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DACA and Immigration Issues

in Light of COVID-19

Multicultural Competency

A Training Resource
By James J. Messina, Ph.D.

NOTE: This page on DACA and Immigration Issues in Light of COVID-19 owes its existence to an American Psychological Association 3 webinar series entitled:Building Cultural Competence in Stressful Times for Immigrants: COVID, DACA and the Supreme Court Decision
The three webinars were:
1.  Understanding the Context of Immigration Policy COVID 19, and Their Impact
2.  Developing Psychotherapy Strategies to Foster Resilience and Resist Trauma among Immigrant Communities
3. Strengthening Communities of Support to Serve Immigrant Clients.
This program was sponsored by the American Psychological Association in collaboration with National Latinx Psychological Association (NLPA), Society of Counseling Psychology (APA Division 17, Lehigh College of Eduction, FWD.us, Informed Immigrant, United We Dream (UWD), and Immigrants Rising.
Download a copy of: A Guide to Providing Mental Health Services to Immigrants Impacted by Changes to DACA and the COVID-19 Pandemic. By: Cardenas, G.A., Campos, L., Minero, L.P. & Aguilar, C. (2020). Click Here to Download
Landmark Dates in the Immigration Story in the United States
1820 - 1840 : Germany, Great Britain and Ireland made 70% of immigrants
May 6, 1882: Chinese Exclusion Act of 1882
August 3, 1882: Immigration Act of 1882
1952:Immigration and Nationality Act (INA)
1970’s: characterized by unauthorized immigrants from Latin America
1976: Amendments to INA: limited immigration from Latin American countries
1996: Illegal Immigration Reform and Immigrant Responsibility Act
2001: Development, Relief, and Education for Alien Minors (DREAM) Act did not pass
2019: The American Dream and Promise Act ( has not been heard in the Senate)
Significant events impacting Immigration Legislation in the USA
Title IV of the Higher Education Act of 1965: Forbade undocumented students from receiving federal aid for postsecondary education
Plyler v. Doe, 1982: Free K 12 public school education Independently enacted State Laws:
  • In state Tuition, 2001 (AB540)
  • Driver Licenses in CA, 2015 (AB60)
  • Limited access to emergency services (e.g., labor and delivery care for pregnant women)
●  Deferred Action for Early Childhood Arrivals (DACA), 2012
Deferred Action for Childhood Arrivals (DACA)
Immigrants were able to request DACA if they:
1. Were under the age of 31 as of June 15, 2012
2. Came to the United States before reaching their 16th birthday
3. Have continuously resided in the United States since June 15, 2007, up to the present time
4. Were physically present in the United States on June 15, 2012, and at the time of making their request for consideration of deferred action with USCIS
5. Had no lawful status on June 15, 2012
6. Are currently in school, have graduated or obtained a certificate of completion from high school, have obtained a general education development (GED) certificate, or are an honorably discharged veteran of the Coast Guard or Armed Forces of the United States
7. Have not been convicted of a felony, significant misdemeanor, or three or more other misdemeanors, and do not otherwise pose a threat to national security or public safety.
Relevant immigrant legislation since January 2017
●  Build wall and militarize the border
●  Expanding definitions and previous policies to justify mass deportations (e.g. definition of “criminal”, 287 (g), expedited removal)
●  Punishing sanctuary cities (CA Sanctuary Laws don’t prevent deportation)
Build and staff more detention centers (CA ending privatization of Detention Centers)
Executive Order banning refugees and immigrants for seven Muslim majority countries
●  In July 2019, the administration banned all people, including children, who have traveled through another country to reach the United States from applying for asylum. This rule is a defacto asylum ban for nearly all asylum seekers seeking to enter the U.S. through the southern border.
●  Possible ending of DACA program
The Current Status of DACA
In September 2017, the Trump administration rescinded DACA.
●  Work permits began to expire.
●  However, several individuals, organizations, and states filed lawsuits against the administration for unlawfully rescinding DACA.
Currently, thanks to the lawsuit by DACA individuals in California (and later across the country), DACA renewals continue.
However, only a portion of the DACA program is in place (no advance parole, no new applications)
The implications of DACA ending
The Supreme Court on June 18, 2020 ruled against the Trump administration in its rescinding of DACA. However the Federal Government has committed to continuing its efforts to rescind DACA
After DACA victory, Attention Turns to Mental Health Needs
DACA recipients and the undocumented immigrant community have enormous mental health needs, psychologist say. Training and resources are available for mental health professionals.
Access to mental health care for the undocumented and immigrant communities still lags. Many DACA recipients report that when they do seek therapy, they have to explain to the therapist what DACA is and what that means for their immigration status. Issues of insurance, cost, and trust are also barriers

