Undocumented Immigrants with Behavioral

Disorders are Left Untreated

An estimated 45% to 71% of the 11.3 million undocumented immigrants living in the United States are lacking health
coverage – comprising the largest group of uninsured individuals in the country. Of these, 725,000 reside in New
York State.
These data have not yet accounted for the recent increase in the number of undocumented immigrants crossing the
southwest border in 2022. Meaning, more and more undocumented immigrants are becoming vulnerable as they lack
access to healthcare, specifically mental healthcare.
Existing studies on the mental health of this population reveal that living as undocumented in the U.S. is chronically
stressful which places a toll on their mental health. With the current sociopolitical climate exacerbated by the Covid-
19 pandemic, life for the undocumented may be unbearable.
Our organization, Applied Behavioral Sciences (ABS), intends to extend its highly effective human betterment
programs to be readily accessible for the undocumented population who are indigent and are in serious need of
behavioral treatment. This undertaking may be possible with the help of individuals and organizations who would be
willing to donate to this cause.

No access to behavioral health care

Except for emergency care, undocumented immigrants are mostly ineligible for federal healthcare programs like
Medicaid and Medicare and most federal health benefits.

Undocumented immigrants are only permitted

by law to access federal benefits that are
deemed essential to preserve life or ensure
safety in emergency situations, such as
emergency Medicaid, access to care in
hospital ERs, or access to healthcare and
nutrition programs under the Special
Supplemental Nutrition Program for Women,
Infants, and Children (WIC), under the
condition of satisfying all Medicaid's other Health Insurance Coverage in New York City, 2013
Source: NYC Government, immigrant_health_task_force_report.pdf
nonfinancial and financial eligibility
requirements in order to be qualified for these emergency care.

Some of them are more fortunate and are qualified for benefits that are only available in certain states, while others
with sufficient income can purchase private health insurance (without the benefit of federal subsidies).
However, with a median household income of $36,000, which is over $20,000 less than that of the general
population, most undocumented immigrants live in poverty and cannot afford to buy health insurance.

While many undocumented immigrants have been part of the labor force and contributed to the economic growth of
our country, still there is a significant number who fall through the cracks and are in desperate need of help.

Being unemployed and ineligible for federal health care benefits, undocumented individuals with behavioral health
issues such as substance abuse, gambling addiction, sex addiction, and mental illnesses, are left untreated.

Without treatment, behavioral illness has devastating effects on both the affected person and society. Untreated
mental health disorders can lead to poor quality of life, unnecessary disability, unemployment, family breakdown,
substance misuse, homelessness, and incarceration.

Very high rates of mental distress

Undocumented immigrants have risked their lives to cross the border to flee from wars, poverty, violence,
persecution, and natural disasters, while some are survivors of human trafficking.
Most of them had hoped for a promise of a better life, but unfortunately, they have been living in the shadows in the
U.S. – battling constant fear of deportation, poverty, and a mix of complex struggles—which create a toll on their
mental health.

According to Dr. Luz Maria Garcini, there are “constant chronic stressors that [undocumented migrants] face in their
everyday lives across multiple domains, including work, family (e.g., separation from family), discrimination,
stigmatization, exploitation, socioeconomic adversity, and limited healthcare, among many others”, that make it hard
for them to cope mentally and emotionally.

A systematic evaluation of 40 publications revealed that undocumented immigrants were more likely to experience
depression, anxiety, and post-traumatic stress disorder than other groups.

They may also experience a range of other mental health effects as a result of their undocumented status, including
substance abuse, destructive behavior (joining a gang), and disillusionment, despair, helplessness, fear, or
hopelessness.

In addition to PTSD and other psychological disorders, undocumented individuals are also at a high risk of suicidal
ideation due to distress associated with social marginalization, intergenerational conflicts, and cultural stress.
Risk of incarceration
If these individuals are left untreated, they face a higher risk of incarceration. Inappropriate behavior or misinterpreted
acts may result due to the difficulty in fitting in with society caused by mental illness that may lead to getting arrested.

