Issue link: https://tmcpulse.uberflip.com/i/1111486
8 t m c » p u l s e | m ay 2 0 1 9 Individuals who seemed most resilient, she said, often had three things in common: a focus on family, a job and strong spirituality. Living in fear The Pew Research Center estimates that 10.7 million undocumented immigrants resided in the U.S. in 2016, half of whom originated from Mexico. Approximately one-quarter of the U.S. foreign-born population is unauthorized immigrants. Garcini hopes that the results of this study will help her and others identify new strategies to reduce the negative effects and mental health concerns among this at-risk population and start implementing intervention, policy and advocacy efforts. She is now involved in studies that take this data a step forward by using blood tests to assess how stress and trauma affect physical health and physiological function. "The purpose is to also identify some of the protecting factors that could lessen that impact on their health," Garcini explained. "Once we identify that, we'll be able to develop and build interventions that could be disseminated to the community through collaboration with social agencies or faith-based communities." Some of the most important collaborators, Garcini said, are clinicians. "We hope these results will raise awareness among providers to develop best practices with these populations," Garcini said. "It's always important when you see these families that you have in the back of your mind that there's a very high possibility that they might have experienced trauma, or they might not disclose certain health conditions because of fear." That fear has been compounded in recent years amid a political and social climate that has grown increasingly hostile toward undocumented immigrants. "The rhetoric has escalated against immi- grants, particularly undocumented and particu- larly people of Mexican origin," Garcini said. "We have seen increased discrimination, threats— you can imagine that the loss and the trauma is going to be much, much higher." Interviewees who had been eager to speak with Garcini in 2014 were afraid to speak with her when she returned this past December. "People didn't want to talk," Garcini said, "and these people know me." Beyond mental health A constant state of anxiety keeps many undoc- umented immigrants from receiving sufficient care for mental and physical health issues. Further complicating the situation is the fact that this population is almost always uninsured. "Generally, these patients are able to get some care at these federally qualified health centers that see patients regardless of citizenship and regardless of insurance, but these centers don't have all the specialists that are required," said Rajeev Raghavan, M.D., an associate professor of nephrology at Baylor College of Medicine who sees many undocumented patients in renal failure who are in need of dialysis or a transplant. "Oftentimes these patients really go untreated and the disease becomes quite severe." Raghavan believes that policy change on a federal level is critical. Luz Garcini, Ph.D., is a postdoctoral research fellow in Rice University's department of psychological sciences and a faculty scholar at the Baker Institute for Public Policy. We knew there was a high prevalence of loss and trauma in this population— we expect it because we know the many challenges they face. However, they were so much higher than I could even imagine, particularly in terms of repeated exposure or multiple losses. — LUZ GARCINI, PH.D.