Policies and laws affecting Mexican-origin immigrant access and utilization of substance abuse treatment: obstacles to recovery and immigrant health

Omnibus or Ominous immigration laws? Immigration policy and mental health of the Hispanic population

This study examines the impact of Omnibus Immigration Laws on the mental health of the Hispanic populations in the U.S. We use a Difference-in-Differences framework and data from the Behavioral Risk Factor Surveillance System Survey of Centers for Disease Control and Prevention for the 2000-2016 period that contains information on more than 400 thousand Hispanics residing in the U.S. We find that the most stringent provision, namely, "show me your papers" laws, adversely affects the mental health of Hispanics and contributes to an increase of 12%-16% in the number of unhealthy mental days and an increase of 13%-18% in the probability of having frequent mental distress in the states with "show me your papers" laws. OIL provisions that enforced the use of E-Verify or limited the use of public benefits to unauthorized immigrants did not have any effect on mental health. The study also examines (1) police stops, (2) physical health, insurance, and employment status, (3) co-ethnic density, and (4) immigration enforcement awareness as potential mechanisms that could lead to a deterioration in the mental health of Hispanics. The evidence indicates their vulnerability to strict immigration enforcement. The social and public health cost should be carefully evaluated when formulating and implementing immigration policies.

Stringent immigration enforcement and the mental health and health-risk behaviors of Hispanic adolescent students in Arizona

This study investigates the impact of the enforcement of SB 1070, a stringent immigration law, on the mental health, health-risk behaviors, and academic performance of Hispanic adolescent residents in Arizona. Using the difference-in-differences method, this study finds that SB 1070 increases their probability of feeling sad and decreases their physical activeness. The impact of SB 1070 on sad feelings and level of physical activity could have serious repercussions while it lasts. In addition, obese male Hispanic adolescents are more likely than their female or non-obese counterparts to develop mental health problems and engage in health-risk behaviors attributable to the stringent immigration policy. This study's empirical evidence on adverse mental health repercussions for Hispanic adolescents of state-level immigration enforcement suggests the need to be careful in formulating and implementing immigration policies.

State-level immigration and immigrant-focused policies as drivers of Latino health disparities in the United States

There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic policies are intrinsically health policies, but research on the relationship between state-level immigration-related policies and Latino health remains scarce. This paper summarizes the existing evidence about the range of state-level immigration policies that affect Latino health, indicates conceptually plausible but under-explored relationships between policy domains and Latino health, traces the mechanisms through which immigration policies might shape Latino health, and points to key areas for future research. We examined peer-reviewed publications from 1986 to 2016 and assessed 838 based on inclusion criteria; 40 were included for final review. These 40 articles identified four pathways through which state-level immigration policies may influence Latino health: through stress related to structural racism; by affecting access to beneficial social institutions, particularly education; by affecting access to healthcare and related services; and through constraining access to material conditions such as food, wages, working conditions, and housing. Our review demonstrates that the field of immigration policy and health is currently dominated by a "one-policy, one-level, one-outcome" approach. We argue that pursuing multi-sectoral, multi-level, and multi-outcome research will strengthen and advance the existing evidence base on immigration policy and Latino health.

Wanting and Getting Help for Substance Problems on Both Sides of the US-Mexico Border

The US-Mexico border presents potential cultural and logistic barriers to obtaining substance abuse treatment. We compare the prevalence and correlates of wanting and getting help between border and non-border residents in both the US and Mexico. Data come from the 2011 to 2012 US-Mexico Study on Alcohol and Related Conditions which surveyed 3214 border and 1582 non-border residents in the US and Mexico. Multivariate logistic regressions estimate the effect of border residence on desire for and receipt of help. In both countries, border substance users were about half as likely as nonborder substance users to have wanted or obtained any kind of help, independent of predisposing, need and enabling factors, including migration status. Among those desiring help, however, about half had obtained it, both on and off the border in both countries. While substantial proportions of those who need help do not get it either on or off the border, lower motivation for treatment may be more important than access in explaining border/non-border differences. Future research should investigate whether there are border-specific barriers to wanting help, and how to minimize them.

Immigration policies and mental health morbidity among Latinos: A state-level analysis

RATIONALE

Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation.

OBJECTIVE

To examine associations between the state-level policy climate related to immigration and mental health outcomes among Latinos.

METHODS

We created a multi-sectoral policy climate index that included 14 policies in four domains (immigration, race/ethnicity, language, and agricultural worker protections). We then examined the relation of this policy climate index to two mental health outcomes (days of poor mental health and psychological distress) among Latinos from 31 states in the 2012 Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey of non-institutionalized individuals aged 18 years or older.