United We Dream and NLPA are collaborating to recruit providers and agencies to provide culturally competent services on a pro bono basis or on a sliding scale. The directory they are building is especially in need of mental health providers in California’s Central Valley; the Washington, D.C., Virginia, and Maryland area; New York; Seattle; southern Florida; Connecticut; and Oklahoma City.

Multicultural and Social Justice Competencies Needed
When dealing with DACA or Non-Documented Immigrants
he above figure come from work by Ratts, Singh, Nassar-McMillan, Butler & McCullough (2016) and demonstrates the pressures on Privileged counselors when working with Marginalized clients as well as the pressures on Marginalized counselor when working with Privileged clients. Counselors need to be aware of their attitudes and beliefs, Knowleged about the cultural background of the clients they are working with, along with developing skills to intervene with people culturally different from them and steps they need to take to assist their clients be at ease and able to get the help they need.

This also requires counselors who work with DACA or Non-Documented immigrants to develop a full self-awareness of the their implicit or explicit biases which might intervere in this work. These counselors also need to be open the worldview of these clients so that the counseling relationship is on a solid ground so that the client not only received respectful and responsive counseling but also interventions which advocate for the rights and needs of the client.

Social Justice  and multicultural needs intersect in the process allowing for these clients to feel respected, listened to, helped and encouraged to survive the emotional toll of their current legal status in this country and the overwhelming negative impact of COVID-19 in their lives.
Counselors need too be aware and avoid Implicit Bias and Immigration
Implicit biases are discriminatory biases based on implicit attitudes or implicit stereotypes (Greenwald & Krieger, 2006).
Implicit bias against Latinx immigrants is linked to preferences for immigration policy, socio- economic concerns, and intolerance towards immigrants (Pérez, 2010).





Implicit Bias: Roots
First immigration law of 1790: citizenship reserved for “free White persons” that “behaved like a man of good moral character” (Teparata, 2016)
Social Darwinism, eugenics, and scientific racism were used as frameworks to craft legislation in the 19th and 20th centuries (Nhai,1999).
History of immigration policy shows more aggressive laws and enforcement against immigrants of color.

