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. Author manuscript; available in PMC: 2025 Oct 8.
Published in final edited form as: J Lat Psychol. 2024 Jul 8;13(1):18–34. doi: 10.1037/lat0000263

Interior Immigration Enforcement Experiences, Perceived Discrimination, and Mental Health of U.S.-citizen, Adolescents with Mexican Immigrant Parents

Jamile Tellez Lieberman 1, Nishita Dsouza 2, Carmen R Valdez 3, Jessie K Pintor 2, Philippe Weisz 4, Amy Carroll-Scott 2, Ana P Martinez-Donate 2
PMCID: PMC12494232  NIHMSID: NIHMS2055753  PMID: 41049454

Abstract

About 5.2 million children and adolescents (4.4 million of whom are citizens) live with at least one undocumented immigrant parent in the US. Increased immigration enforcement under former President Trump put thousands of mixed-status families with children at risk for family separation via deportation. Additionally, enforcement activities bolstered an anti-immigrant/anti-Latinx climate that encouraged discriminatory or racist rhetoric and encounters against Latinx families across the country. This study examines the extent to which distinct types of hostile immigration experiences, namely discrimination, detainment, and parental deportation increase the mental health burden on Latinx adolescents with at least one immigrant parent. We used baseline survey data (n=101) from the Between the Lines Study, a panel pilot study with US-citizen adolescents (13 to 17 years) with at least one Mexican origin parent or caregiver affected by or at risk for parental deportation, conducted across the United States from 2019 to 2020. We examined the effects of exposure to different levels of immigration enforcement and perceived discrimination on mental health symptomology by fitting multivariable logistic regression models. After adjusting for other covariates, exposure to parental deportation significantly increased the odds of high levels of anxiety and depressive symptoms among participants. Similarly, exposure to discrimination significantly increased the odds of high levels of depressive symptoms and internalized stigma. Immigration enforcement and discrimination both negatively affect Latinx citizen adolescents’ mental health. In the absence of comprehensive immigration reform, evidenced-based, family-friendly policies and interventions that prioritize psychological well-being are necessary to reduce mental health disparities.

Keywords: Latinx, internalized stigma, mental health, deportation, children

Background

The United States has a vibrant and complicated immigration history. This history includes unauthorized immigrants, or those who do not have proper permission to reside in the US. The number of unauthorized immigrants in the US has stabilized over the past decade; the Migration Policy Institute estimates that there were 11 million unauthorized immigrants in the US as of 2018 (Capps et al., 2020). One of the largest immigrant populations in the US is of Latin American origin. In 2018, Mexicans accounted for about half of all unauthorized immigrants, although their share was shrinking as migrant flows from Guatemala and other Central American countries was increasing (Capps et al., 2020). Between 2014 and 2018, about 5.2 million children and adolescents, or 7% of all children in the US, lived with at least one unauthorized immigrant parent and among them, 4.4 million were US citizens (Batalova et al., 2021). Many of these children live in mixed-status families where one household contains members with differing legal status (Hamilton et al., 2019). These families are vulnerable to detention by local, state and federal immigration authorities and at risk of separation due to deportation of one or more family members.

Modern immigration legislation in the US has centered around reducing federal benefits to immigrants, increasing border security, and supporting broader exclusion of immigrants in response to terrorism fears (Pew Research Center, 2015). These policies reflect and shape larger socio-political narratives that are xenophobic and racist. The Trump Administration’s anti-immigrant stance at the US-Mexico border and throughout the interior of the country is a recent example of discriminatory policies in the US that have persisted since the early 1900s against communities of color, including Latinx and frequently Mexican Americans (Pew Research Center, 2015). In January of 2017, as one of his first executive acts as president, former President Trump directed Immigration and Customs Enforcement (ICE) to broaden their immigration strategies to identify, detain and remove any ‘illegal’ individual without documentation, regardless of circumstance. According to ICE statistics, arrests of noncitizens were approximately 40% higher in 2018 and 2019 than the last year of the Obama administration (Berger Cardoso et al., 2021). In fiscal year (FY) 2020, despite the COVID-19 pandemic, ICE detained and removed almost 200,000 “aliens who pose a threat to public safety” (ICE, 2020, p. 4). In a departure from previous administrations, the proportion of immigrants without criminal convictions who were detained increased under Trump from 55% in 2016 to 63% at the end of 2019 (Transactional Records Access Clearinghouse, 2019). Further, under Trump, the length of detention of immigrants at any one immigrant prison or jail increased from an average of 21 days in FY 2015 to 34 days in FY 2017 (Freedom for Immigrants, 2018). The indiscriminate and punitive nature of Trump’s efforts to remove any and all immigrants was shocking, but not necessarily new.

Increased immigration enforcement efforts under Trump put thousands of mixed-status families with children at risk for family separation. The number of families separated during the Trump Administration by ICE is difficult to estimate. As many as half-a-million US citizen children experienced the deportation of at least one parent from 2011 through 2013 (American Immigration Council, 2021). More recently, ICE claimed to have removed 14,324 individuals between January 1, 2019, and June 30, 2019, who reported having at least one US-born child (Department of Homeland Security, 2020). Deportation of parents and other family members has serious consequences for youth, including citizens. Immigration enforcement, as well as the threat of enforcement action, can profoundly affect the physical, mental/emotional, developmental and economic well-being of children and adolescents (American Immigration Council, 2021; Eskenazi et al., 2019). Researchers have documented increased levels of anxiety, depression, and psychological distress among Latinx children and adolescents who experience the detainment and/or deportation of a parent (Eskenazi et al., 2019; American Immigration Council, 2021; Lovato et al., 2018; Giano et al., 2020; Rojas-Flores et al., 2017; Perreira & Pedroza, 2019). Latinx children also exhibit symptoms of toxic stress—the biological result of prolonged activation of stress response systems—due to fear or worry that a family member will be deported (American Immigration Council, 2021; Eskenazi et al., 2019; Cervantes, et al., 2018; Rayburn et al., 2021; Shonkoff et al., 2021).

