Immigrant Protections Improve Children’s Mental Health

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New Stanford research shows that legal protections for immigrant families had a profound impact on the mental health of the children. | iStock/Nadezhda1906

Children of undocumented parents face high levels of anxiety, a natural result of living with the fear and uncertainty that a parent could be targeted for deportation, swept up by Immigration and Customs Enforcement, and sent back to his or her country of origin. Lack of documentation causes many such families to live in the shadows, attempting to stay off government radar while remaining in the United States.

A team of researchers led by the Stanford Immigration Policy Lab set out to examine if some measure of protection for undocumented mothers could result in less anxiety — and lessen the need for mental health treatment — for their children. Their research, published this month in Science, shows that U.S.-born children of mothers protected by the Deferred Action for Childhood Arrivals (DACA) program suffer from lower rates of anxiety and adjustment disorders when compared with U.S.-born children of undocumented mothers not protected by DACA.

President Donald Trump announced plans this month to rescind DACA, a program enacted in 2012 that allows some people who entered the U.S. illegally as minors to receive renewable two-year periods of deferred action from deportation and eligibility for a work permit. DACA has protected nearly 800,000 undocumented immigrants brought here as children. But researchers hope policymakers will use a broader calculus in future decision making and take into account the positive impacts DACA has on recipients’ families — and the negative impacts that could result from wholesale deportation.

Co-lead study author Jens Hainmueller, Stanford Graduate School of Business professor, by courtesy, of political economy and co-director of the Stanford Immigration Policy Lab, says the researchers were motivated by the lack of evidence that exists on the undocumented population in the U.S. They chose to examine DACA, he says, because it’s the most significant immigration policy of the last two decades.

“There are a lot of beliefs about policies, but not a lot of evidence on how policies impact the undocumented and the communities in which they live,” Hainmueller says. Moreover, little has been written about how DACA protections impact a recipient’s family, with most research and policy focusing instead on the individual recipients, including studies that show DACA recipients have higher rates of employment and improved health outcomes.

“We decided to look at the intergenerational effects of DACA and whether there were spillovers on the protections of parents into the lives of their kids. That was the motivation — there had been no research on the intergenerational effects of DACA,” Hainmueller says.

Study co-author Fernando Mendoza, a professor of pediatrics at Stanford, points to the loss of a parent, whether by death, divorce, or deportation, as one of the greatest stresses of children.

Digging Into the Data

“However, in the case of deportation, the level of stress is heightened by the uncertainty of the event. Think about a young child going to school one day and returning home and not finding their mother. Or having the father leave in the morning, and always thinking, ‘Will this be the last time I see him?’” Mendoza says. “This is the current status of 4 million children who have one undocumented parent. This is the stress and uncertainty that DACA was able to relieve.”

The research team used claims data from Oregon’s Emergency Medicaid program, which is heavily used by undocumented immigrant mothers. The data on births spanned 2003–2015; because the children were born in Oregon, and thus are U.S. citizens, those children became eligible for traditional Medicaid.

In all, they identified 5,563 mothers born between 1980 and 1982 who were covered by Emergency Medicaid and gave birth to 8,424 children during 2003–2015. Then they tracked the children’s mental health outcomes using their Medicaid claims.

Researchers further narrowed in on adjustment and anxiety disorders on the idea that children may be stressed by the uncertainty of their parents’ immigration status.

What they found is that mothers’ DACA eligibility significantly decreased adjustment and anxiety disorder diagnoses among their children and that parents’ unauthorized status is a significant barrier to normal child development and perpetuates health inequalities.

“We found that before DACA was implemented, the rates of mental health diagnosis were exactly the same; but in the post-DACA period, mothers started to benefit from protection and the rates of adjustment and anxiety disorders dropped by half,” Hainmueller says.

“When you consider the social determinants of mental health, there are a lot of things that are hard to change, but here we have an instance of a dramatic improvement in the mental health of those kids. You can, through a law, get a dramatic improvement in health. And unlike poverty, that’s something uniquely changeable,” he says.

But just as a law helped change mental health outcomes for kids in this study in a positive way, so too can an absence or reversal of the law change outcomes in a negative way.

“If it were to be reversed, those gains would quickly evaporate and maybe reverse and these parents would be back in the shadows,” Hainmueller says.

Next Steps

The researchers are trying to obtain similar mental health data of children of DACA recipients in California and New York. Also, as a follow-up to the Oregon research, the team has an ongoing effort to interview families impacted by DACA. So far, they’ve completed 25 interviews.

“One of the things the study can’t do, with quantitative data, is determine what’s leading to the dramatic improvement we see,” Hainmueller says. “We don’t know if it’s job security, reduced stress because there’s less anxiety, but hopefully that will come out in more qualitative interviews.”

The study’s results imply that expanding deferred action to the millions of unauthorized immigrant parents who do not meet the current DACA eligibility criteria could further promote the health and well-being of this next generation of American citizens. And the study states it’s also reasonable to expect that permanent legal status or a pathway to citizenship would have an equal, if not greater, effect in improving children’s health.