Arrest and incarceration often destabilize an individual’s life. For some, even brief incarceration leads to adverse
consequences, including loss of employment and future employment opportunities, disruptions in family life and
social connections, and even loss of housing.

Law enforcement officers use discretion to arrest when they believe a person needs health care services from
community-based behavioral providers like our organization, Applied Behavioral Sciences (ABS). ABS receives
referrals of cases from NYS and NYC courts to provide behavioral treatment and services to justice-involved
individuals. We operate in conjunction with the criminal justice system in all New York State counties and the City of
New York.

However, these courts are now swamped with undocumented individuals who have no means of access to insurance
nor make out-of-pocket payments for behavioral care. If these undocumented individuals will fail to attend to
behavioral treatment, the courts will order that they serve jail time and may even lose child custody.

The societal cost of incarceration

In the recent report released by Statista Research Department on August 5, 2022, the United States has the highest
number of incarcerated individuals worldwide — having 2.1 million prisoners, with violent offenses as the most
common type of committed crimes2.

In New York City, this results in an annual cost per prisoner of just about $150,000. The average cost per person per
day increased to $1,525 as of 2021 and that equates to each prisoner receiving more than $500,000 annually.

Indeed, there is a great need to reduce criminal involvement and implement alternatives to incarceration programs.
Prior studies indicate that expanding access to behavioral health care may be a successful strategy for lowering
criminal participation as it is found that about 2 in 5 people who were incarcerated have a history of mental illness:
37% are being held in state and federal prisons while 44% are in local jails.

Our organization, ABS, offers human betterment programs as alternatives to incarceration, where defendants under
parole or probation can be rehabilitated to avoid unnecessary detention when they are unable to post bail.

Granting Free Access to ABS Human Betterment Programs

The ABS Division of Forensic Behavioral Sciences actively shares in the responsibility to correct defiant behavior and
diminish criminal activity in New York State by providing fiscally responsible clinical service in the specialties of
forensic behavioral and mental health.

ABS meets the mental and behavioral health needs of clients seeking help or those referred by criminal justice, court
systems, child welfare agencies, concerned employers, and loved ones.

As we envision a society where no one in need of behavioral health service is left untreated, we are advancing the
need of the most underserved population: the undocumented immigrants.

With the help of our individual sponsors and corporate donors, we are getting more and more undocumented
individuals to carry on with their ABS programs such as:

1. Anger Management and Stabilization Program

2. Violence Prevention and Intervention Program
3. Addictions Rehabilitation Program
4. Sexual Behavior Program
5. Impaired Driver Counseling Program
6. Gambling Treatment Program
7. Women’s Stress & Emotional Support Program
8. Men’s Stress & Emotional Support Program
9. Supportive Parenting Counseling Program

Accessible behavioral treatment will improve people’s lives and make our communities stronger and more resilient.

Help us change lives!

If you or your organization would like to take part in the provision of equitable behavioral health care access for
everyone, click here.
Together, let us change lives for the better.

References:
Berman, A., James J. García, Farzana Saleem, Shraddha Sundaram, and David Zelaya. "Living in the shadows:
Undocumented people and the emerging role of psychologists." American Psychological Association, September
2015, www.apa.org/pi/oema/resources/communique/2015/09/undocumented-people
Cohut, M. “Why mental healthcare is not a safe space for undocumented migrants.” Medical News Today, 14 July
2020, https://www.medicalnewstoday.com/articles/why-mental-healthcare-is-not-a-safe-space-for-undocumented-
migrants
American Immigration Council. “Immigrants of New York.” 6 August, 2020.
www.americanimmigrationcouncil.org/research/immigrants-in-new-york
NYC Mayor's Office for Economic Opportunity. “An Economic Profile of Immigrants in New York City 2017: Results
from NYC Opportunity’s Experimental Population Estimate”. February 2020.
https://www1.nyc.gov/assets/opportunity/pdf/immigrant-poverty-report-2017.pdf

National Immigration Forum. Fact Sheet: Undocumented Immigrants and Federal Health Care Benefits. September
21, 2022. https://immigrationforum.org/wp-content/uploads/2022/09/Fact-Sheet-Undocuemnted-Immigrants-and-
Health-Care.pdf