As the Trump administration’s intensified immigration enforcement entered its second year, clinicians and researchers warn it has become a major driver of mental health problems in immigrant communities. Data from a Los Angeles primary care clinic that serves mostly Latino Medicaid patients show sharp increases in anxiety, depression and suicidal thoughts tied to periods of heightened raids and detentions.
Zocalo Health, which screens every patient for anxiety and depression, shared its clinic data with NPR. Sophia Pages, a licensed marriage and family therapist and Zocalo’s executive director of behavioral health, says the patterns were striking: during waves of enforcement, screening scores climbed noticeably. ‘Immigration enforcement is acting like a public‑health stressor in real time,’ she says.
According to Zocalo’s findings, more than half of screened patients reported anxiety severe enough to disrupt daily life, and nearly three quarters showed signs of depression. Almost one in eight patients reported suicidal thoughts — a rate more than twice that seen in the general population, the clinic found. Pages says a common theme beneath these symptoms was a pervasive sense of helplessness: people tried to change routines, stay home, and take precautions, but still felt they could not protect themselves or their families. That loss of control, she explains, can intensify depression, trauma‑related distress and suicidal ideation.
Anyone in crisis or considering suicide can call or text 988 to reach the National Suicide & Crisis Lifeline. Press 2 for help in Spanish.
Many patients at Zocalo carry trauma histories from violence or persecution before arriving in the U.S., and the added threat of immigration enforcement can worsen existing wounds. One patient, who asked to be identified only as Esperanza, fled Oaxaca, Mexico, with her husband and son in 2023 after cartel threats escalated. Her husband had farmed and produced mezcal at home; when criminal groups began demanding payments and coercing him to transport drugs, the family decided to leave.
The trip north was fraught: they felt followed and unsafe until they reached the border. Once in California, the stress persisted. Esperanza describes months of poor sleep, heart palpitations and constant sweating. When local ICE operations began targeting farms and neighborhoods around Los Angeles, her fears increased. Court dates and the possibility of deportation left her overwhelmed: ‘What if they send me back? What happens to my children?’ Her 11‑year‑old son has absorbed the fear, worrying that his mother could be taken and expressing despair at the thought of being left behind.
Children in immigrant communities are particularly vulnerable, experts say. Ariana Hoet, a pediatric psychologist at Nationwide Children’s Hospital, notes that Latino children already face elevated risks for anxiety and depression because families contend with past traumas, cultural and linguistic adaptation, discrimination and economic stress. Adding a persistent threat of detention or deportation turns those risks into a chronic toxic stressor, Hoet says — one that research suggests can have long‑term effects on development, physical health and mental well‑being.
A recent analysis published in the New England Journal of Medicine concluded that the current enforcement policies have created toxic stress for children. Hoet points out that children who experience a parent’s deportation are more than twice as likely to develop PTSD, and that even kids who are not directly separated report higher levels of anxiety, depression and trauma symptoms. These can show up as stomachaches, headaches, disrupted sleep or appetite, withdrawal from activities, clinginess, and changes in behavior at home and school.
School counselors and community organizations in areas affected by raids have reported rising numbers of children showing anxiety and behavioral problems, Hoet says. In Los Angeles, adult therapists at Zocalo have been occupied with treating patients like Esperanza, while community health workers try to connect families to services even as some go into hiding.
Therapeutic supports at Zocalo have focused on symptom management and rebuilding a sense of agency. Esperanza credits therapy with helping her regain some control: she has learned breathing techniques and grounding strategies for panic attacks, and she finds relief in simple routines like baking and listening to music. Joining a local church has also provided social support. She has begun sharing coping strategies with her husband and son so the whole family can better manage stress.
Pages emphasizes that clinics serving immigrant communities need resources to respond to surges in psychological distress tied to enforcement activity: expanded mental‑health staffing, culturally and linguistically appropriate care, and partnerships with schools and community groups. ‘When enforcement spikes, the mental‑health needs spike too,’ she says. ‘Health systems and public officials should treat immigration policy as more than an enforcement issue — it’s a determinant of community health.’