In addition to removing Latinx immigrants from their communities and families, the Trump Administration openly encouraged rhetoric that criminalizes them, especially Mexicans. Trump himself infamously stated that Mexicans crossing the border were “criminals” and “rapists” (Reilly, 2016). This rhetoric contributes to public discourse about immigration that villainizes Latinx immigrants, portraying them as a threat to national security (Berger-Cardoso et al., 2021; Morey, 2018). Stigma associated with being an immigrant and/or Latinx can affect health in the form of anti-immigrant or anti-Latinx discrimination (Bennett et al., 2020; Chavez et al., 2021). Internalized stigma, also known as self-stigma, is the fear of societal attitudes, which can include the expectation of discrimination (Crespo-Ramos et al., 2018). Self-stigma is an internal process, but it is the direct effect of stigmatization (e.g., stereotyping, prejudice and discrimination) by the general public against individuals or groups (Umaña-Taylor et al., 2002; Yang et al., 2014). Experiencing discrimination and stigma are known risk factors for poor mental health for youth of color, especially in terms of internalizing and externalizing problems (Ramos et al., 2021; Berger Cardoso et al., 2021; Lazarevic et al., 2021). Studies suggest that Latinx individuals experience cumulative racism and discrimination as traumatic (Torres et al., 2011). For example, the race-based traumatic stress theory suggests that racial and ethnic minorities, including Latinx, experience discrimination as psychological trauma (Polanco-Roman et al., 2016). This unique traumatic stress is the result of the emotional pain individuals experience as a result of racism and discrimination (Kirkinis et al., 2018). A climate that is hostile to Latinx immigrants—where discrimination/racism and fears about the deportation of family members proliferate—is harmful to the mental and emotional well-being of Latinx adolescents. (Gonzales et al., 2013).

Despite increasing attention, significant gaps in the literature remain in terms of the consequences of Trump’s immigration enforcement, perceived discrimination and stigma on the health and well-being of US citizen, Latinx children (Lovato et al.,2018; Walsdorf et al., 2021; Gulbas et al., 2015). Literature suggests that traumatic events may contribute to increased discrimination-related stress and threat appraisals, which can predict psychological symptoms (Matheson et al., 2019; Kubiak, 2005). The detainment or deportation of a parent can be considered a traumatic event, which can increase reported discrimination by children due to greater vulnerability or sensitivity to these kinds of encounters. Further, both perceived discrimination and immigration enforcement in tandem could affect mental health (Ellis et al., 2008; Lewis et al., 2015).

Purpose of this Study

The consequences of immigration enforcement on Latinx children of immigrants’ mental health, coupled with anti-immigrant racism/discrimination, is not well understood nor well documented empirically. Donald Trump is no longer president, yet exclusionary US immigration policy is still in place and related xenophobic rhetoric is recurrent. The risks to children’s health and well-being are still very real and warrant scientific attention. Understanding of the impacts of enforcement and discrimination on Latinx adolescent mental health is important to inform future changes to immigration policy, responsive program design and appropriate allocation of resources to prevent and/or mitigate these impacts. Accordingly, the purpose of this paper is to quantitatively investigate the dual association of exposure to immigration enforcement and perceived discrimination with the mental health of a nationwide sample of US-citizen, Mexican American adolescents exposed to parental deportation, as well as lesser forms of immigration enforcement at the height of the Trump administration.

Our analytical approach was informed by ecological and intersectionality theory. Per these theories, forces on the societal level of the social ecological model (SEM), specifically anti-immigrant rhetoric/climate and immigration enforcement policies under the Trump Administration, directly impact the health and well-being of Latinx adolescents and children of immigrants by targeting their parents or primary caregivers (Dillon et al., 2019). Factors on the societal level of the SEM also interact with factors on the community/organizational, interpersonal, and individual levels (Dillon et al, 2019). Intersectionality refers to the intersecting effects of marginalizing characteristics such as race, gender, migration/legal status, and class (Seng et al., 2012). These social identities and different social group memberships create different vulnerabilities that can degrade health via social processes, like discrimination, on different ecological levels (Kern et al., 2020; Seng et al., 2012). These two theories together help to capture how high-level intangible factors, such as rhetoric and sentiment, influence tangible factors like immigration enforcement legislation that directly impacts adolescents’ health and well-being.

Other relevant theories that support our theoretical framework are the Immigration-Related Adverse Childhood Experiences (ACEs) and legal violence (Barajas-Gonzalez et al., 2021; Mejívar & Abrego, 2012). These frameworks emphasize how violence can manifest in diverse ways, including structurally, legally, and systematically (e.g., family separation via immigration enforcement), and traumatize adolescents. Intersectionality and social-ecological theory informed the selection of variables for our analyses, as well as how we organize and discuss our results. These theories, in addition to legal violence and immigration-related ACEs, also provided context for our study and helped to frame our findings conceptually. Based on theory and previous research, we developed some initial hypotheses. Specifically, we hypothesized that a) immigration enforcement would be associated with higher odds of mental health symptoms (e.g., anxiety, depression, and internalized stigma); and b) exposure to discrimination would be associated with higher odds of mental health symptoms in our sample.

