Immigration & mental health

Asylum seekers ask for safety after they arrive. The APA describes the asylum process as distressing in itself: people may have to repeat their trauma story, find evidence, and wait a long time and pay a lot to get a work permit or a decision.

Many people move to join family who came before them. This can mean years of waiting, then a joyful reunion that is also hard, because everyone has changed while apart.

Adopted children cross borders too, often very young. They may later have questions about their birth country, birth family, language and how they look compared with their family.

Under U.S. law, refugees are people pushed out of their country by persecution, or a well-founded fear of it, because of race, religion, nationality, membership of a particular social group or political opinion. Many have lived through war, loss and long waits in other countries first.

Students may arrive with big hopes and a family’s savings behind them. They often face a new language, new teaching styles and life without family nearby.

Some people enter without permission. Others enter legally and stay after their visa ends. Estimates suggest 10.3 to 11.4 million undocumented people live in the U.S. Many families are “mixed status”: in 2019, about 6 million U.S. children lived with at least one undocumented parent.

The APA notes that one person’s uncertain status affects everyone in the family, including children who are citizens.

Some people come on visas sponsored by employers. Others come to find any work they can, often to support family. More than half of foreign-born people in the U.S. are between 25 and 54, the main working years.

Common stresses

• A visa that depends on keeping one job
• Long hours that leave little time for language classes or rest
• Pressure to send money home
• Work below your training or skills

WHO lists stresses before migration such as no way to earn a living, no access to school, armed conflict, violence, disasters, poverty and persecution.

Change can start before the move, too. The APA describes “remote acculturation”: films, music, the internet and travel mean many people start absorbing another culture while still at home.

The APA notes that journeys vary hugely. Some people take one flight. Others face shortages of food and water, violence, sexual assault, theft, dangerous border crossings, separation from family, kidnapping or extortion. WHO also names detention during transit.

After arrival, the APA lists stresses such as money problems, loneliness, feeling lost, worry for family back home, hard family reunions, and barriers to health care, jobs, school and legal status.

Later, during settling in, WHO adds poor living or work conditions, unemployment, racism, exclusion, threats to cultural or gender identity, isolation and the fear of being sent back.

In one study of asylum-seeking children at the Texas–Mexico border, 60% screened positive for likely post-traumatic stress, compared with 3.9% of U.S. youth in general. The APA notes that trauma before migrating and how long a child was apart from a parent mattered most.

The APA describes “secondary traumatic stress”, when helpers are affected by hearing others’ trauma. It also describes “vicarious resilience”: helpers being strengthened by the resilience they witness.

The APA notes that older immigrants who lived through trauma may feel it again when they see anti-immigrant hate in the news or in person. Fears for safety and social isolation can add to this.

What can help

• Get updates from one trusted source instead of rumours
• Set limits on news and social media, especially before bed
• Talk with people who understand, not alone in your head

People seeking asylum are often asked to repeat their trauma story and prove what happened. The APA says this process can be as distressing as what came before.

Ways to care for yourself

• Bring a trusted person to wait for you, if allowed
• Plan something calm for after each appointment
• Tell your legal helper if you need breaks
• Use slow breathing or grounding before and after

The U.S. Office of Refugee Resettlement cites research from the Center for Victims of Torture suggesting that, as of 2015, 44% of refugees, asylees and asylum seekers living in the U.S. had experienced torture.

The Office of Refugee Resettlement runs a Survivors of Torture program that helps survivors and their families restore their health and dignity and rebuild their lives.

In a 2026 study of 16 older migrants in the U.S., many described feeling “half and half”: not fully from their birth country, and not fully American. Some felt a growing distance from friends and family back home.

One older migrant in that study said that when feelings run high, the words that come out are not English. Others described children laughing at their accent.

Some people slowly lose parts of their first language too. Researchers list this “language attrition” among the losses older migrants face.

Researchers describe loss of status within the family, more dependence on others, and missed or changed mourning rituals as part of ambiguous loss for older migrants.

Many immigrants work below their training. Researchers call this “occupational downgrading”. In a 2024 study of 1,738 undocumented migrants at a clinic in Milan, Italy, two in three workers had lost job status after moving, and those who had were more likely to have a mental health condition.

Many people brace themselves before going out: planning answers, softening their accent or hiding signs of faith. This constant alertness is tiring, and it is a reasonable response to past hurt.

The APA notes that laws aimed at immigrants can affect not only the people directly targeted but also their schools and communities.

The APA cites a 2023 Gallup poll in which 68% of people in the U.S. said immigration is a good thing for the country.

The APA describes research showing that for immigrant youth, understanding unfairness and taking part in community action can be a healthy outlet and can protect mental health.