Image of colonial caste system from Chavez Dueñas et al. (2014)
Implicit Bias and Mental Health Services
Review of experimental studies: Implicit bias among mental health providers diverges from their self reported attitudes (Boysen, 2009).
Bias is present across levels of training: Implicit bias is reported among mental health counseling trainees despite high multicultural competency, and it does not vary by training level (Boysen & Vogel, 2008).
Color blind attitudes are detrimental in preparing teachers to teach immigrants: Based on a
study about culturally responsive teaching among 323 teachers ( Cadenas et al., 2020).
 Healthcare professional exhibit same level of bias as the general population: Based on review of systematic review of 42 articles ( FitzGerlad & Hurst, 2017).
● Healthcare providers (across levels of training and disciplines) exhibit pro White or Light skin
bias and anti Black, Latinx, Indigenous, or dark skin bias: Based on review of 37 studies            (Maina et al., 2018).
Implicit Bias: Common Myths About Immigrants
Today's immigrants don't want to learn English.
● Immigrants take good jobs from U.S. citizens.
● The worst” people from other countries are coming to the United States and bringing crime and violence.
● It's easy to enter the country legally. My ancestors did; why can’t immigrants today?
● Undocumented immigrants don’t pay taxes and burden the national economy.
● We can stop undocumented immigrants coming to the United States by building a wall along the border with Mexico.
● Banning immigrants and refugees from majority Muslim countries will protect the United States from terrorists.
Immigrants are overrunning our country, and most are here illegally.
Immigrants bring crime and violence to our cities and towns.
Immigrants are coming to the U.S. to obtain welfare and other benefits.
Immigrants are coming to the U.S. with the express purpose of having babies here.
Immigrants are bringing diseases into the U.S.
All undocumented immigrants sneak across the Mexican border.
We can stop undocumented immigrants coming to the U.S. by building a wall along the border with Mexico.
Source: Anti Defamation League and Teaching Tolerance
Implicit Bias: Sources of Factual Information
● Overcoming the Odds: The Contributions of DACA Eligible Immigrants and TPS Holders to
the U.S. Economy:
https://research.newamericaneconomy.org/report/overcoming-the-odds-the-contributions-of-daca-eligible-immigrants-and-tps-holders-to-the-u-s-economy/
Implicit Bias: Strategies for Challenging it as a Therapist
A starting point is for providers to identify their thoughts and feelings about immigrants (Cadenas, Campos, Minero, & Aguilar, 2020). Useful questions to reflect upon include:
● What do I know about immigrants (the facts)?
● What perceptions and beliefs do I have about immigrants?
● How did I develop those perceptions? What emotions come up as I think about my perceptions towards immigrants (fear, sadness, guilt, anger)?
Contact with undocumented immigrants and exposure to their real life narratives, combined with learning facts about policies , have been linked to long term increases in pro immigrant attitudes (Cadenas et al., 2018; Cadenas & Cisneros, 2017).
Steps Counselors can Take with DACA or Non-Documented Immigrants Clients
1. Promote Liberation Psychology by addressing the underlying power dynamics in human relations and social systems with the aim of helping their clients and themselves to transform inequality and oppression to meet the needs of their clients.
2. Counselors need to be culturally sensitive to these clients and approach them with cultural humility, encouraging the clients to see their own cultural background as a strength and to not shy away from their native language usage but rather celebrate their diversity because they deserve to be seen as equal to all of the other people around whom they work, live and socialize.
3. Counselors need to recognize that the extremist social discrimination faced by their clients impacts their levels of anxiety and depression and to shy away from extreme diagnoses which imply their mental health needs cannot be met thourgh outpatient counseling and collaborative support.
4. Counselors need to be aware of the power dynamics and transference at play when working with these clients and to lay to rest their clients worry over being misunderstood, ignored and ultimately not helped.
5. Counselors need to be aware of the contextual and sociopolitical factors which impact the mental health of their clients
6. Counselors need to develop skills to help empower these DACA and Non-documented immigrant clients to standup for themselves and to face their life issues in a self-empowered positive "can do" attitude
7. Counselors can support their clients by identifying the impact of oppression on their psychological wellbeing and to learn new behavioral coping skills such as self-advocacy planning and community engagement.
Counselors Need to Become Advocates for DACA and Undocumented Clients
1, They can volunteer their skills in the community to give voice to these clients needs
2. They can arrange meetings with decision-makers to advocate for these clients needs
3. They can host events in their communities, churches and clubs which are related to advocate for immigrant mental health
4. They can work to promote responsive policies, programs and services for these clients in their communities.
5. They can promote the creation of community based committees who are active advocated for this client population to advocated for social justice and change for them
6. They can develop and implement programs and services which are tailored to immigrant communuities.
Mental Health Professions need to Address Public Arena and Systems Change
Mental health professionals in their local communities, states, region and country need to come together to increase public information about DACA and undocumented immigrants by:
1. Increasing the publics awareness about the needs of these people
2. Sharing their knowledge and facts about this population
3. Engaging with them media about this population and its need
4. Encouraging public organizations to draft public statements
5. Connecting local, state or national organizations advocating for policy changes for this population
6. Contacting their local elected officials at all levels to express support for changes for this population
7. Lobbying institutional and professional associations to change their policies and procedures in dealing with this population.
All Policies are Health Policies
Virtually all policies of government are ultimately health policies (e.g., education, housing, taxation, health care, environmental health).(McEwen, 2017)

