The COVID-19 pandemic has induced intense financial and life stress besides its toll on health, including its relatively high mortality. A new study by researchers at Delaware State University and published on the preprint server medRxiv* in September 2020 reports that the impact on mental health is disproportionately felt among undocumented immigrants studying in US colleges.
Fears in DACA Group
The top fears in this community include the possibility of getting COVID-19, losing family members, and not being able to earn enough to live due to unemployment and the global economic recession. Also called dreamers, these undocumented immigrants first entered the USA during their minority. Still, the DACA (Deferred Action for Childhood Arrivals) program allows them to continue their education and to work in the USA legally, without the fear of deportation.
Despite DACA protection, they are still very much a marginalized and poor community. The discussion on tightening the laws against illegal immigrants may lead to the deportation or detention of friends or family, heightening their anxieties. In addition, they are plagued by financial stress as well as academic challenges, aggravated by having to cope with a new social network while being separated from their families.
The pandemic has only worsened things because of its economic impact. Undocumented immigrants are not typically eligible to claim unemployment benefits or stimulus plans. Mental health issues are largely ignored. This has led some scientists to predict an unusually large rise in mental health problems in this community during the pandemic.
Blacks and Hispanics Unduly Affected
The current study was aimed at exploring the effect of the pandemic on dreamers who are enrolled in colleges at present. The 2017 estimate for this group was 241,000 across the US, with a projected GDP contribution of over $460 billion over the subsequent decade.
The researchers point out the disproportionate impact of the pandemic on Black and Latinx Americans, concerning the higher rate of infection and death, higher unemployment rates, and a slower rate of job recovery.
The investigators came up against the fear of deportation initially, with many dreamers hesitant to identify themselves and thus enable a large sample to be studied. The reasons include fear of being discriminated against by peers or being refused admission because of a lack of documentation. In addition, the admission data collected by many colleges do not allow dreamers to be identified, while others may not release such information.
The current study overcame this obstacle by using a group of dreamers enrolled at a Delaware public university on a scholarship from TheDream.US. Using online surveys as well as clinical tools, they assessed mental health problems like anxiety and depression as well as related factors, including academic stress, immigration-related concerns, the pandemic, and the current job situation. They aimed at finding rates of mental ill-health issues, compared to that of college students in general, and to relate specific factors to these issues.
Percentages of undocumented college students in our sample meeting clinical cutoffs for anxiety (GAD-7 score ≥ 10), depression (PHQ-9 score ≥ 10), anxiety or depression (GAD-7 score and/or PHQ-9 score ≥ 10), and suicidal ideation (i.e., having thoughts within the past 2 weeks “that you would be better off dead, or thoughts of hurting yourself in some way”). Findings suggest a high proportion of undocumented college students are suffering from anxiety and depressive symptoms, in addition to suicidal ideation, during the COVID-19 pandemic. Respondents would likely meet criteria for a full diagnosis of an anxiety or depressive disorder upon further evaluation.
*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
Dreamers Have Twice the Risk of Depression
The researchers found that 45% and 50% of the dreamers in this study samples were over the cut-off for anxiety, and depression, respectively by the GAD-7 and PHQ-9 scales. In contrast, ~30% and 40% of the general student population met cut-offs for these conditions. In particular, the rate of depression among dreamers is double that in the general US population (50% vs. 24%).
Two-third of dreamers met the cut-off score for anxiety, depression, or both. This serves to show how common these issues are among these students, and the researchers say, “Those who met the clinical cut-offs would likely meet full diagnosis for an anxiety or depressive disorder upon further evaluation.”
This observed rise in anxiety and depression continued to be present after adjusting for race and age.
Stress is Much Higher Among Dreamers
Almost 30% of the dreamers said they had suicidal ideas, with the perceived stress score of ~23 being significantly higher than that expected in the age group of 18-29 years (~14) or the general population (13).
The researchers consider that this is a considerable increase in mental health issues in this group compared to the pre-pandemic period, even though mental health findings for this group are not available. For one, a larger percentage of dreamers met cut-offs for anxiety and depression are much higher than those observed in research before the pandemic in the same type of population.
Secondly, over half the dreamers in the current survey self-reported a serious decline in their mental health caused by the pandemic, and these were also found to have higher average mental ill-health scores, as well as higher chances of meeting the cut-off for anxiety, depression, and suicidal ideation.
Recently reported statistics for mental ill-health among the college student population, in general, are much lower. This shows that not all of this increase in anxiety and depression can be attributed to the general increase in stress in this period of life when young adults face many and varied difficulties. The findings, therefore, confirm the projections of scientists that this group would face a disproportionate share of the mental stress due to COVID-19.
Financial and Health-Related Issues
In most of the households of origin, savings are hardly sufficient to sustain the family through any but the briefest period of unemployment. Lacking eligibility for government assistance, these households are at high risk of being plunged into greater poverty.
The heads of households that still have jobs are likely to be essential workers, but this increases the risk of acquiring COVID-19. This is a grave risk since most immigrants are at higher odds for comorbidities that are related to severe or critical COVID-19.
In almost every case, the immediate family of the participant was not insured for medical claims, tending to put them beyond the pale of medical treatment. These are likely to trigger increased stress among children in these families as well.
Implications and Future Directions
This preliminary study helps to explore mental health among dreamers as well as indicate future research areas. A more heterogeneous sample would be optimal, for instance, as in a national survey. However, this sample group was representative of dreamers at national-level studies conducted earlier, in significant social and demographic characteristics.
The researchers found that those dreamers who were more worried about finances and academics, as well as immigration, including students whose parents lost jobs during the pandemic, were more likely to have higher anxiety and depression scores.
The interpretation put on these findings was that the pandemic increased concerns about already existing issues. The best way to confirm the validity of this conclusion is by carrying out longitudinal studies in order to follow the relationship between the changes in these relevant concerns and the high percentage of mental health issues.
The researchers also suggest that the negative impact of the pandemic was more pronounced in this group, at over half, than in the general population, where a third of Americans reported a deterioration in mental health in this period.
With respect to the reasons for this phenomenon, some promising leads were thrown up: the worry about meeting academic demands, fear of deportation, and financial stress.
The specific influence of DACA is another factor to be examined, as some research shows that DACA itself affects the mental health of dreamers.
Again, this study may point to the need to explore other issues like panic disorder and post-traumatic stress disorder in the community of undocumented immigrants as a whole. The purpose of this and related exercises is to promote government policies that will encourage the integration of this group of students into the mainstream, not only in the COVID-19 crisis but in other emergency situations that may occur in the
*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
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