Methods

Study Participants and Data Collection

We used data from surveys collected as part of a larger, mixed-methods, longitudinal study called Between the Lines (BTL). The BTL study collected quantitative and qualitative data from adolescents in mixed-status households who have experienced, or were at risk for, parental deportation. BTL was a two-year, collaborative project between researchers at Drexel University and the Mexico section of the US-Mexico Border Health Commission and included a cohort of Mexican immigrant families directly affected by parental deportation and a comparison cohort. The BTL team in Mexico recruited a sample of deported, Mexican parents from three different deportation stations in three border towns in Mexico—Tijuana, Matamoros and Nogales (n=67). During randomly selected sampling shifts, parents who were deported were approached by trained project staff at the study sites, informed about the study, screened for eligibility and consented to participate in the study. Consenting deported parents served as recruitment brokers for their families in the US. Families were contacted by phone by trained study staff, after an informal introduction by the deported parent. With their help, a sample of 49 US-based separated families were recruited (60 caregivers, 50 adolescents) between February 2019 and March 2020. A comparison sample of 51 families in the US (51 caregivers, 51 adolescents) was also recruited during that time, via referrals from separated families, community-based organizations, providers and community health workers. Eligible separated adolescents were 13 to 17 years old, a US-born or naturalized citizen, fluent in English or Spanish, able to complete surveys over the phone, and living in the US at the time of the deportation. Non-separated adolescents, the comparison group for BTL, were also 13 to 17 years old, a US citizen or naturalized, able to complete surveys over the phone and living in the US at the time of enrollment. Additionally, these adolescents had to have at least one immigrant parent of Mexican origin who was not a naturalized US citizen or green card holder and no history of parental deportation at the time of enrollment in the BTL study.

After providing informed consent/assent, study participants completed a baseline survey by phone at study enrollment, which for separated families occurred within 2 weeks of the deportation of a parent. Separated and non-separated adolescents and primary caregivers completed a follow-up survey by phone 6 months after baseline. Each family received a monthly check-in call from the research team between the baseline and follow-up surveys. This paper will focus on survey data collected from BTL adolescents at baseline only. Our analytical sample included adolescents from both the separated and comparison cohorts (n = 101). All study procedures were approved by Drexel University’s institutional review board.

Measures

Immigration enforcement and perceived discrimination.

Baseline measures for adolescents in the BTL study were adapted from previous studies with larger and similar samples, including the Add Health Study (Harris et al., 2009), Children of Immigrants Longitudinal Study (CILS) (Portes & Rumbaut, 2018), and the Youth Risk Behavior Study (YRBS) (Centers for Disease Control and Prevention, 2018). The main independent variables for this study were exposure to immigration enforcement and perceived discrimination. Adolescents’ exposure to immigration enforcement was measured based on whether or not the adolescent experienced the deportation of a parent (e.g., their classification in the separated or comparison sub-sample for BTL), as well as whether they reported that 1) they know or have heard of someone who was detained by immigration authorities in the last 12 months, and 2) they know or have heard of someone who was deported by immigration authorities during the last 12 months. We created a composite ordinal variable for immigration enforcement to reflect increasing intensity of exposure by combining the answers to these questions (coded as 0 = no exposure to either parental deportation or detainment, 1 = exposed to detainment or deportation, but not the deportation of a parent, 2 = exposed to parental deportation). We also created mutually exclusive dummy variables for deportation and detainment exposure (each coded as 0 = no exposure, 1 = exposed).

Adolescents’ self-reported experiences of discrimination were measured using two questions adapted from CILS (Portes & Rumbaut, 2018): 1) a screening question asking the participant whether they had or had not felt discriminated against by someone in the last 12 months (coded as 0 = No, 1 = Yes); and 2) a follow-up question based on the sources of discrimination in the last 12 months. Specifically, the question inquired whether they had felt discriminated against by acquaintances, neighbors, friends or peers, teachers, providers, police, staff at restaurants or businesses, the media, and others. We created a numeric variable for discrimination exposure reflecting the number of sources of exposure, ranging from 0 (not discriminated against) to 2 (discriminated by two or more distinct sources).

Mental health symptoms.

The main dependent or outcome variables for this study measured mental health symptoms related to anxiety, depression (adapted from Add Health and YRBS), and internalized stigma. During the survey, adolescents were asked various questions about how often they experienced symptoms and related behaviors in the preceding 30 days, where the responses ranged from never (0) to every day (4). Questions for anxiety (three items, possible range 0 to 3, α = 0.70) and depression (6 items, possible range 0 to 3, α = 0.85) symptomology queried about difficulty relaxing or concentrating, feeling afraid, falling asleep or staying asleep, tiredness, feeling depressed or “blue,” crying, moodiness, and feeling worried. All items were rated on a four-point scale, with 1 indicating “Never” and 4 indicating “Every day.” For immigration-related internalized stigma, adolescents responded to three questions related to feeling ashamed or worth less than others because of having a parent who came from another country or having immigrant parents, not wanting others to know their family came from another country, and not wanting people to hear them or their parents speak Spanish. These items were rated on a five-point scale, with 1 indicating “Strongly disagree” and 5 indicating “Strongly agree.” Scores on this scale could range from 0 to 4 (α = 0.70).