Immigration Policies ARE Health Policies
There are physical health consequences associated with anti-immigrant policies that reach beyond the undocumented community in the United States
Families report worse physical health for their children as
compared to their U.S. citizen co ethnics
Parental perceptions of their states’ immigration policies further
exacerbate health disparities between families (Vargas & Ybarra,2017).
Suggests that health disparities among Latino children arising as a result of the social
stratification experienced by their parents
Latino immigrant health advantage erodes from one generation to the next
This analyses doesn’t even account for role of deportations and family disruption
among immigrant families
Given the likelihood of continued policy activity in the area of immigration at both
the state and federal level for the foreseeable future, the consequences of these
policies will continue to be felt among Latino Americans (Vargas & Ybarra, 2017)
Lack of access to preventative primary care encounters often results in this
population's dependence on acute emergency services for treatment
Lack of opportunity for advance care planning discussions and lack of eligibility to
hospice services commonly contributes to poor end of life care
In situations when the unauthorized immigrant parent is terminally ill, these
children have limited support including grief counseling. If the parent dies, these
children may not have any benefits available to them (e.g., unauthorized parent will
not have life insurance, pension, 401K, burial, and cremation benefits). Even in
situations when they have a second living parent or relatives, they may be forced
into the foster care system if the adults caring for them are undocumented (Metchnikoff, Naughton, & Periyakoil, 2018)
Impact of COVID-19 on Immigrant Communities
The current global pandemic has significantly affected millions causing disproportionate health (CDC, 2020) and economic effects (Congressional Research Service, 2020).
It has uncovered significant disparities in the impact of COVID 19 by race and ethnicity with particularly poor outcomes for Latinx and Blacks (Overton, 2020).
The current COVID 19 pandemic presents as another reason for portraying and stigmatizing undocumented immigrants and asylum seekers as agents of disease
and as a public health hazard to the U.S. (Trump, 2020).
● The COVID 19 pandemic has exposed the irony inherent in these negative attitudes.
● Over 27,000 DACA recipients are healthcare practitioners supporting occupations on the frontline of responding to COVID 19 ( Svajlenka, 2019)
● During the pandemic, many undocumented immigrants are also deemed “essential”,
performing other jobs that are keeping the U.S economy afloat.
● Despite the invaluable service they are providing and the sacrifices they are making, these undocumented immigrants are excluded from receiving and benefits or resources, including the Coronavirus Aid, Relief, and Economic Security (CARES) Act, including emergency aid for college students. The COVID 19 pandemic has exposed the irony inherent in these negative attitudes.
● Over 27,000 DACA recipients are healthcare practitioners supporting occupations on the frontline of responding to COVID 19 (Svajlenka, 2019)
Amid the COVID 19 pandemic, recent events have exacerbated and intensified fear among the DACA recipients.
● On April 21, 2020, reports from an internal investigation revealed that the Immigration and Customs Enforcement (ICE) has access to DACA recipients personal information (Lind, 2020). (Talk: Thinking While Black at The Philip Lind Initiative is a Speakers Series at the University of British Columbia Vancouver Campus at https://lindinitiative.ubc.ca/series/thinking-while-black/ )
● This shocking revelation during the current pandemic is another example of anti-immigration action that bestows unprecedented levels of fear to an already vulnerable community.
DACA recipients and their families are at risk for diminished health given the many complex stressors that they face, which are often chronic and compounded by harsh living conditions and limited or no access to adequate health, social, and legal services (Garcini et al.,2016).
● Common and chronic stressors among young undocumented immigrants and their
families include:
     ○ acculturative stress, identity confusion
     ○ feelings of alienation, social exclusion
     ○ discrimination, stigmatization
     ○ fear of deportation, threat of family separation
     ○ restricted access to resources, loss of rights
     ○
limited educational and work opportunities (Garcini et al.,2016).
● In the face of additional unexpected and threatening events, such as natural disasters or health crises, DACA recipients and their families are likely to be at increased risk for diminished health and social outcomes.
● The combined stress of having to face the COVID 19 pandemic with limited resources and healthcare access compounded with the possible termination of their protected status can seriously compromise the physical and mental health as well as of their social networks.
 APA Immigration Task Force Report (2013)
Guiding Principles of this report:
Evidence-based practices
Culturally-competent Treatment
Ecological Framework
Comprehensive community-based Services
(Suárez-Orozco, et al., 2013).

