climate Index (IPC) to evaluate how state policies shape the political environment for immigrants. IPC ratings, which range from -10 to 10, reflect 714 state-level policies across key social determinants of health, including access to:

1. Public health and welfare benefits.
2. Higher education.
3. Labor and employment.
4. Driver’s licenses and IDs.

The index also considers the nature of immigration enforcement. The U.S. currently has a mean IPC of -2.5, indicating the prevalence of exclusionary policies that contribute to a difficult climate for many immigrant communities.

Impact on Immigrant Health and Well-Being

The structural changes brought about by new policies are compounded by other social crises affecting immigrants and refugees. For instance, immigrants with precarious immigration legal status were disproportionately impacted by the COVID-19 pandemic due to structural factors such as exclusion from remote work opportunities, limited access to health resources, and difficulty maintaining social distancing in crowded living and working conditions. These factors contributed to higher morbidity and mortality rates, as well as increased symptoms of anxiety and depression. In contrast, the citizenship shield framework suggests that U.S. citizens were more likely to benefit from legal protections and benefits— such as access to health care and workplace safeguards — positioning citizenship as a protective factor for health.

Psychological Challenges

In addition to significant physical health challenges, immigrants also face psychological obstacles. Living with precarious immigration legal status is generally associated with lower inclusivity, poorer mental health, and reduced educational persistence.

• In one study, immigrants with precarious immigration legal status reported clinically significant levels of psychological distress related to their immigration experience.
• College students without permanent residency experienced greater psychological distress compared to those with more secure immigration legal status.

These effects are not limited to immigrants — research shows that immigration-related stress impacts many Latino communities, regardless of immigration legal status. At the same time, Cadenas emphasized that immigrants with undocumented legal status often demonstrate strong resilience, relying on well-developed coping strategies to navigate difficult circumstances.

Community Activism as a Resilience Strategy

Cadenas noted that activism can serve as a form of social support, promoting immigrant well-being by reducing psychological stress, improving academic performance, and strengthening individuals’ sense of agency. In this context, activism refers to immigrant-led campaigns aimed at reducing harm and creating safer, more supportive environments in the U.S.

Together with other researchers, Cadenas developed the Anti-Racism Activism for Immigrant Rights (AAIR) framework to clarify how activism in response to systemic stress can promote healthy coping. The framework outlines three key forms of activism:

1. Racial justice.
2. Immigrant rights.
3. Electoral engagement.

He explained that heightened stress may mobilize communities to engage in activism, which in turn is linked to increased use of healthy coping strategies. He identified three main methods:

1. Active coping — engaging in efforts to change unfavorable social conditions.
2. Positive reframing — viewing challenges through an optimistic lens.
3. Planning — using strategic, collective actions to address challenges.

Cadenas noted that awareness of systemic oppression, often called critical consciousness, is linked to better psychological outcomes. By fostering this awareness, activism can help reduce psychological distress, including anxiety and depression.

Community and Policy Responses

Engaging in collective action in response to challenging social conditions can improve psychological health, empowering communities to promote their own well-being. While exclusionary immigration policies pose significant mental and physical health risks, community connection and advocacy offer a path toward resilience and healing.

Community-engaged strategies, even small steps like learning and sharing information about legal rights, can provide valuable social support. Encouraging dialogue across diverse groups further promotes understanding and shared solutions.

At the policy level, the American Psychological Association’s statement on immigrant health urges psychologists, educators, researchers, and policymakers to work toward improving immigrants’ access to health care and supportive services.

These approaches highlight how individual actions, community-led efforts, and professional advocacy can combine to improve conditions for immigrants and promote the overall well-being of U.S. communities.

This publication was produced on behalf of Rice University’s Baker Institute for Public Policy. Wherever feasible, the material was reviewed by external experts prior to its release. Any errors are the responsibility of the author(s) alone.

This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author(s) and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s) and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.