On Monday, Aug. 19, 2013, the Texas Tribune, as part of their On The Road series, presented a daylong symposium on mental health policy at the University of Texas at San Antonio campus.  There were four main topics of discussion: Criminal Justice and Mental Health, Immigration and Mental Health, Mental Health and the 83rd Legislature, and Success Stories in Mental Health.  The symposium was timely, and I had the privilege of participating on the panel that addressed immigration and mental health.  This is not an attractive topic nor is it a politically popular one.  Even in the health care arena, the health of immigrants, especially undocumented immigrants, is at best marginalized and at worst too-often ignored.  This has dire consequences for a great many people.

In Texas, we are talking about over 4.1 million souls, of which 1.7 million meet the criteria for undocumented status.  Note that the majority are here legally, but the barriers to accessing mental health services affect all, and these barriers are many and formidable.  This is extremely unfortunate in a great nation like ours and a great state like Texas.  The barriers to accessing mental health services are partly a reflection of our fragmented health care system, and partly due to our inability to develop a comprehensive immigration policy that addresses the many individuals and families who look to the United States, much like our forefathers, as a beacon of opportunity to a better life.

The toll on mental health of our immigration policy is hard to calculate, but we do know it is resulting in increased symptoms of anxiety and depression.  A recent study by the Carolina Population Center at University of North Carolina–Chapel Hill highlights the risks and mental health symptoms affecting Hispanic/Latino immigrant families. It is especially disturbing how children are affected in these families, particularly those of mixed citizenship status where citizen children have one or both non-citizen parents.  The emotional burden on a child who worries about a parent at risk for deportation, or worries about saying or doing the wrong thing which could place their parent at risk of exposure, can be overwhelming.  It is not uncommon for children of low-income families, who are the majority of immigrant families, to self-impose the burden of trying to lift their family out of poverty.

This may have been the case with Joaquin Luna, Jr., who took his own life at the age of 18 in November 2011.  He was a bright student who dreamed of becoming a civil engineer.  At some point, this young undocumented immigrant lost hope.  Depression and suicide are complicated matters, and we will probably never know exactly what factors drove Mr. Luna to the conclusion that taking his own life was a viable solution to his problems. However, we do know that we currently have inadequate mental health policies in place as they relate to immigrants.  We can do better.  For Mr. Luna it is too late.  He was accepted to the University of Texas–Pan American, but he died before his admission was official.  We will never know what contributions he could have made to his family, to his community, to Texas.