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Deportation experiences and depression among U.S. citizen-children with undocumented Mexican parents

L. E. Gulbas,* L. H. Zayas,* H. Yoon,* H. Szlyk,* S. Aguilar-Gaxiola† and G. Natera‡

*School of Social Work, The University of Texas, Austin, TX, USA †Center for Reduction in Health Disparities, University of California, Davis, USA, and ‡Instituto Nacional de Psiquiatría, Distrito Federal, Mexico

Accepted for publication 21 October 2015

Keywords children, deportation, depression, immigration, undocumented

Correspondence: Lauren E. Gulbas, School of Social Work, The Uni- versity of Texas, 1925 San Jacinto Blvd D3500, Austin, TX 78712-0358, USA E-mail: laurengulbas@ austin.utexas.edu

Abstract Background There is a critical need to document the mental health effects of immigration policies

and practices on children vulnerable to parental deportation. Few studies capture the differential

experiences produced by U.S. citizen-children’s encounters with immigration enforcement, much

less in ways that analyse mental health outcomes alongside the psychosocial contexts within which

those outcomes arise.

Methods We explore the psychosocial dimensions of depression in U.S. citizen-children with

undocumented Mexican parents to examine differences between citizen-children affected and not

affected by parental deportation. An exploratory mixed-method design was used to integrate a

quantitative measure of depression symptoms (CDI-2) within qualitative data collected with 48

citizen-children aged 8 to 15 with and without experiences of parental deportation.

Results Stressors elicited by citizen-children in the qualitative interview included an inability to

communicate with friends, negative perceptions of Mexico, financial struggles, loss of supportive

school networks, stressed relation with parent(s) and violence. Fifty percent of citizen-children with

probable depression – regardless of experiences with parental deportation – cited ‘stressed relation

with parents,’ compared to 9% without depression. In contrast, themes of ‘loss of supportive school

network’ and ‘violence’ were mentioned almost exclusively by citizen-children with probable

depression and affected by parental deportation.

Conclusions While citizen-children who suffer parental deportation experience the most severe

consequences associated with immigration enforcement, our findings also suggest that the burden

of mental health issues extends to those children concomitantly affected by immigration

enforcement policies that target their undocumented parents.

Recent political debate has intensified regarding the estimated

11.1 million undocumented immigrants living in the U.S. – the

majority of whom come from Mexico – and their citizen-

children, who number an estimated 4.5 million (Pew Hispanic

Research Center 2013). Of particular concern is the growing

number of citizen-children who experience parental

deportation (De Genova 2010). Studies have documented the

immediate consequences accompanying the loss of a parent

through deportation, including changes in family income,

difficulties with childcare and barriers to public health

resources and social services (Brabeck and Xu 2010; Chaudry

et al. 2010; Dreby 2010; Dreby 2012). However, it is only

Original Article doi:10.1111/cch.12307

bs_bs_banner Child: care, health and development

recently that researchers have considered the mental health

needs of this vulnerable population (Suárez-Orozco et al.

2010). Research indicates that U.S. citizen-children subjected

to parental deportation suffer from a greater burden of anxiety

and depression, attention problems, social withdrawal and

rule-breaking behaviors (Suárez-Orozco et al. 2010; Suárez-

Orozco et al. 2011; Allen et al. 2013; Dreby 2014). Preliminary

research demonstrates that experiences of parental deportation

are linked to future emotional and behavioral problems,

including substance abuse, unemployment and interpersonal

difficulties with family members (Zuñiga and Hamann 2006;

Brabeck et al. 2014).

Following an unprecedented escalation of immigration

enforcement within the past decade (De Genova 2010), there

is a critical need to document the mental health effects of

immigration policies and practices on children vulnerable to

parental deportation. Despite the increased burden of mental

health problems among citizen-children experiencing parental

deportation, some studies suggest that the daily stressors

associated with having an undocumented parent shape mental

health prior to direct encounters with immigration enforce-

ment (Sullivan and Rehm 2005; Perreira and Ornelas 2011;

Yoshikawa and Kalil 2011; Delva et al. 2013). Citizen-

children’s health has been shown to be intimately tied to the

myriad risks associated with having undocumented parents,

including economic hardship and poverty (Perreira and

Ornelas 2011), hunger and food insecurity (Kersey et al.

