Joaquin Luna’s suicide made headlines last year. (Photo by Gabe Hernandez/The Monitor)

Joaquin Luna’s dream was simple. He wanted to become a civil engineer.

But the Texas student’s undocumented status limited his options for the future. Left without hope, the 18-year-old shot himself the day after Thanksgiving last year.

In his goodbye letters, Luna expressed despair. In one letter addressed to Jesus Christ, he wrote that he had “no point of existence in this cruel world.”

“I’ve realized that I have no chance in becoming a civil engineer the way I’ve always dreamed of here… so I’m planning on going to you and helping you construct a new temple in heaven.”

Luna was one of the more than 2 million undocumented children and young adults living in the United States. The inability for them to legally obtain a social security number makes it a struggle to get a driver’s license, apply to college and find a job.

Young people like Luna are already at a heightened risk of having anxiety disorders, that often go untreated, according to the National Institute of Mental Health.

But for undocumented youth, the risks are even greater due to uncertainty over their future, fear of getting arrested and deported, and social stigma about being undocumented.

“Being undocumented means instability, uncertainty,” says Fanny Lopez-Martinez, an undocumented 23-year-old graduate student at the University of Chicago. “You have no future. You can’t plan. You can’t envision what you want to do. You feel locked in a box. And it’s hard to come to terms with the fact that you’re going to be like this for you don’t know how many years.”

Looking at clinical research

According to Josefina Alvarez, a professor on Latino mental health at the Adler School of Professional Psychology in Chicago who works with immigrant community organizations, evidence about the mental health consequences of being undocumented are beginning to emerge out of case studies with immigrant children and families.

“Feeling insecure and uncertain about your life and your future has serious mental health consequences and may lead to anxiety and depression,” Alvarez says. “Feeling stigmatized and unwanted can also have a negative impact on self-esteem and may lead to depression and other negative behaviors.”

In a 2008 study done by the Carolina Population Center at UNC-Chapel Hill, 31% of Latino adolescents in North Carolina showed signs of sub-clinical or clinical anxiety and 18% showed signs of depression. The study did not distinguish between those who are here legally and those who are undocumented, but the demographics of those surveyed reflect that 93% of the children were not U.S. citizens.

The study also looked at the participants’ usage of mental health services and found that only 4% of those surveyed had received any mental health services in their lifetime. Undocumented immigrants are already at a disadvantage due to the structural barriers to accessing these services, such as lack of health insurance, cost of services and language barriers.

Barriers to access

Even though the Obama administration overhauled health care in order to cover more uninsured Americans, the Affordable Care Act excludes undocumented immigrants from receiving benefits. It also slashes funding for safety-net hospitals, which provide significant levels of care for low-income, uninsured and vulnerable populations, including undocumented immigrants. On Sept. 17, the White House clarified that the exclusion from health insurance coverage applies even to young undocumented immigrants who obtain deferred action status from deportation for two years (DACA).

Angelica Velazquillo, a graduate student at the University of Chicago and an undocumented youth activist, says that even accessing health services at local clinics can be cumbersome, as many have waiting lists for mental services.

Fellow activist Marco Saavedra adds that the health service centers at universities and high schools might not have counselors who have a lot of experience with undocumented immigrants.

“From my experience, the counselors in my boarding school didn’t know how to help me because they haven’t come across undocumented students before,” says Saavedra, an Ohio resident who immigrated from Mexico in 1993. “In order to fully understand their patients, they have to be well-versed enough in the immigration system of this country and know what these people have been through.”

Another hurdle is the psychological barrier in accessing these services. In the Carolina Population Center’s study, one-half of Latino immigrant parents expressed reluctance to seek mental health services because they are uncomfortable with talking to a medical provider. Dr. Octavio Martinez, a psychiatrist from Texas and the executive director of the Hogg Foundation for Mental Health, finds this issue particularly pertinent with undocumented immigrant families.

“You worry about going to the doctor because you think, ‘Is the doctor going to ask about my immigration status?’” Martinez says. “’Will they tell the police?’ And stories like this are circulated among communities because sometimes it does happen, so there is misconception about seeking help.”

Paralyzing fear

Fear of authorities and fear of deportation isn’t just a barrier to seeking mental health care. It can often be the very cause of anxiety and depression for undocumented immigrants.

In 2010, 19-year-old undocumented Brazilian Gustavo Rezende hung himself behind his Marlborough, Mass., home, reportedly worried about his court hearing after being arrested on misdemeanor charges for driving under the influence and driving without a license. Rezende’s family and friends said he was afraid of being deported back to a country he barely knew.

In a case earlier this year, 22-year-old Yanelli Hernandez attempted suicide twice while being detained at Butler County Jail in Ohio. Hernandez had been arrested on a DUI charge and was awaiting deportation. Her case became the cause célèbre for many immigration groups, including National Immigrant Youth Alliance (NIYA) and the Chicago-based Immigrant Youth Justice League (IYJL). Activists demanded that Hernandez be released from detention so she could receive treatment for depression, but Immigration and Customs Enforcement officials announced in late January that she was deported to Mexico.