For each mental health outcome, composite subscales were first calculated as the average score of the items comprising them. Some items were reverse coded for consistency of interpretation, such that higher scores represent more symptoms of mental health issues. A summary composite scale (18 items, possible range 0 to 3, α = 0.92) for overall mental health was computed by combining the subscales for anxiety, depression, somatic complaints (e.g., headaches, stomach aches, trouble eating, trouble sleeping, feeling sick, pain and dizziness) and internalized stigma. For all composite scales, a Cronbach’s alpha was generated to test internal consistency of the scale items. An alpha coefficient of .70 was considered acceptable (Dennick & Tavakol, 2011). Each scale was dichotomized at the median for analyses.

Adolescent demographic characteristics were extracted from the baseline survey and served as correlates for our adjusted models. These included sex (coded as 0 = male, 1 = female), age (in years) at baseline assessment, and race. The racial identity question allowed for selection of multiple categories, and included White, Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander and Other race (coded as White = 0 and all other racial groups, including other race = 1). Ethnicity was not included in the analyses since self-identification as Hispanic/Latinx was an eligibility criterion. These individual-level demographic variables help to capture some aspects of social vulnerability; for example, racial identity other than white can be a proxy for racism, which we consider relevant to our study given our focus on anti-Latinx immigration enforcement and discrimination.

Analytical Strategy

Descriptive statistics, means, standard deviations and percentages were computed to describe the dependent variables, including anxiety and depressive symptoms, internalized stigma and overall mental health among the adolescents in our sample (n = 101), and to explore associations with the independent variables of exposure to detention, exposure to parental deportation, and perceived discrimination. Likelihood Ratio tests were computed to explore bivariate associations between independent and dependent variables. We also estimated four sets of univariate logistic regression models to examine the unadjusted association between each of the independent variables and our mental health outcomes (e.g., internalized stigma, anxiety, depression and overall mental health). We then fitted four subsequent multiple logistic regression models to estimate the adjusted association between exposure to deportation, detention, and discrimination and each of the mental health outcomes, while adjusting for age, racial identity and sex. The minimum set of controls was selected based on the small size of the sample and to avoid over-adjustment. For these adjusted models, we included both independent variables (discrimination exposure and immigration enforcement exposure) to isolate the independent effects of each of them, as well as the control variables. We considered results to be statistically significant if p < 0.05. All analyses were performed using IBM SPSS Statistics Version 26 (IBM Corp, Armonk, NY, 2019).

Results

Descriptive Statistics

Our sample of adolescents was majority female (55%, n = 55), 15 to 17 years old (57%, n = 57) and in high school (grades 9th through 12th) 55.6%, n = 65. All of the participants identified as Hispanic/Latinx, and the majority identified their race as Other (71.8%, n = 84). Most of the deported parents were male; for this sample, adolescents’ caregivers in the US were mostly female (92.8%, n = 103). The majority of caregivers did not complete high school (59.8%, n = 64), either in the US or another country and were not US citizens or lawful permanent residents (85.9%, n = 85) The majority of adolescents and their caregivers lived in the Pacific region of residence the US (48%, n = 48), followed by the Southwest (15%, n = 15), and the Southeast (21%, n = 21). See Table 1 for sample characteristics.

Table 1.

Demographic Characteristics of Between the Lines Adolescents (n=101)

Characteristics n % Mean SD
Participant group
 Separated 50 49.5
 Not separated 51 50.5
Gender
 Male 46 46.0
 Female 55 55.0
Age (years)1
 13–14 43 43.0
 15–17 57 57.0
Enrolled in school, job training or vocational education program2
 Yes 96 98.0
 No 2 2.0
Education level3
 6th–8th grade 32 27.4
 9th-12th grade 65 55.6
Ethnic identity4
 Hispanic/Latinx 100 100.0
Racial identity4
 White 33 28.2
 Other racial categories 84 71.8
Caregiver’s level of education7
 Less than high school 64 59.8
 High school or greater 43 40.2
Caregiver’s gender
 Male 8 7.2
 Female 103 92.8
Caregiver’s immigration status8
 US citizen or lawful permanent resident 14 14.1
 Other immigration status 85 85.9
Exposure to immigration enforcement9
 Parental deportation only 50 50.0
 Detainment or deportation (not a parent) 25 25.0
 Neither deportation nor detainment 25 25.0
Exposure to discrimination10
 No exposure 79 79.0
 Exposure to one source 9 9.0
 Exposure to two or more sources 13 13.0
# of discriminatory sources 0.51 1.10
Anxiety scores 1.74 0.60
Depression scores 1.83 0.59
Internalized stigma scores 0.10 0.16
Overall mental health scores 1.70 0.43
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1

Percentages were calculated excluding missing data, with the valid percentage (n=100)

2

Percentages were calculated excluding missing data, with the valid percentage (n=98)

3

Percentages were calculated excluding missing data, with the valid percentage (n=97)

4

Categories not mutually exclusive. Percentages were calculated excluding missing data, with the valid percentage (n=98 for race, n=100 for ethnicity)

5

Percentages were calculated excluding missing data, with the valid percentage (n=96)

6

Percentages were calculated excluding missing data, with the valid percentage (n=96)

7

Percentages were calculated excluding missing data, with the valid percentage (n=100)

8

Percentages were calculated excluding missing data, with the valid percentage (n=99)