• Choose actions that keep you safe
• Join a community or student group
• Learn your rights and share them
• Volunteer with newcomers

The APA notes that fear about legal status keeps some immigrants away from mental health care, and that one person’s uncertain status can weigh on the whole family.

What can help

• Ask a qualified legal helper what applies to you, instead of relying on rumours
• Keep a short list of trusted people and numbers
• Name the fear out loud with someone safe
• Notice the parts of your day that are still yours

• Check for updates at a set time, not all day
• Keep all papers in one folder, with copies stored somewhere else
• Keep one page with your case details and your legal helper’s number
• Write your next important date where you will see it

Waiting with no end date can keep the body on alert. Building things you control, like a skill, a friendship, a routine or a hobby, gives your days meaning while the decision is out of your hands.

U.S. Citizenship and Immigration Services (USCIS) says only licensed attorneys and accredited representatives working for recognised organisations can give immigration legal advice. USCIS warns that notary publics (“notarios”) are not attorneys in the U.S. and cannot represent you.

Red flags

• Asking you to lie or leave things out
• Asking you to sign forms you don’t understand
• Promises of guaranteed results or fast papers
• Refusing to give you copies of what was filed

• ImmigrationLawHelp.org lists over 1,000 free or low-cost non-profit immigration legal services in all 50 states. Only organisations that are recognised or have attorneys on staff are listed. Search by zip code, language or detention centre.
• USCIS “Find Legal Services” explains who can help and links to official lists of attorneys and accredited representatives.
• The U.S. Department of Justice keeps a list of free (pro bono) legal service providers for people in immigration court.

WHO says that for most refugees and migrants, distress improves over time. The APA notes that with emotional support and caring relationships, immigrant children can build new secure bonds.

WHO says being part of a community with a shared background protects the mental health of refugees and migrants. The APA notes that belonging in relationships, organisations and cultural groups helps immigrants feel secure and rooted.

• Courage to leave the familiar
• Faith and traditions that give meaning
• Problem-solving in a new system
• Seeing the world from more than one side
• Speaking more than one language
• Strong family and community bonds

Research links language skills, close family ties and family cultural traditions with healthier adjustment for immigrants.

The APA notes that immigrants living in U.S. states with more inclusive policies, such as in-state tuition, access to health insurance and driver’s licenses regardless of status, report better mental health.

The APA also notes that both immigrants and people born in a country need to adjust to live well together.

• Ask open questions, like “What do you miss most?”
• Don’t ask for details of a hard journey
• Let silence be okay
• Take their feelings seriously, even years after the move

• Explain how things work, without making them feel slow
• Go with them to a first appointment if they want company
• Offer to practise phone calls or forms together
• Share local tips: buses, shops, free classes, libraries

• Ask about holidays, food and traditions, and join in if invited
• Don’t joke about accents or names
• Learn to say their name the right way
• Treat their faith and family roles with respect

WHO says distress after migration usually gets better over time. If sadness, fear or poor sleep stay for weeks and get in the way of daily life, gently suggest talking to a counselor or clinical provider.

• Asian Mental Health Collective: an Asian Therapist Directory
• Inclusive Therapists: filter by language, cultural knowledge, the provider’s identity and spiritual knowledge
• Therapy for Latinx: therapists who share Latinx clients’ cultural background

• They are happy to work with an interpreter
• They ask about your journey without pushing you to share before you’re ready
• They don’t treat your culture as the problem
• They respect your faith and family roles
• They understand worries about status and privacy, and explain who can see your records

The Center for Victims of Torture offers healing care such as counselling, physiotherapy and social work for torture survivors. The U.S. Office of Refugee Resettlement also funds services for survivors of torture and their families.

The National Consortium of Torture Treatment Programs is a network of 38 member centres in 22 U.S. states.

• ImmigrationLawHelp.org: over 1,000 free or low-cost non-profit providers in all 50 states
• U.S. Department of Justice list of pro bono legal service providers for immigration court
• USCIS “Find Legal Services”: who is allowed to give legal advice, and official lists

You can also call or text 211 to be connected with local services, including legal aid and counseling. Local libraries and places of worship can point you to newcomer services too.

• International Rescue Committee (IRC): resettlement, asylum and integration programmes, with offices in about 30 U.S. cities
• HIAS: a refugee protection organisation rooted in Jewish values that works with refugees, asylum seekers and immigrants, including U.S. legal help through lawyers in New York and Maryland
• Center for Victims of Torture (CVT): healing care for torture survivors
• National Consortium of Torture Treatment Programs: 38 member centres in 22 states

Find A Helpline (findahelpline.com) lists free, confidential crisis lines in many countries. You can search by country and by topic.