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DACA recipients cope with health challenges in face of uncertainty

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DACA recipients cope with health challenges in face of uncertainty

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This article was produced as a project for the Dennis A. Hunt Fund for Health Journalism, a program of the USC Annenberg Center for Health Journalism. It's the second in a series of stories exploring how the Trump administration's immigration policies are affecting the physical, mental and emotional health of the kids of undocumented immigrants and health providers and educators who work with them.

Other stories in the series include:

Trump stokes anxiety among U.S. citizen kids of undocumented parents

"If uncertainty continues for a long period of time, the body's going to resent it and something's going to fall apart."
"If uncertainty continues for a long period of time, the body's going to resent it and something's going to fall apart." (Getty Images)
'Dreamers' face stress, sleep problems and anxiety.
U.S. News
Thursday, October 12, 2017

Since President Donald Trump announced he was ending the Deferred Action for Childhood Arrivals program, Dulce Castro's heart beats faster whenever she thinks or talks about DACA, which shields from deportation hundreds of thousands of undocumented young people who were brought to the U.S. as kids. The 18-year-old college student in Tennessee, a DACA beneficiary, used to sleep eight hours a night, but since the September 5 announcement, she's been lucky if she gets four hours of uninterrupted rest.

Maria Guadalupe Valtierra rarely suffered from nightmares, but the Bothell, Washington, resident, who is also protected by DACA, has had plenty since the administration said it was ending the program. Some of the nightmares haven't been subtle. In one, Trump threw a woman down some stairs. "I think that represented me or my family," says the 34-year-old single mom, who works as a medical interpreter in a hospital, translating for Spanish-speaking women who are giving birth.

DACA beneficiary Josue Salinas, 18, of Harrisonburg, Virginia, also grapples with constant anxiety. "It's that feeling in your gut when you're in trouble or scared," he says. Salinas, who works in the distribution center of a department store in Virginia, prays each morning that everything will turn out OK, but sometimes quietly sobs when he's alone.

The three are among the approximately 690,000 "Dreamers" who are protected from deportation under DACA, a program created by executive order by President Obama in 2012. DACA shields undocumented people who came to the U.S. as children and grants them work permits for two years at a time. As of Sept. 5, the Trump administration stopped taking new applications for DACA. Beneficiaries of DACA who had two-year work permits that were to expire between Sept. 5 and March 5, 2018 could apply for a renewal, so long as they met an Oct. 5 deadline. These applications will be considered on a case-by-case basis, administration officials have said. President Trump said he plans to "revisit" DACA if Congress does not legislate a long-term solution by next March.

The chances of lawmakers finding a long-term solution may have taken a blow Oct. 8, when the White House sent Congress a list of hard-line immigration control measures it insists on before agreeing to legislation that provides legal status to DACA beneficiaries. The White House told Congress that before it would agree to providing relief for people now protected under DACA, it would require the construction of a border wall across the U.S.-Mexico border, funding to hire an additional 10,000 immigration agents, cuts to legal immigration and a crackdown on children from Central America who cross the border without their parents, typically to flee gang violence. These demands may derail an agreement that Senate Minority Leader Chuck Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-San Francisco) said they had with Trump to enact legislation to provide permanent legal status to DACA recipients. In announcing the end of the program, Attorney General Jeff Sessions said it was unconstitutional.

DACA applies to immigrants who first came to the U.S. before their 16th birthday and were not yet age 31 on June 15, 2012. Applicants must be currently in school or have graduated from high school, obtained a GED or have been honorably discharged from the armed forces. People who have been convicted of a felony, a significant misdemeanor (such as domestic violence or burglary) or three misdemeanors aren't eligible.

Since its inception, DACA has provided a kind of benign purgatory for hundreds of thousands of people whose parents brought them to the U.S. without authorization, typically to escape violence or poverty in their home countries. The program doesn't afford full legal standing and rights, but DACA status – renewable every two years – provides its beneficiaries with a work permit and protects them from deportation. The administration's decision to end DACA has thrown many Dreamers into a nightmare of uncertainty, which can have significant negative health consequences.

Research suggests that living with ambiguity can be more stressful than being certain something painful will happen. For example, knowing there's a small chance of feeling a painful electric shock can lead to much more stress than knowing you'll be shocked, according to a study by University College London researchers published in 2016 in Nature Communications. "It turns out that it's much worse not knowing you are going to get a shock than than knowing you definitely will or won't," researcher Archy de Berker said in a UCL publication.

"A human body can only take so much," says Nayeli Chavez-Dueñas, an associate professor at the Chicago School of Professional Psychology. "If uncertainty continues for a long period of time, the body's going to resent it and something's going to fall apart. Dreamers are living in a state of hyper-alertness, which is associated with stress." Such stress can lead to an array of physical and mental health problems, such as digestive issues, sleeplessness, fatigue and depression, she says. With the administration's decision to end the program, people with DACA status "can't plan for the future, even though some are going to school and some have jobs and careers," Chavez-Dueñas says. "It's an overwhelming sense of having no control over their entire life."

Studies also suggest that DACA has improved the mental health and well-being of its recipients. Exposure to DACA led to "meaningful reductions in symptoms of psychological distress among DACA-eligible individuals. The effects on mental health were large and clinically significant, with the DACA program significantly reducing the odds of individuals reporting moderate or worse psychological distress," according to a study published in 2017 in The Lancet. A separate study, published in 2017 in the Journal of Immigrant and Minority Health, found that for people protected by DACA, its protections "may alleviate stressors, with implications for their mental health and well-being."