2007), and lack of access to healthcare, safe housing and

education (Chavez et al. 1997; Guendelman et al. 2006).

Moreover, children with undocumented parents express fears

of separation, mixed sentiments about their heritage and

citizenship and an acute awareness of their families’ legal

predicament (Chaudry et al. 2010; Suárez-Orozco et al. 2010;

Suárez-Orozco et al. 2011; Dreby 2014).

Few studies capture the differential experiences produced by

U.S. citizen-children’s encounters with immigration enforce-

ment, much less in ways that analyse mental health outcomes

alongside the psychosocial contexts within which those

outcomes arise. In this article, we present results from such a

study. Through a binational research collaboration between U.S.

and Mexican institutions, our analysis integrates a quantitative

assessment of depression with a qualitative exploration of the

social factors that shape mental health. Our study, which

explores the psychosocial dimensions of depression in U.S.

citizen-children, is motivated by research that identifies

depression as a significant mental health concern within this

population (Zayas et al. 2015). Although the extant scholarship

is limited, some research suggests that between 10% and 15% of

children living in immigrant families exhibit symptoms for

depression (Perreira and Ornelas 2011). Alleviating the burden

of depression within this vulnerable group requires not just

evaluating depression clinically, but also attending closely to the

voices of U.S. citizen-children in ways that contribute to an

understanding of their meanings and perceived causes of

emotional suffering. Doing so improves our awareness of the

proximal psychosocial stressors that give rise to depression – a

critical first-step toward the reduction of mental health

disparities. Accordingly, our analysis is framed within the

following research question: What psychosocial factors distin-

guish citizen-children with elevated scores of depression from

those with lower scores?

Methods

We draw from a sub-sample of data from a federally funded,

mixed-method study conducted between 2012 and 2014. The

purpose of the larger study was to examine the psychosocial

experiences and clinical profiles of U.S. citizen-children living

with at least one undocumented parent. Purposive sampling

strategies were utilized to select children aged 8 to 15 in

families that were (1) directly experiencing parental deporta-

tion because a parent had been detained or deported (n = 49),

or (2) not undergoing active detainment or deportation

proceedings (n = 34). The former group included children

who stayed in the U.S. under the care of another parent or

guardian after one or both parents had been deported to

Mexico (n = 18) or accompanied their deported parent to

Mexico (n = 31). A total of 83 participants participated.

Recruitment proceeded through a binational collaboration

between sites in the U.S. (Austin, Texas; Sacramento,

California) and Mexico (Distrito Federal, Hidalgo, Michoacán,

Oaxaca and Sinaloa). Local community agencies serving

Mexican-origin individuals were engaged as community

partners and received training from the research team in

participant recruitment procedures. After identifying families

who met purposive sampling criteria for participation, agency

staff discussed the study with parents. Parents who expressed

interest were referred to the research team. Parents provided

consent for their children’s participation, and all children

assented to participate. IRB approval was granted at all

respective institutions and sites where research activities were

undertaken.

Research design

In this paper, we use an exploratory, mixed-method design to

integrate a quantitative measure of depressive symptoms within

Citizen-children and depression 221

qualitative descriptions of emotional suffering (see Fig. 1;

Mathison 1998; Teddlie and Tashakkori 2006). All methods of

data collection (quantitative measures, qualitative interview)

were conducted in either Spanish or English depending on the

preference of the participant.