9

Percentages were calculated excluding missing data, with the valid percentage (n=100)

10

Percentages were calculated excluding missing data, with the valid percentage (n=100)

Table 2 contains the distribution of exposure to immigration enforcement and perceived discrimination by outcome of interest. In our sample, 25% (n = 25) of adolescents reported no exposure to immigration enforcement (e.g., parental deportation or detention), 25% (n = 25) reported exposure to detainment only (not of a parent), and 50% (n = 50) reported exposure to parental deportation. Among adolescents who reported higher (i.e., above the median) levels of anxiety symptoms, 14.3% (n = 5) were not exposed to parental deportation or detention, while 17.1% (n = 6) were exposed to detainment or deportation of someone who was not a parent (e.g., lesser forms of enforcement), and 68.6% (n = 24) were exposed to parental deportation. Among those who reported higher levels of depressive symptoms, 14.6% (n = 6) were not exposed to immigration enforcement (e.g., deportation or detention), 19.5% (n = 8) were exposed to lesser forms of enforcement, and 65.9% (n = 27) were exposed to parental deportation. For internalized stigma, 54.2% (n = 13) of adolescents who reported higher levels of symptoms experienced the deportation of a parent, compared to 29.2% (n = 7) who were exposed to lesser forms of enforcement and 16.7% (n = 4) who reported no exposure to immigration enforcement.

Table 2.

Mental Health Outcomes by Exposure to Immigration Enforcement and Perceived Discrimination (n=101)

Variable Adolescent Anxiety Scores1 p Adolescent Depression Scores2 p Adolescent Internalized Stigma Scores3 p Adolescent Overall Mental Health Scores4 p
High Low High Low High Low Yes No
N (%) N (%) N (%) N (%) N (%) N (%) N (%) N (%)
Exposure to immigration enforcement
Not exposed to deportation or detention 5 (14.3%) 18 (31.0%) - 6 (14.6%) 17 (38.6%) - 4 (16.7%) 20 (27.8%) - 8 (16.3%) 17 (35.4%) -
Exposed to detainment or deportation (not parent) 6 (17.1%) 19 (32.8%) - 8 (19.5%) 14 (31.8%) - 7 (29.2%) 18 (25.0%) - 9 (18.4%) 16 (33.3%) -
Exposed to parental deportation 24 (68.6%) 21 (36.2%) - 27 (65.9%) 13 (29.5%) - 13 (54.2%) 34 (47.2%) - 32 (65.3%) 15 (31.3%) -
Overall 35 (100%) 58 (100%) 9.40* 41 (100%) 44 (100%) 12.01* 24 (100%) 72 (100%) 1.30 49 (100%) 48 (100%) 11.60*
Exposure to discrimination
No exposure 21 (60.0%) 46 (77.9%) - 22 (53.7%) 40 (88.9%) - 13 (54.2%) 56 (76.7%) - 26 (53.1%) 44 (89.8%) -
Exposure to one source 4 (11.4%) 5 (8.5%) - 6 (14.6%) 2 (4.4%) - 2 (8.3%) 7 (9.6%) - 6 (12.2%) 3 (6.1%) -
Exposure to two or more sources 10 (28.6%) 8 (13.6%) - 13 (31.7%) 3 (6.7%) - 9 (37.5%) 10 (13.7%) - 17 (34.7%) 2 (4.1%) -
Overall 35 (100%) 59 (100%) 3.70 41 (100%) 45 (100%) 13.95* 24 (100%) 73 (100%) 5.94* 49 (100%) 49 (100%) 19.30*
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*

indicates significance at p <.05, based on bivariate Likelihood Ratio tests.

1

Anxiety was calculated as a composite scale, which was dichotomized at the median (1.67).

2

Depression was calculated as a composite scale, which was dichotomized at the median (1.83).

3

Internalized stigma was calculated as a composite scale, which was dichotomized into children who have not experienced internalized stigma and adolescents who have not experienced internalized stigma.

4

Overall mental health was calculated as a composite scale, which was dichotomized at the median (1.62).

For discrimination, 79.0% (n = 79) of the sample reported no exposure to any sources of discrimination, 9.0% (n = 9) reported experiencing discrimination from one source, and 13.0% (n = 13) reported experiencing discrimination from two or more sources. The most commonly cited sources of discrimination were staff at restaurants, stores and businesses (10.3%, n = 3), White Americans in general (16.2%, n = 5), and from other students (11.1%, n = 4). In terms of adolescents who reported higher levels of anxiety symptoms, 60.0% (n = 21) had no exposure to discrimination, 11.4% (n = 4) reported experiencing discrimination from one source, and 28.6% (n = 10) reported exposure to two or more sources. For depression, 53.7% (n = 22) of adolescents who reported higher levels of symptoms were not exposed to discrimination, 14.6% (n = 6) were exposed to one source and 31.7% (n = 13) reported experiencing discrimination from two or more sources. Finally, for internalized stigma, 54.2% (n = 13) of adolescents with higher levels of stigma symptoms were not exposed to discrimination, 8.3% (n = 2) reported experiencing discrimination from one source and 37.5% (n = 9) reported discrimination by two or more sources.

Primary Analyses

Factors associated with reported mental health symptoms.