Saavedra, who is a friend of Hernandez’s and organizes with NIYA, experienced the conditions inside a detention facility firsthand when he infiltrated the Broward Transition Center in Florida in July. Saavedra and another NIYA activist, Viridiana Martinez, intentionally turned themselves in at Port Everglades in order to raise awareness about the detention and deportation proceedings are like.

“The wait while you’re inside [the detention center] is huge mentally,” Saavedra says. “It was taxing. The center is nowhere near their families and these people don’t know their legal rights. They’re about to be deported to countries where they have no resources.”

Saavedra says that though the detention center was very similar to a motel, the psychological effects of being imprisoned take a toll on the undocumented immigrants, especially the minors.

Angelica Velazquillo sits with her brother Erick at a vigil held for his deportation case. (Photo courtesy of Angelica Velazquillo)

Furthermore, detention and deportation often causes family separation, something that Velazquillo personally experienced. In 2010, her brother Erick was driving home from the gym in North Carolina when a cop pulled him over for driving with his high beams on. He was arrested and charged for driving without a license and spent three days in jail. He posted a bond and was released, but for almost a year, his future remained uncertain as he faced the prospect of deportation back to Mexico. Velazquillo and her family worked with NC DREAM Team to publicize her brother’s case. After a judge granted her brother a reprieve, ICE officials decided in August 2011 to let him stay in the country.

“For those who find themselves or their loved ones in detention, it causes a lot of distress,” Velazquillo says. “You’re separated from your family, and it’s hard to get in touch with them to try to get information about what’s going on. The financial aspect is also a huge burden, having to post a bond for them to be released. And the effect it has on children in the family, it’s hard to explain to them what’s going on.”

Keeping secrets

Even those who manage to avoid arrest and deportation still deal with the daily worries of keeping their status a secret. Yaxal Sobrevilla, a Chicago resident and organizer for IYJL, says that while her parents were open about their immigration status within their family, her mother told her she had to be careful about whom she talked to about being undocumented.

Furthermore, simple tasks that citizens and legal residents sometimes take for granted become a source of frustration, such as getting a driver’s license.

“What were supposed to be minimal privileges, such as getting a driver’s license, become such an obstacle,” Sobrevilla says. “I became dependent on my parents and friends to get me places. Although they were, for the most part, willing to drive me around, it made me feel like such a burden.”

For Saavedra, the constant lying and keeping secrets took a toll on his mental health. Saavedra said that as he came closer to graduating from college, the pressure about his immigration status and uncertain future caused a lot of stress.

“The timeline for me was getting shorter, so I started feeling really depressed during my junior year of college,” Saavedra says. “For the sake of my mental health, I decided it was time to tell people the truth about my immigration status.”

Life after college

In a study conducted last year by University of Chicago professor Roberto Gonzales, only 31 of the 150 undocumented immigrants interviewed received a bachelor’s degree or more. Of those 31, none were able to pursue their chosen careers after graduation. And though all of the 150 respondents were educated in the United States, they ended up in the same jobs their parents had, such as working in construction, cleaning services and restaurants.

Carla Navoa wants to be a teacher, but her undocumented status is preventing her from getting a teacher’s certificate. (Photo by RJ Aguinaldo)

Carla Navoa, a 23-year-old undocumented Filipina who studies at University of Illinois at Chicago, says that while her immigration status inspired her to work hard in school, she found out later that she wouldn’t be able to achieve her dream of becoming a teacher.

“In high school, knowing that I was undocumented made me work harder in school to prove I was just as good as other students and the sacrifices my parents made coming here were worth it,” Navoa says. “But in my junior year in college, I found that I couldn’t apply for a teacher’s certificate. I had a serious breakdown and had a lot of mental issues, and I had to leave school for a while to work through that.”

In an incident similar to Luna’s, Chicago resident Benjamin Pintor committed suicide on Thanksgiving weekend in 2010 because, friends and family say, his undocumented status left him without many options. Dr. Martinez says that undocumented youth have a tendency to take it upon themselves to help their family rise above their immigration status.

“They take on a lot of responsibility, in some ways self-imposed, that they have to be the one to lift up and advance their family,” Martinez says. “It’s common in undocumented families, a lot of whom are low on the socioeconomic scale. They know that education is the key to a good quality of life, but when the opportunity to succeed is taken away, it takes a severe toll on their mental health.”

Hope through legislation

Luna’s story made national headlines because his family, friends and immigration activists said he lost hope after the DREAM Act failed in Congress in late 2010. The Development, Relief, and Education for Alien Minors Act is a proposal that would provide a pathway to conditional permanent residency for undocumented youth, if they serve in the military or obtain higher education.

Luna, who came to the United States as an infant, would have been eligible for the DREAM Act. Like many DREAMers, Luna was a hardworking student. He was in the top 20 % of his class and he worked a part-time job on weekends to make extra money. He had applied to the University of Texas-Pan American but died before he found out about his acceptance.