Anti-Immigration Policy and Mental Health: Why May DACA Recipients in the United States be at High Risk of Distress During the COVID 19 Pandemic
● A recent study conducted by Garcini, Domenech Rodriguez, and Mercado (2020) assessed the association between immigration legal status and trauma related distress among individuals directly or indirectly affected by news of the recission, of DACA in 2017.
● Over 40% of participants in this study showed trauma related symptoms indicative of probable PTSD diagnosis.
● Findings are consistent with previous studies highlighting highest risk for psychological distress due to trauma and discrimination related to anti immigrant sentiment, including the current political climate in the United States and its anti immigration policies, and the continued
rescission of DACA.
● This psychological distress coupled with that from an ongoing global pandemic places the health of this population at a significant risk
Healing Ethno Racial Trauma (HEART) In Immigrant Communities
Community Services by and for Community Members who are Impacted
Community Based Model: Outreach
Incorporating storytelling, personal, and professional expertise - Staff reflect the community the organization is serving - with vicarious trauma and staff mental health support
Program members and broader community - Recognizes the diversity among undocumented community - And aims to create community dialogues about intersecting issues and unique experiences within sub community groups across community
Mental health information materials and resources - Practical and culturally inclusive
Partnerships with local and national immigrants rights organizations - and University counseling centers and Identify, connect, and collaborate with undocumented immigrant professionals in the
community
Reducing Stigma & Increasing Trust
Education:
●  Promote mental health education and healing
  Drop-in support groups: Weekly, 1 hour, virtual, diverse and inclusive of various therapeutic modalities and theoretical orientations that explain human behavior that take into consideration language and culture. With mental health topics/presentations with: Stress, Anxiety, Depression, Trauma and Identity covered.
Group & Community Support
  6 series closed meditation support group
Education & Training for Providers
  Collaboration and bidirectional education and training between staff and community healers (Licensed clinicians, yoga practitioners, artists, energy and spiritual guides)
Trauma-Informed Direct Services  
Implementing a clinical-based intervention which addresses the effects of violence and its impact on physical and psychological safety
Conducted in culturally and cost effective program services which matches pro-bono and sliding scale though outreach and recruitment and maintenance of a Mental Health Clinicians Directory
Provision of Direct Services
  Mental Health Assessment
  Psycho-education/Health Education
  Medical, Social and Legal Referral (within/across program and broader community)
  Recommendations
  Therapy (facilitate connection and access match)
Importance of Resilience and Context
Create opportunities to raise awareness, reflect, discuss and cope with stressor related to:
  Current political climate
  Immigration policies
  Intersecting movements and identities (COVID-19, Black Live Matter, DACA)
Draw from cultural experiences, beliefs and attitudes
●  Honor traditional and original medicine - Everyone heals differently and there is no one size fits all
  Address impact of colonization, racism, poverty, colorism on individual and community mental health well being and healing
Watch this Video: Cultivating Mental Health and Resilence on YouTube at:
Websites to be used in Building Resilience and Sound Mental Health for DACA and Undocumented Immigrants

THRIVE - The Center for Human Development (TCHD) -  Multidimensional Identities of the 1.5 Undocumented Generation at: https://thethrivecenter.org/resources/multidimensional-identities-of-the-undoc-generation/

Immigrants Rising - Transforming Lives Through Education at: https://immigrantsrising.org/start-here/mental-health/


Storytelling:
Short Latina Stories at:https://www.shortlatinastories.com/
     Example: Reflection: I Don't Have an Anxiety Disorder, I'm Just DACA at: https://www.shortlatinastories.com/blog/blog

Things I'll Never Say at: http://www.thingsillneversay.org/
      Example: Memories at: http://www.thingsillneversay.org/memories.html

Define American at: https://www.defineamerican.com/
      Example: Community Stories at: https://www.defineamerican.com/stories/view
A Psychological Framework of Radical Healthing
(French et al., 2020)
What do Mental Health Providers Need to provide Radical Healing to the DACA and Undocumented Immigrant Clients
Mental health providers who want to work with this population need:
1. Ongoing self-evaluation of personal competency to take on these clients
2. Continuing Education
3. Culturally Sensitive Supervision
4. Consultation with other Mental Health Professionals Engaged in this work
5. Self-Care
A Call to Action
As the pandemic evolves, the risk for serious health hazards and diminished mental health among at risk immigrants increases rapidly; thus, the need for a rapid proactive response aimed at mitigating risk and harmful health and social consequences (Garcini , Mercado, Domenech Rodriguez, and Paris, 2020).
All helping professions have an ethical responsibility to help individuals in their
time of need. They are charged with ensuring their basic human rights
regardless of class, gender, political affiliation or legal status.
TPA, NLPA, APA, UWD, and other non profit organizations have mobilized
efforts to address this national crisis amid a global pandemic.
     ○ Mental health directory for DACA recipients
     ○ Providing clinical tools for culturally competent mental health services.
     ○ Psychoeducation on mental health and social support
References