Participants first completed a series of standard measures

to evaluate their mental health. To index depressive

symptoms, children completed the full-length Children’s

Depression Inventory 2nd Edition (CDI-2; Kovacs and Staff

2003). The CDI-2 is the most widespread scale used to

screen depressive symptoms among children (Twenge and

Nolen-Hoeksema 2002), and it is designed to provide a

comprehensive assessment of affective and functional

problems of depression in children and adolescents aged

7 to 17 years (Kovacs and Staff 2003). The reliability and

validity of the CDI-2 have been well documented (Saylor

et al. 1984; Liberman et al. 2012) and tested and validated

with Hispanic children (Liberman et al. 2012). The measure

consists of 28 items that yield a total score (computed as

raw total or as standardized T-score), two scale scores

(emotional problems and functional problems) and four

subscale scores (negative mood/physical symptoms, negative

self-esteem, ineffectiveness and interpersonal problems).

Children were asked to indicate the level of symptomatology

with a 3-point scale: 0 (absence of symptom), 1 (mild or

probable symptom) or 2 (definite symptom). All items on the

CDI-2 were summed into total scores that ranged from 0 (no

depressive symptoms) to 56 (severe depressive symptoms),

with higher scores indicating greater symptomatology. The

total raw scores were then converted to standardized T-scores.

Cronbach’s alpha in this study was initially very low (α = 0.13). Upon closer evaluation of the items, we found that no child

endorsed the answer, ‘I want to kill myself’ on the sole

question about suicidal ideation. After removing this item for

analysis, Cronbach’s alpha increased to .92.

After completing the quantitative measures, all children

participated in a qualitative interview designed to elicit their

narratives about living with undocumented parents, and

when applicable, to draw out detailed accounts of

experiences with immigration enforcement and parental

deportation. Interviews were conducted by fully bilingual

Hispanic women who were trained in conducting qualitative

interviews with children to facilitate rapport and contribute

to a sense of empowerment in the interview process (Hill

et al. 1996; Mauthner 1997). To help reduce interviewer

bias across multiple research sites, a semi-structured

interview guide was carefully constructed to provide a series

of probes to facilitate deeper exploration of topics.

Interviews began with an exploration of children’s percep-

tions about home and family life, descriptions of family

activities and relationships, household roles and responsibil-

ities, and life outside the home. These questions set the

stage for a conversation about legal status aimed at eliciting

what the child remembered as salient (Mauthner 1997).

Emphasis was placed on having children describe their

perceptions, thoughts, emotions, feelings, reflections and

interpretations to ascertain the psychosocial impact of

parental removal or having an undocumented parent.

Interviews were digitally recorded, transcribed and analysed

in the language of the interview to enhance validity (Guest

and MacQueen 2008). To monitor and enhance data

quality, systematic reviews of interview transcripts and

routine debriefing meetings with interviewers were

conducted.

Figure 1. Framework for an exploratory integrative mixed-method analytical design.

222 L.E. Gulbas et al.

Study sample

For this article, a criterion sampling strategy was used to select a

sub-sample of citizen-children with the highest and lowest T-scores

on the CDI-2, stratified by experiences with parental deportation

(Sandelowski 2000). In qualitative research, thematic saturation

has been shown to occur within the first 6 to 12 interviews (Guest

et al. 2006). Using this recommendation, we selected 12

participants to represent each sub-group (highest T-scores/

affected by deportation; highest T-scores/not affected by deporta-

tion; lowest T-scores/affected by deportation; lowest T-scores/not

affected by deportation). This led to a sub-sample of 48

participants. To determine which participants with the highest

scores had probable clinical depression, we used the established

cutoff of T-scores of 60 or above. This resulted in two comparison

groups used for the present analysis: probable depression

(n=16); no depression (n=32).

Table 1 describes the characteristics of children in this sub-

sample. All children had at least one parent of Mexican origin.

Children’s ages ranged from 8 to 15 years, with an average of

11.3. More than half were girls (58.3%), and almost all (97.9%)

were enrolled in school when interviewed. Participants lived

with both parents (70.8%), with one parent (25.0%) or with

neither parent (4.2%). More than half (52.1%) were directly

affected by parents’ deportation or detention. The T-scores of

depressive symptoms averaged 54.2. Approximately one-third

scored in the range indicative of probable depression.