In the bivariate analyses (Table 2), exposure to immigration enforcement was significantly associated with anxiety symptoms χ2 (2, n = 93) = 9.40, p = 0.01, depressive symptoms χ2 (2, n = 85) = 12.01, p = 0.002, and overall mental health χ2 (2, n = 97) = 11.60, p = 0.003. Exposure to discrimination was significantly associated with depressive symptoms χ2 (2, n = 86) = 13.95, p = <0.001, internalized stigma χ2 (2, n = 97) = 5.94, p = 0.04, and overall mental health χ2 (2, n = 98) = 19.30, p = <0.001.

Simple logistic regression models (Table 3) demonstrate that exposure to parental deportation was significantly and positively associated with the probability of having higher levels of anxiety symptoms (OR = 4.11, 95% CI [1.30, 13.01]), depressive symptoms (OR = 5.90, 95% CI [1.90, 18.44]), and overall mental health (OR = 4.53, 95% CI [1.60, 12.83]). Lesser forms of immigration enforcement (e.g., exposure to detainment or deportation, but not a parent) were not significantly associated with any of our mental health outcomes, although all odds ratios were greater than one. Exposure to discrimination was also correlated with levels of depressive symptoms (OR = 2.30, 95% CI [1.30, 3.90]), internalized stigma (OR = 1.74, 95% CI [1.20, 2.60]), and overall mental health (OR = 2.61, 95% CI [1.50, 4.70]) in the same models.

Table 3.

Factors Associated with Mental Health Outcomes and Internalized Stigma Among Between the Lines Adolescents (n=101)

Variable Adolescent Anxiety p Adolescent Depression p Adolescent Internalized Stigma p Adolescent Overall Mental Health p
Unadjusted OR (95% CI) Unadjusted OR (95% CI) Unadjusted OR (95% CI) Unadjusted OR (95% CI)
Exposed to parental deportation 4.11 (1.30, 13.01) 0.02* 5.90 (1.90, 18.44) 0.002* 1.91 (0.60, 6.70) 0.31 4.53 (1.60, 12.83) 0.004*
Exposed to detainment or deportation (not parent) 1.14 (0.30, 4.40) 0.90 1.62 (0.50, 5.80) 0.50 1.94 (0.50, 7.80) 0.40 1.20 (0.40, 3.90) 0.80
Exposed to neither Ref. Ref. Ref. Ref.
Exposure to discrimination (# of sources) 1.50 (1.00, 2.20) 0.05* 2.30 (1.30, 3.90) 0.004* 1.74 (1.20, 2.60) 0.006* 2.61 (1.50, 4.70) 0.001*
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*

indicates significance at <0.05

In the adjusted models for immigration enforcement and discrimination (Table 4), controlling for exposure to discrimination, adolescent’s age, gender, and race, reported exposure to deportation was still significantly and positively associated with the likelihood of reporting higher levels of depressive symptoms (AOR = 7.32, 95% CI [1.80, 30.10]), compared to no exposure to either deportation or detention. However, after adjusting for other variables in the model, detainment was no longer significantly associated with any of the outcomes. Results from the multiple regression models showed that after controlling for other covariates, including immigration enforcement, reported exposure to discrimination (e.g., number of sources of discrimination) was significantly and positively associated with depressive symptoms (AOR = 3.10, 95% CI [1.50, 6.30]), internalized stigma (AOR = 2.00, 95% CI [1.30, 3.10]), and overall mental health (AOR = 3.70, 95% CI [1.71, 7.84]). Both exposure to parental deportation (AOR = 3.40, 95% CI [0.93, 12.21]) and discrimination exposure (AOR = 1.60, 95% CI [1.00, 2.60]) were also independently but only marginally associated with anxiety symptoms.

Table 4.

Factors Associated with Mental Health Outcomes and Internalized Stigma Among Between the Lines Adolescents (n=101)**

Variable Adolescent Anxiety p Adolescent Depression p Adolescent Internalized Stigma p Adolescent Overall Mental Health p
Adjusted OR (95% CI) Adjusted OR (95% CI) Adjusted OR (95% CI) Adjusted OR (95% CI)
Exposed to parental deportation 3.40 (0.93, 12.21) 0.05+ 7.32 (1.80, 30.10) 0.006* 3.50 (0.81, 14.96) 0.09 3.50 (1.00, 12.40) 0.05+
Exposed to detainment or deportation (not parent) 0.64 (0.13, 3.20) 0.60 0.82 (0.14, 4.84) 0.83 2.40 (0.50, 11.90) 0.30 0.30 (0.10, 1.90) 0.20
Exposed to neither Ref. Ref. Ref. Ref.
Exposure to discrimination (# of sources 1.60 (1.00, 2.60) 0.05+ 3.10 (1.50, 6.30) 0.002* 2.00 (1.30, 3.10) 0.002* 3.70 (1.71, 7.84) <0.001*
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*

indicates significance at <0.05

+

indicates marginal significance

**

Adjusted logistic regression models adjusted for adolescent’s age, sex/gender and race

Discussion

Research Implications

In our sample, experiencing immigration enforcement appears to negatively affect adolescent mental health (e.g., higher odds of mental health symptoms), which we initially hypothesized. In particular, symptoms of depression appear to be strongly correlated with enforcement, especially parental deportation. These results are supported by other data (Capps et al., 2015; Androff et al., 2011). Existing literature on family separation by deportation demonstrates that children and adolescents who are separated from their parents are more likely to report depressive symptoms like sadness or crying than those who have not been separated (Capps et al., 2015). In our sample, anxiety symptoms were correlated with parental deportation in the bivariate analyses. Symptoms of anxiety, such as being fearful or hypervigilant, have also been reported in other quantitative and qualitative studies with Latinx adolescents whose parents are legally vulnerable (Rubio-Hernandez, 2016; Dreby, 2012). Other mental health issues, including co-occurring behavioral and somatic issues such as problems eating, sleeping, stomach aches and dizziness (symptoms that were included in our measure for overall mental health) have been documented among adolescents and children with a deported parent (Brian et al., 2015; Chaudry., 2011). Since the baseline data for our study were collected within two weeks of the parent’s deportation, our analyses capture the more immediate consequences of this highly stressful experience. Future research in this area should examine the immediate consequences of enforcement, as well as changes over time.