Cadenas, G.A., Campos, L., Minero, L.P. & Aguilar, C. (2020). A Guide to Providing Mental Health Services to Immigrants Impacted by Changes to DACA and the COVID-19 Pandemic. Immigrants Rising, UCLA Division of Population Behavioral Health, Lehigh University College of Education and Hope Center for Wellness.

Cadenas, G.A., Cisneros, J., Todd, N.R.& Spanierman, L.B.(2018). DREAMzone: Testing two vicarious contact interventions to improve attitudes toward undocumented immigrants. Journal of Diversity in Higher Education, 11(3), 295-308. http://dx.doi.org/10.1037/dhe0000055

Chavez-Dueñas, N. Y., Adames, H. Y., Perez Chavez, J. G., & Salas, S. P. (2019). Healing ethno racial trauma in Latinx immigrant communities: Cultivating hope, resistance, and action. American Psychologist, 74(1),49-62. DOI: 10.1037/amp0000289.

Cisneros, J., & Cadenas, G. (2017). DREAMer-Ally Competency and Self-Efficacy: Developing Higher Education Staff and Measuring Lasting Outcomes. Journal of Student Affairs Research and Practice, 54(2), 189–203.ISSN: 1949-6591 (print)/1949-6605 (online)

French, B. H., Lewis, J. A., Mosley, D. V., Adames, H. Y., Chavez-Dueñas, N. Y., Chen, G. A., & Neville, H. A. (2020). Toward a psychological framework of radical healing in communities of color. The Counseling Psychologist , 48(1), 14 46.https://doi.org/10.1177/0011000019843506

Garcini, L.M., Murray,K. E., Zhouc, A., Klonoffa, E,  Myer, M. G. &, Eldere, J.P. (2016). Mental health of Uundocumented immigrant dults in the United States: A Aystematic Eeview of Methodology and Dindings (2016). Journal of Immigrant & Refugee Studies, 14(1), 1-25. http://dx.doi.org/10.1080/15562948.2014.998849

Garcini, L. M., Domenech Rodríguez, M. M., Mercado, A., & Paris, M. (2020, June 15). A Tale of Two Crises: The Compounded Effect of COVID-19 and Anti-Immigration Policy in the United States. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. http://dx.doi.org/10.1037/tra00ts

Ratts, M.J., Singh, A.A., Nassar-McMillan, S., Butler, S.K. & McCullough, J.R. (2016). Multicultural and social justice counseling competencies: Guidance for the counseling profession. Journal of Multicultural Counseling and Development, 44(1), 28-48. https://doi.org/10.1002/jmcd.12035

Suárez-Orozco, C., Birman, D., Casas, J. M., Nakamura, N., Tummala Nara, P.,
& Zárate, M. (2013).. Working with immigrant origin clients: An update for mental
health professionals. Washington, DC: American Psychological Association

Svajlenka, N,P. (2019). What we know about DACA recipients in the United States. Retrieved at: https://www.americanprogress.org/issues/immigration/news/2019/09/05/474177/know-daca-recipients-united-states/

Vargas, E. & Ybarra, V. (2017). U.S.citizen children of undocumented parents: The link between state immigration policy and health of Latino children. Journal of Immigrant & Minority Health, 19(4), 813-920. DOI: 10.1007/s10903-016-0463-6.

Wong, T.K., Rosas, G.M., Luna, A., Manning, H., Reyna, A., O'Shea, P., Jawetz, T. & Wolgin, E. (2017). DACA recipients' economic and educational gains continue to grow.  Retrieved at: https:/www.americanprogress.org/issues/immigration/news/2017/08/28/437956/dacarecipients economic educational gains continue grow/