Data analysis

Qualitative interviews from this sub-sample were analysed for

themes related to the personal and social factors that

participants identified and described as being salient to their

experiences of emotional suffering. To develop the coding

framework, two coders read two interviews independently and

recorded initial interpretations of the text. Emergent themes

were discussed in a team meeting, and a codebook was

developed from this discussion. We repeated this process until

themes were well established, and the codebook was finalized.

To test the coding framework, we uploaded four interviews to

NVivo9, independently coded them and calculated percent

agreement using the coding comparison module. Any text that

fell below a 90% threshold was discussed during a team

meeting. The codebook was revised as necessary. Interviews

were subsequently coded using NVivo9. To facilitate the

transparency of the coders’ interpretations of the data, all

coded text was reviewed and monitored, and all coding

discrepancies were discussed during team meetings.

After interviews were coded, scores from the CDI-2 and data

from the qualitative interviews were integrated within a matrix

to compare the frequency of themes across groups of

participants (probable depression/no depression; affected by

deportation/not affected by deportation). We then returned to

the qualitative interviews to contextualize our results within

participants’ narratives.

Results

Table 2 describes, defines and illustrates through participants’

quotes the themes that emerged with greatest frequency during

the qualitative interview. Each of these themes, which we call

‘psychosocial stressors,’ was discussed by children as contrib-

uting to feelings they described as ‘sad,’ ‘depressed’ or ‘painful.’

Stressors elicited by citizen-children included: (1) an inability

to communicate with friends, (2) negative perceptions of

Mexico, (3) financial struggles, (4) loss of supportive school

networks, (5) stressed relation with parent(s) and (6) violence.

Table 1. Demographic characteristics of participants in sub-sample

Participants with probable depression (N = 16) Participants with no depression (N = 32) Total participants (N = 48)

M ± SD n (%) M ± SD n (%) M ± SD n (%)

Age 11.3 ± 2.06 11.3 ± 1.93 11.3 ± 1.95 Gender (female) 13 (46.9) 13 (81.3) 28 (58.3) School enrollment (yes) 15 (83.8) 32 (100.0) 47 (97.9) Living arrangement

Both parents 12 (75.0) 22 (68.8) 34 (70.8) One parent 3 (18.8) 9 (28.1) 12 (25.0) No parents 1 (6.3) 1 (3.1) 2 (4.2)

Deportation experience Directly affected 12 (75.0) 16 (50.0) 28 (58.3) Not directly affected 4 (25.0) 16 (50.0) 20 (41.7)

CDI-2 70.6 ± 8.65 45.9 ± 4.54 54.2 ± 13.3

Citizen-children and depression 223

To facilitate the comparison of themes across sub-groups

(probable depression/no depression; affected/not affected by

deportation), thematic frequencies are presented in Table 3. As

evident in Table 3, certain themes manifested across sub-

groups, such as an inability to communicate with friends,

negative perceptions of Mexico and financial struggles.

However, citizen-children with probable depression reported

stressors with greater frequency than citizen-children without

depression. This pattern was notable among citizen-children

experiencing both probable depression and parental deporta-

tion. Differences across sub-groups were especially pro-

nounced in the frequency with which citizen-children

described ‘loss of supportive school networks,’ ‘stressed

relation with parents’ and ‘violence.’ Fifty percent of citizen-

children with probable depression – regardless of their

experience with parental deportation – cited ‘stressed relation

with parents,’ compared to 9% of citizen-children without

depression. In contrast, themes of ‘loss of supportive school

network’ and ‘violence’ were mentioned almost exclusively by

citizen-children with probable depression and affected by

parental deportation.

To attend to the voices, meanings and experiences of

citizen-children included in our analysis, we chose three cases

to illustrate and contextualize the ways in which these themes

Table 2. Qualitative themes described with greatest frequency in interviews with U.S. citizen-children (n = 48)

Theme Definition Example of theme in interview

Inability to communicate with friends

An explicit reference to the ways in which youth feel inhibited in their conversations with friends (i.e. children they identify as friends) and/or the reasons why

‘I haven’t really told them about my situation. They always ask me, though. They’re like, “What’s wrong.”’ ‘They don’t know. I’ve never told them. I don’t talk to them about this or to anyone really. Because my mom tells me not to tell anyone she doesn’t have papers because I can get her in trouble if I do.’