Exposure to lesser forms of immigration enforcement in our study, measured as knowing others who were detained or deported but who were not their parent, was not as strongly associated with mental health as exposure to parental deportation. Small-scale studies in the aftermath of workplace raids by ICE have documented negative mental health symptoms among children and adolescents exposed to these events. Similar to youth with incarcerated parents, these include psychological trauma, aggression and other externalizing issues (Capps et al., 2015; McLeigh, 2010). To our knowledge, most published studies about immigration enforcement and health have not examined how a gradient (or increasing levels of exposure) of enforcement events affect health. While it is clear that the loss of a parent via deportation is psychologically traumatic, it is plausible that experiencing the detainment of a parent or other family member can also negatively affect mental/emotional health, albeit to a lesser degree since adolescents and their families may believe that the detained family member will eventually be released and return to them. Additionally, studies conducted during the Trump Administration have found that the threat of immigration enforcement can also be damaging to child and adolescent mental health (Barajas-Gonzalez et al., 2018; Eskenazi et al., 2019). Future studies should consider including different forms of immigration enforcement in their analyses to further explore a potential dose-response relationship between enforcement exposure and health outcomes.

Scholars have posited that exposure to immigration enforcement, especially the deportation of a parent or family member, can be likened to a violent or traumatic event that results in symptoms which indicate post-traumatic stress disorder or psychological distress, including anxiety, worry and extreme sadness, or depression (Barajas-Gonzalez et al., 2018). Violence encompasses intentional actions that result in harm (Becerra et al., 2020). Exposure to physical violence is usually the focus when it comes to studying the effects of trauma on health, with the result that non-physical violence, including imprisonment or discrimination, are ignored, though psychological outcomes may be similar (Becerra et al., 2020). In the aforementioned legal violence framework, increasing criminalization of immigration legally permits different forms of violence perpetrated by the government and related entities (Becerra et al., 2020; Menjivar & Abrego, 2012). Violence is a public health issue, especially with regards to law enforcement, where the resulting trauma can be studied and conceptualized on a population level (Barajas-Gonzalez et al., 2018). Given the consensus in emerging empirical studies on immigration enforcement and mental health, a violence framework is useful to inform study designs on this topic, as well as interventions and programming. This includes the ACEs framework, which historically has primarily focused on childhood adversity in the home (Barajas-Gonzalez et al., 2021). However, researchers have argued that immigration policy and the threat of enforcement exposes Latinx children of immigrants to threat and deprivation that negatively affects their health and well-being (Barajas-Gonzalez et al., 2021). The ACEs model could inform the conceptualization and measurement of enforcement, as well as other risk and protective factors, to understand how different vulnerabilities intersect to affect health and development.

Changes to immigration policy, including those under the Trump Administration, often reinforce and amplify social prejudices, which can lead to an increasingly hostile climate for immigrants and their families (Androff et al., 2011). In this study, we hypothesized that exposure to discrimination would be associated with higher odds of mental health symptomology. Our results support this relationship. The association between discrimination and negative mental health is well-established for Latinx adults (Almeida et al., 2016; Mann-Jackson et al, 2018), though research on children and adolescents is still evolving. Our examination of these variables among a sample of adolescents contributes to these gaps. Self-reported discrimination has been linked to internalizing issues, specifically anxiety, depression and somatic symptoms, among Latinx adolescents (Sirin et al., 2015; Vernice et al., 2020). Discrimination takes many forms and can occur on the individual or interpersonal level, as well as institutional level (Ayón, 2015). Individual-level discrimination may negatively affect health, while institutional discrimination may create structural barriers to social or health services (Ayón, 2015). Researchers agree that experiencing discrimination on different levels can have a cumulative impact (Ayón, 2015; Vines et al., 2017). Our findings suggest that increasing exposure to discrimination, specifically the number of discriminatory sources that the adolescent reports, increases the risk for poor mental health symptomology. Considering the source of discrimination helps to capture the context of the exposure, although we did not include this variable in our analyses. The social context of discriminatory events is a domain that is receiving more attention in discrimination research (Vines et al., 2017), because it highlights the complex nature of experiencing discrimination and emphasizes the need for measures of discrimination to be more nuanced to capture these complexities and contextual influences. Moving forward, and in studies with larger samples, researchers should consider how multiple social identities may contribute to the potentially multiplicative effects of discrimination, including generational status, gender, sexuality, socioeconomic status, and perceived racial or ethnic classification, as well as the context of the exposure (Sirin et al., 2015; Córdova & Cervantes, 2010; Vines et al., 2017).