The U.S. House of Representatives passed the DREAM Act in December 2010, but the bill stalled in the Senate. Since then, 11 states, including Illinois, have passed a state version of the DREAM Act. Because states cannot grant citizenship status, most of the state laws focus on providing better access to higher education for undocumented youth, like creating scholarship funds that raise money independently.

Earlier this year, the Obama administration announced the Deferred Action for Childhood Arrivals program that grants a two-year employment authorization for eligible undocumented youth. The program does not provide a pathway to citizenship, however. As of Nov. 15, more than 300,000 undocumented youth have applied for DACA and more than 53,000 have been approved, according to the U.S. Citizenship and Immigration Services (USCIS).

Navoa took advantage of the program and is in the process of receiving her work permit. While her dreams of becoming a teacher are temporarily on hold, she found a job working as a youth organizer with the Korean American Resource and Cultural Center, where she plans on working after finishing up her senior year at UIC.

“For the short-term future, I know that I have a job and I can save money for grad school,” Navoa says. “It’s still not completely certain, but at least I know there is more opportunity with deferred action.”

Comprehensive reform

But Alvarez of the Adler School points out that DACA is not a long-term solution, with many concerned about what will happen when the program ends. For some, even the DREAM Act, though a much broader solution, doesn’t completely alleviate the worries of undocumented youth.

“Even if the DREAM Act were to pass, it would still not give me any sense of security over my parents’ situation,” Sobrevilla says. “It increasingly worries me how they can find health services as they grow older or how I will be able to look after them when they can no longer work themselves.”

Though the lawful status that undocumented youth might obtain through the DREAM Act, if enacted, may eventually lead to a paying job with health insurance, it doesn’t improve immediate access to mental health care. Both Alvarez and Martinez say there is plenty of work to be done outside of immigration policy in helping undocumented youth deal with mental illness.

“Mental health professionals come to the field with similar blind spots and stereotypes as the rest of us,” Alvarez says. “In the absence of training, most of us are not prepared to work effectively with immigrant groups.”

Martinez notes that without addressing society’s general stigma toward mental health, anyone — undocumented or not — might still be reluctant to seek out treatment and medical help.

“It’s not a good thing to be known as ‘crazy,’” Martinez says. “It also doesn’t help that we criminalize mental illness by locking people up. That kind of information gets disseminated, and that’s not good encouragement that someone should go to the doctor when they see symptoms of mental health problems.”

Some activists said that coming out about their undocumented status has helped them deal with the anxiety and depression. (Photo courtesy of IYJL)

Undocumented and unafraid

One bright spot is that young activists are feeling empowered by the DREAMers movement and many of them say that organizing and getting involved has helped them cope with depression and anxiety.

“For me, coming out and being outspoken about how urgently the immigration system needs to be fixed is so necessary,” Sobrevilla says. “It was hurting me more not being able to try to change my situation.”

Sobrevilla says that groups like IYJL and NIYA provide a support network for many undocumented youth. That network is particularly comforting for undocumented young adults, as they risk getting arrested and deported by coming out about their immigration status.

The University of Chicago’s Lopez-Martinez says she found comfort in attending an IYJL meeting and hearing the stories of undocumented youth just like her. She says she first heard about the group from two of her college friends.

“They told me that there’s a group of students just like us,” Lopez-Martinez says. “They’re undocumented, they’re young and they want to make a difference. IYJL is a place to talk about your feelings, what it means to be undocumented. That’s very empowering, to know that you’re not alone and that many other youth just like you are going through the same thing.”

Velazquillo and other organizers from NIYA decided to use the healing power of a support system to help other undocumented youth across the country. They started Undocuhealth, a blog that deals specifically with the mental health needs of undocumented immigrants.

“We wanted a place where we could talk about these issues because they are not being addressed,” Velazquillo says. “We want to be able to provide resources for those who need it.”

But ultimately, the lack of action on immigration reform continues to be taxing for undocumented youth. Though there was a lot of buzz after the election on the increasing electoral power of Hispanics and the pressure they can levy on politicians, immigration, in the immediate future, has taken a backseat to the fiscal cliff discussions in Washington.

“Continuing to delay a solution to the problems related to undocumented immigrants adds to the stress these young people feel,” Alvarez says. “If they see that we, as a society, can’t find a solution to this problem, they will become more discouraged and hopeless.”

Saavedra says that he is hopeful he and other activists can increase understanding and awareness among Americans about undocumented youth.

“I hope our work humanizes DREAMers instead of having people think of us as ‘illegal’ or ‘border crossers,'” Saavedra says. “People need to recognize that we can suffer from depression just like they can.”

Alvarez agrees that humanizing the issue would help address the problem.

“Immigration policy has real mental health consequences,” she says. “It’s not just about dealing with those who have broken the law and securing the borders. There are real human beings that are going to be affected by our immigration policies.”