Negative perceptions of Mexico

Reference to feelings of fear, lack of safety, worry, stress, sadness, etc., that stem from having a negative perception of Mexico; perceptions can be the result of things learned through media, conversations with friends/family or direct experience

‘Here, there are only gang members, drug addicts and drunks. Because of this, I don’t like to leave the house.’ ‘I don’t like it ’cause my mom tells me that they rob a lot over there. And one time I heard my dad say that a friend called him that his sister died ’cause they lived in Mexico. ’Cause his sister, they robbed her, and then they found her with her head cut off, and her heart out. Well, I heard that. Since that day, I didn’t want to move to Mexico.’

Financial struggles

Socioeconomic strain as referenced through a description of parent’s (un)employment status, inability to meet subsistence needs, or ways in which family members find ways to supplement household income

‘My dad told me once that he would like to have another job but he can’t because he doesn’t have any papers. But I know he wants another job because he wants to earn more money. He was thinking of taking a job for more hours, but then at the end, he decided not to because he would have to be there all the time, and we wouldn’t be able to see him. So he didn’t take that job at the end. It’s like, it makes me kind of sad because he can’t get a regular job with regular hours that would pay him more money.’ ‘It was more than ten people living at my aunt’s house, and she didn’t have enough money for us so she got most of the teachers . . . They donated food and clothes for my little brother and all the stuff that a baby needs. And I remember coming home from school with a lot of bags full of like food and diapers and other stuff.’

Loss of supportive school networks

Descriptions of a halt in supportive school relationships or services, including school administration, counselors, teachers, but also classmates

‘I’ve talked to my teachers. Because they noticed I’ve been going down, and they didn’t know what it was. They noticed my behaviour was also weird and grew worse. And I talked to them about it. They were really supportive. But I don’t have anyone. Now that school’s over, I really don’t.’ ‘Here [in Mexico], they don’t help you. They might say they are going to help you, but they never help you.’

Violence Description of experiences of physical or sexual abuse, or witnessing domestic violence

‘One day, my dad got really mad, really, really, really mad. He grabbed my mom and began to choke her.’ ‘We had problems with the mother of my aunt. Because she hurt us a lot.’

224 L.E. Gulbas et al.

manifested. Additionally, we draw on quotations from other

citizen-children in our sample to exemplify how themes

operated dynamically and in conjunction with one another. All

names used below are pseudonyms.

Case A

Erika’s case illustrated the ways in which multiple themes

converged as a result of parental deportation. She identified her

negative perception of Mexico, loss of supportive school

network, stressed relation with parents and household financial

struggles as sources of her distress. Erika’s parents, both

undocumented, had migrated to the U.S. in 1992. Erika did

not remember when she learned about her parents’ status, but

she recalled being in a constant state of fear that her parents

would be detained, particularly when she was not in their

direct presence. Her worst fears were realized just months

prior to her 14th birthday when her father was arrested,

detained and immediately deported. Erika refused to talk about

the time following her father’s deportation. She noted, instead,

that she learned on her birthday that the family would reunite

with her father in Mexico. ‘I was scared,’ she remembered.

‘Where were we going to live? To work?’ Despite the fear, she

remembered packing quickly and feeling ‘happy’ that she

would see her father soon.

When she arrived in Mexico, she realized quickly that

‘everything is so different here.’ Her parents had never spoken

to her about Mexico, and she had learned what little she knew

about the country from television. She noted that she was scared

to be outside of her house alone because Mexico was ‘violent.’ Her

fears of Mexico invoked memories of the life she left behind,

resulting in feelings of sadness. Similarly, Erika’s transition to

school had also been difficult. The students in her class often

teased her about her Spanish pronunciation, and their behaviour

only highlighted for Erika the loss of the supportive school

network that she had in the U.S.