DACA Beneficiaries Facing Stark Choices

Unless Congress legislates a solution, Chavez-Dueñas says, some DACA beneficiaries will worry about whether the government will use their personal information to track them down. (Officials have said they don't plan on sending such information to U.S. Immigration and Customs Enforcement. Ultimately, DACA beneficiaries may be left with stark choices when their status runs out: Slide back into the shadows and hope ICE agents don't arrest them, or return to the country of their birth, even though they may not know how to function there and may not speak the language, Chavez-Dueñas says.

DACA has created positive health effects not just for its beneficiaries, but for their kids, according to research published in 2017 in Science. The study, by researchers with the Stanford Immigration Policy Lab, found that the rate of acute stress disorder, adjustment disorder and anxiety disorder dropped by more than half, from 7.8 percent to 3.3 percent, when the mothers were eligible for DACA. "It's not a big leap to see that these huge gains would be reversed if DACA were rescinded," says Fernando S. Mendoza, a professor of pediatrics at Lucile Packard Children's Hospital Stanford in Palo Alto, California. This would apply to thousands of kids, who are U.S. citizens by virtue of having been born in the United States.

Some advocates are trying to help DACA recipients develop strategies for coping with the uncertainty and the Trump administration's anti-immigrant rhetoric and policies.

In late August, for example, in response to the Trump administration's opposition to immigrants in general, the pro-Dreamer group We Are Here to Stay shared an online "mental health emergency toolkit." The toolkit is part of the UndocuHealth Project, which immigrants' rights advocates launched to promote "self-love, community healing and wellness when organizing in times of trouble, turbulence and chaos."

The toolkit includes seven strategies to "keep calm and organize." It advises DACA beneficiaries to reach out to health care professionals, community leaders and mentors who are willing to help the undocumented community. The toolkit also suggests facilitating a healing circle to help people meditate and share their feelings about news affecting efforts to advocate and organize on behalf of the undocumented community.

Employing coping strategies like those detailed in the toolkit has helped some DACA beneficiaries cope with the uncertainty of the program and whether they'll have to uproot their entire lives.

Josue De Luna Navarro, 21, a DACA beneficiary in Albuquerque, New Mexico, says the program "gave me relief and hope that I had a future." Using tourist visas, Navarro's mother and father brought him to the U.S. from the state of Coahuila, Mexico, when he was 9. The family stayed in the U.S. to escape poverty.

Navarro's family lived for a while in California and eventually settled in New Mexico. Navarro did well in school and is now a student at the University of New Mexico, where he's studying bioengineering and sociology. The administration's announcement hasn't shaken him the way it has other DACA beneficiaries, thanks to coping strategies a college mentor taught him a couple of years ago, he says. Those approaches include practicing meditation and Tai Chi, a noncompetitive Chinese martial art that emphasizes relaxation, breathing and focusing the mind. "With or without DACA, as long as I breathe, I'll be alive," Navarro says. "I'm definitely not pessimistic. At the end of the day, anything put in front of you, you can process and make something positive out of it."

Another DACA beneficiary, Angie Kim, 34, of New York City, says she's remained mentally centered by staying busy working as a community organizer with a nonprofit group that provides legal services to immigrants and by practicing yoga. "I'm in a pretty good place," she says. "It's constant work. You constantly have to remind yourself to work to keep yourself in balance and make sure you take care of yourself emotionally, physically and psychologically."

Dreamers Grapple With Emotional Fallout and Physical Symptoms

But many other DACA beneficiaries are struggling with the possibility their legal protection from detention and deportation by ICE agents may soon end.

Castro, the Tennessee college student, was 6 when her parents brought her to the U.S. from the Mexican state of Nuevo Leon to escape poverty and violence. In a college essay she wrote the day of Sessions' announcement, Castro described hearing gunshots in her Mexican neighborhood almost every night before she went to sleep. "I remember the vibrations of my walls as the sirens of the police and ambulance passed by my house," she wrote. "In my old house, we only had one window, and that's because my father covered the rest of the windows with bricks to protect my family and me from any violence or robbery."

The student, who has participated in pro-DACA rallies, says she's felt "overwhelmed" since Sessions announced the end of the program. "I have a ton of schoolwork, reading to do and essays to write, and I'm stressed because I'm not sure what's going to happen [with DACA] in the coming months," she says. Since Sessions' announcement, Castro's gained 10 pounds, which she attributes to stress eating. "When I worry, I eat snacks like chips and drink sodas and Gatorade," Castro says. She used to exercise four times a week, by walking or working out at the gym, but hasn't done much of either lately. "Now, I just don't feel like doing it," she says. "I don't have the energy."

In addition to her nightmares, Valtierra, the single mother in Washington state, has in recent weeks been suffering from headaches, neck pain, an upset stomach and fatigue. "My eating habits have changed," she says. "I'm eating way too much sugar and drinking too much caffeine. Before, I had a sense of going somewhere, I had hope. Now, I feel a sense of hopelessness. I don't know what's going to happen." Earlier in her life, Valtierra says, she struggled with depression, and the news about DACA has made her vulnerable to that illness, she says. "I just want to get through the day, so I'll eat sugar, which will make me feel better momentarily but then I go into a downward spiral and my depression kicks in," Valtierra says. "I'm older [than many 'Dreamers'] and have more resources, and this is still breaking me."

Having enjoyed the limited freedoms afforded by DACA and facing the possibility of losing those privileges might be worse than when she lived as an undocumented person, she says. "When you give someone hope and take it away, that feels very traumatic," Valtierra says.

Valtierra cried when she learned the government was ending DACA. Later that day, a representative of a Native American program to teach permaculture – the development of agricultural systems, with the goal of making them sustainable – called to notify her the program had accepted her. "Here's the government saying, 'We don't want you here,' and then a Native American woman called to say they want me in this program," she says.

[This story was originally published by U.S. News.]