Clinical Implications

This study links both discrimination and enforcement to poor mental health among Latinx adolescents. Conceptually, this is not surprising given both exposures are independently associated with negative mental health, and both are manifestations of a larger anti-immigrant and anti-Latinx climate in the US that reached a fever pitch under Trump (Neinhusser & Oshio, 2018). However, gaps remain in terms of the pathways and mechanisms through which discrimination and immigration enforcement relate to each other in terms of mental health (Ayón & Becerra, 2013; Walker et al., 2020; Almeida, 2016), which has clinical implications. In our study, we did not find a correlation between immigration enforcement and discrimination, so we could not assess mediation (data not shown). A recent study conducted by Berger Cardoso and colleagues analyzed survey data collected from first- and second-generation Latinx high school students (N = 306) in Texas and Rhode Island (2021). They found that immigration enforcement fear was associated with anxiety and somatic symptoms in their sample, and, importantly, that perceived discrimination partially mediated this association (Berger Cardoso et al., 2021). Their study suggests that immigration enforcement fear may heighten youth’s awareness of perceived discrimination (Berger Cardoso et al., 2021). However, they did not measure direct exposure to immigration enforcement as we have done in this study. Future investigation utilizing quantitative, qualitative and mixed methods with the integration of clinical approaches is warranted to further describe the relationship between discrimination and enforcement from the perspective of Latinx children and adolescents. Mental health experts and providers may also want to consider these stressors as potentially linked in terms of therapeutic treatment.

Limitations

There are some limitations to this study. Most notable is the relatively small sample size of 101 adolescents, which limited our analytical strategies. For example, we had to be conservative in terms of number of covariates to due to the limited statistical power. The small sample size, as well as study eligibility and recruitment based on experiences of parental deportation, also resulted in a very small number of adolescents who experienced lesser forms of enforcement (e.g., detention of someone who was not a parent). This limited variation and lower power may have precluded our ability to properly examine the effects of these events on mental health, as well as our ability to speak more definitively about the role of discrimination as a moderator. Studies with larger sample sizes would achieve greater confidence in confirming our results and further exploring these important research questions. However, it is interesting to note that the effect sizes were of such magnitude that even in a small sample, statistical significance was achieved for many of the hypothesized associations between immigration enforcement, discrimination, and mental health.

The cross-sectional nature of the data, collected at baseline per BTL protocols, impedes our ability to examine causal relationships between our exposures and outcomes. Further, since we analyzed baseline data collected from adolescents for whom the parental deportation had just occurred, whereas their exposure to other forms of enforcement could have occurred at any time, we are unable to assess longer-term impacts of deportation or detention on their mental health or assess a potential moderating effect of the timing of the event. Future work with longitudinal designs and larger samples should be conducted to differentiate between correlation and causality.

Another limitation pertains to the measurement of the outcomes. The baseline survey for BTL participants was lengthy and covered many topics beyond immigration enforcement exposure and discrimination, and so the already-existing instrument and space constraints did not allow for the introduction of new measures for the present study. For discrimination in particular, it is possible that the two survey items, although validated, did not properly capture experiences of discrimination, likely resulting in underestimates. Additionally, the validity of the composite scale that we used for overall mental health is uncertain. This study is part of a larger, mixed-methods study that includes a qualitative component that explores lived experiences of discrimination and immigration enforcement. This qualitative counterpart allows for a more nuanced exploration of the context of discriminatory experiences, as well as adolescent’s interpretations, which may be better suited to studying this phenomenon and establishing more effective survey measures. Additionally, we relied on data collected from adolescents who self-reported their mental health symptomology in this study. Although reliance on parental reporting is a well-established practice in research and clinical settings (Patalay & Fitzsimons, 2016), given the scarcity of primary data collected from youth like those in our sample, we believe this also represents a strength. Finally, it is possible that separated and comparison families differed in their selection into BTL in some unmeasured way, which could have introduced selection bias and affected the generalizability of the findings.

Conclusion

This study suggests potentially significant psychological consequences of exposure to different forms of immigration enforcement and discrimination among Latinx children and adolescents. Indiscriminate interior immigration enforcement activity under the Trump Administration, coupled with heightened anti-immigrant and anti-Latinx rhetoric and climate, are likely to have worsened the mental health of millions of children of Latinx immigrants in the US, many of whom are citizens. It is clear that US immigration policy requires comprehensive reform that is family-friendly and that prioritizes the health and wellbeing of Latinx children and adolescents. Public health practitioners, providers and advocates should work to expand access to trauma-informed health and social services for Latinx families affected by or threatened by immigration enforcement. Simultaneously, interventions are needed that help adolescents and their families cope with discrimination and racism, as well as raise the awareness around the individual, familial, and societal consequences of anti-immigrant messaging. It is important to recognize that the consequences of these policies are not limited solely to those who are detained and deported but spill over to affect the health and well-being of their children, who are a significant and growing segment of our US population. Future administrations should consider the deleterious effects of these policies on their citizens, who are guaranteed certain rights by law.

Public Impact Statement:

This study suggests that children and adolescents of Mexican immigrants were susceptible to mental health issues (e.g., anxiety and depressive symptoms) associated from different levels of exposure to stepped-up interior immigration enforcement ordered by former US President Donald Trump. Additionally, under an anti-immigrant/anti-Latinx climate during Trump’s administration, these youth experienced psychological distress and internalized stigma due to perceived discrimination against them.

Acknowledgments

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) under Grant R21HD085157 (PI: Ana Martinez-Donate) and by the National Institute on Minority Health and Health Disparities (NIMHD) Research Training Program, the Global Alliance for Training in Health Equity T37MD01425. NIMHD did not participate in the work. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health, the NICHD, or NIMHD.

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