RESULTS

Individuals in states with a more exclusionary immigration policy climate had higher rates of poor mental health days than participants in states with a less exclusionary policy climate (RR: 1.05, 95% CI: 1.00, 1.10). The association between state policies and the rate of poor mental health days was significantly higher among Latinos versus non-Latinos (RR for interaction term: 1.03, 95% CI: 1.01, 1.06). Furthermore, Latinos in states with a more exclusionary policy climate had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with a less exclusionary policy climate. Results were robust to individual- and state-level confounders. Sensitivity analyses indicated that results were specific to immigration policies, and not indicators of state political climate or of residential segregation. No relationship was observed between the immigration policy index and psychological distress.

CONCLUSION

These results suggest that restrictive immigration policies may be detrimental to the mental health of Latinos in the United States.

Sociopolitical contexts for addiction recovery: Anexos in U.S. Latino communities

BACKGROUND

Anexos are community-based recovery houses that were created in Mexico to serve people struggling with addiction to alcohol and other drugs. Brought to the U.S. by Mexican migrants, anexos provide residential care to primarily male Latino migrants and immigrants who are unable or unwilling to access formal treatment. While some Mexican anexos have come under fire for coercion, confrontational treatment methods, and corporal punishment, little is known about treatment practices in U.S. anexos.

METHODS

We conducted a two-year ethnographic study of three anexos in urban Northern California. The study included over 150h of participant observation and semi-structured interviews with 42 residents, 3 directors, 2 assistant directors, and 3 former directors (N=50). Qualitative data were analyzed thematically using ATLAS.ti software.

RESULTS

The anexos in our study differed in important ways from Mexican anexos described in the scientific literature. First, we found no evidence of corporal punishment or coercive internment. Second, the anexos were open, allowing residents to leave the premises for work and other approved activities. Third, the anexos were self-supported through residents' financial contributions. Fourth, collective decision-making processes observed in the California anexos more closely resembled sober living houses than their authoritarian counterparts in Mexico.

CONCLUSION

Anexos may operate differently in the U.S. versus Mexico due to variations in sociopolitical context. This exploratory study suggests that anexos are addressing unmet need for addiction treatment in U.S. Latino immigrant and migrant communities. As a community-created, self-sustained, culturally appropriate recovery resource, anexos provide important insights into Latino migrants' and immigrants' experiences with substance abuse, help-seeking trajectories, and treatment needs.

Barriers to drug abuse treatment for Latino migrants: treatment providers' perspectives

This article disseminates findings from a pilot study undertaken to learn more about treatment providers' perceptions of treatment access barriers faced by Latino migrants with substance use disorders (SUDs) in Northern California. Semi-structured interviews were conducted with treatment providers (N = 11) at 7 residential treatment programs with Spanish-language services. Interviewees identified and described three primary types of treatment barriers: language, legal, and gender based. In response to these barriers, Latino migrants with SUDs have opened their own residential recovery houses called anexos (annexes). Collaborative efforts by community clinics and public health agencies are needed to facilitate Latino migrants' access to SUD treatment.

Toward a Typology of Acculturative Stress

The objective of this study is to identify latent classes of Hispanic immigrants on the basis of acculturative stress and, in turn, examine the links between membership in acculturative stress classes and the prevalence of mental disorders. We use latent class analysis (LCA) and multinomial logistic regression with data from a population-based study of Hispanic immigrants in the United States ( n = 1,630). Classes were identified as “Low Acculturative Stress” (38.40%); “Social and Linguistic Stress” (32.27%); “Acculturative Stress, No Fear of Deportation” (20.06%); and “Acculturative Stress, Fear of Deportation” (9.26%). Members of the “Acculturative Stress, Fear of Deportation” class were significantly more likely than members of the “Low Acculturative Stress” class to meet criteria for generalized anxiety disorder (risk ratios [RR] = 3.55, 95% confidence interval [CI] [1.00, 12.56]). The present study represents an important step in the development of a typology of acculturative stress among Hispanic immigrants in the United States.

Preimmigration Family Cohesion and Drug/Alcohol Abuse Among Recent Latino Immigrants

Given the growing population of Latino immigrants in the United States, it is critical for counselors to understand pre- and postimmigration social contextual factors affecting the mental health of this heterogeneous ethnic population. The objective of our cross-sectional, retrospective study was to investigate the potential protective influence of preimmigration family cohesion on drug/alcohol abuse just prior to migration among 527 Latino young adults (age 18-34 years). Multivariate Poisson regression indicated that preimmigration family cohesion was inversely related with harmful/hazardous alcohol consumption, the frequency/quantity of alcohol use, and illicit drug use when controlling for the potentially confounding sociodemographic factors of gender, age, education, income, marital status, and immigration status (documented or undocumented). Associations between family cohesion and drug/alcohol use behaviors varied between Central American immigrants and Caribbean/South American regional groups. Preimmigration findings offer a fuller contextual understanding of the lives of Latino young adult immigrants and support the importance of family cohesion as a buffer against drug/alcohol abuse.