Undocumented immigrant young adults growing up in the United States face significant challenges. For those qualified, the Deferred Action for Childhood Arrivals (DACA) program’s protections may alleviate stressors, with implications for their mental health and wellbeing (MHWB). We conducted nine focus groups with 61 DACA-eligible Latinos (ages 18–31) in California to investigate their health needs. Participants reported MHWB as their greatest health concern and viewed DACA as beneficial through increasing access to opportunities and promoting belonging and peer support. Participants found that DACA also introduced unanticipated challenges, including greater adult responsibilities and a new precarious identity. Thus, immigration policies such as DACA may influence undocumented young adults’ MHWB in expected and unexpected ways. Research into the impacts of policy changes on young immigrants’ MHWB can guide stakeholders to better address this population’s health needs. MHWB implications include the need to reduce fear of deportation and increase access to services.
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This research was made possible by funding from the Blue Shield of California Foundation. Rachel Siemons’ time was also supported by the UCSF Dean’s Office Medical Student Research Program, the Philip R. Lee Institute for Health Policy Studies, the UC Berkeley-UCSF Joint Medical Program Thesis Grant, and the Schoeneman Grant. Dr. Marissa Raymond-Flesch’s time was supported by the Leadership Education in Adolescent Health Program from the Maternal and Child Health Department (T71MC00003) and the Philip R. Lee Institute for Health Policy Studies. Dr. Colette Auerswald’s time was supported by the UC Berkeley-UCSF Joint Medical Program. Dr. Claire Brindis’ time was supported by grants from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (U45MC 00002 and U45MC 00023). We are grateful to the following people for their valuable contributions to this project: Irene Bloemraad, PhD (UC Berkeley, Department of Sociology), Ken Jacobs, BA (UC Berkeley Center for Labor Research and Education), as well as Laurel Lucia, MPP (UC Berkeley Center for Labor Research and Education), Nadereh Pourat, PhD, Efrain Talamantes, MD, MBA, and Max Handler, MPH, MA (UCLA Center for Health Policy Research), our interns Arlette Lozano and Kathy Latthivongskorn, our advisory board members, and our community-based organization partners. Most of all we thank the participants who shared their personal experiences with us.
Conflict of interest
None of the authors have conflicts of interest to disclose regarding this research. The study sponsor, Blue Shield Foundation of California, had one representative on the study’s advisory board, but was not directly involved in data collection or analysis, nor required review of this manuscript.
Human and Animal Rights and Informed Consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.
An erratum to this article is available at http://dx.doi.org/10.1007/s10903-016-0395-1.
Appendix: Focus Group Questions
Appendix: Focus Group Questions
What health problems do you think DACA-eligible young people face?
Probes: What health conditions do you think are particularly challenging for this group? How are health problems for young people like yourselves different from other young adults? Are stress or mental health issues something that DACA-eligible young people struggle with?
What decisions or actions affect the health of young adults like yourselves, who are eligible for DACA?
Probes: In your experience, how easy is it for young adults like yourselves to maintain a healthy diet and lifestyle? Can you tell me about experiences with tobacco use among young adults like you? What about alcohol or other substances?
What do young adults like yourselves do when you need health care?
Probes: Where do you think that DACA-eligible young adults get health care? Do you, or other DACA-eligible young adults that you know, have a regular doctor? Are there particular programs in your area that give health care to immigrants without documentation? What is it like to get care in those places? What about mental health care access?
What is it like for young people like yourselves to get health care?
Probes: What factors do young people like you consider when deciding whether to go the doctor? What barriers make it challenging for you to get medical care? Mental health care? Do you feel like your doctor understands you? Have you ever gone without seeing a doctor for a long time? If so, why?
Have you heard of young adults who might be eligible for DACA not getting the health care that they need because it is too expensive? Can you tell me about that?
Probes: Have you heard of someone who might be DACA-eligible ever deciding to skip a doctor’s appointment or not to have a test done because of cost? How much is “too expensive” for a doctor’s visit? Is cost a barrier for mental health care as well?
Do you think that having insurance is important to DACA-eligible young adults? Do you know what type of insurance they might have or how they find out about insurance and where they get it?
Probes: What might be some reasons that DACA-eligible young adults may not have health insurance? Have you or someone you know had a period of time in which they lost their insurance in the last few years? Why? How did that change the ways you or that person got health care? If you could design an insurance program for DACA-eligible young people what would you want it to look like? What services would you include in your health insurance? Who would you trust to tell you about an insurance program like this?
If you were able to get health insurance under a public program, what would be the best way to reach out to you to enroll you in a health insurance program?
Probes: What types of information would you want to know about the program before you decided to enroll? Would you enroll? If so why or why not?
What specific types of health services do you think are most needed or most in-demand by DACA-eligible young adults?
Probes: How about general primary care services? Reproductive health care services? Dental care services? Stress can be a very challenging thing for young adults to manage. Do you know young adults like yourselves who have used mental health services like therapists to manage stress? Where do DACA-eligible young adults get these different types of care?
Are there any medical services that are hard for young adults like yourselves to find or access?
Probes: What are these services? What makes them hard to access? Are there things that have made it particularly difficult for young adults like yourselves to get mental health care?
What other barriers exist that might prevent DACA-eligible young adults from seeking care? For example, concerns about their citizenship status? Stigma?
Probes: Since the DACA program went into effect last year, has this concern changed among your friends or family members who are your age?
What do you think DACA has done for you? Have you had any increased stress or responsibility because of DACA?
Do you have any other thoughts that you would like to share with us about health or health care needs of young adults like yourselves?
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Siemons, R., Raymond-Flesh, M., Auerswald, C.L. et al. Coming of Age on the Margins: Mental Health and Wellbeing Among Latino Immigrant Young Adults Eligible for Deferred Action for Childhood Arrivals (DACA). J Immigrant Minority Health 19, 543–551 (2017). https://doi.org/10.1007/s10903-016-0354-x
- Deferred Action for Childhood Arrivals (DACA)
- Mental health
- Well-being Latino
- Young adults
- Qualitative research