Erika also described a radical shift in family dynamics that

accompanied reunification. Her mother, at the time of the

interview, had been unable to secure employment, and the family

was struggling to live from the meager salary her father earned. As

she explained,

‘When I see the problems that we have, I get sad. Sometimes,

we don’t have anything to eat. My mom doesn’t have work,

and my father starts telling her things. I don’t feel that it’s fair

that he says these things to her because it isn’t her fault.’

The way in which her father treated her mother made Erika

feel angry, sad and powerless. She blamed her father for the

Table 3. The frequency of qualitative themes across participant sub-groups

Probable depression (n = 16) No depression (n = 32)

Total (N = 48)

Affected by deportation (n = 12)

Not affected by

deportation (n = 4)

Sub-total (n = 16)

Affected by deportation (n = 15)

Not affected by deportation (n = 17)

Sub-total (n = 32)

n (%) n (%) n (%) n (%) n (%) n (%) n (%) Inability to communicate with friends

7 (58) 3 (75) 10 (62) 8 (53) 11 (65) 19 (59) 29 (60)

Negative perceptions of Mexico

6 (50) 2 (50) 8 (50) 5 (33) 6 (35) 11 (34) 19 (40)

Financial struggles

5 (42) 0 (0) 5 (31) 5 (31) 5 (29) 10 (31) 15 (31)

Loss of supportive school network

7 (58) 0 (0) 7 (44) 3 (20) 2 (12) 5 (16) 12 (25)

Stressed relations with parent(s)

6 (50) 2 (50) 8 (50) 1 (7) 2 (12) 3 (9) 11 (23)

Violence 6 (50) 0 (0) 6 (38) 0 (0) 0 (0) 0 (0) 6 (12)

Notes: The percent total represented in the last column represents the sub-total sums for a given theme divided by the total number of participants (n = 48). It should be noted that this table does not represent an exhaustive list of themes. It includes only those themes discussed by five or more participants. Additional themes mentioned by participants with less frequency included experiences of discrimination; parental divorce or separation unrelated to immigration enforcement procedures; death of a nuclear or extended kin member; illness within the family; and conflict with friends, peers or boyfriends.

Citizen-children and depression 225

family’s worsening circumstances. ‘It’s his fault,’ she explained.

‘It’s his fault that we came here.’ Erika exclaimed that she felt

powerless about the situation and noted, ‘I can’t do anything. I

feel bad.’ These feelings were intensified by her separation

from her older siblings, who remained in the U.S. The family

in Mexico relied heavily on the remittances sent by her older

brother. Without the extra money, ‘we wouldn’t have anything

to eat.’

Erika’s case illustrates the multiple stressors that citizen-

children faced when they reunited with a deported parent in

Mexico. Like Erika, many citizen-children described a difficult

transition to their new cultural setting. Fears of violence in

Mexico – being killed, robbed or kidnapped – loomed large in

the minds of participants, particularly among those with

probable depression. For example, one 11-year-old participant

noted, ‘I’m scared they’ll kidnap me.’ Apprehension about

their surrounding community led citizen-children to stay close

to home. As a result, few citizen-children reported playing

outside, in contrast to their former daily lives in the U.S.

Perhaps one of the most difficult transitions to life in

Mexico was school, especially for citizen-children with

probable depression. Participants described teachers as being

too authoritative or unwilling to help. In the words of a 9-year-

old participant, ‘Here, they don’t help you at all. Some say that

they are going to help you, but they never do.’ Other

participants commented on the disruptive behaviour of their

classmates, particularly when teachers left the classroom. As

one child, 10 years old, remarked, ‘[The students] begin to

jump all over the place.’ Perceived differences in the school

environment between Mexico and the U.S. highlighted the

cultural practices, institutional expectations and systems of

support that children were forced to leave behind when they

left. As one 15-year-old participant described, ‘It is really

horrible to leave them. They are people that have been with

you your whole life.’

Although citizen-children often anticipated that living in

Mexico would be difficult, few were prepared for the possibility

that family dynamics might worsen following reunification.

Overwhelmingly, participants who described a stressed family

dynamic following family reunification also screened within

the range of probable depression. Some children with probable

depression noted that economic hardships destabilized family

bonds in multiple ways. Parents worked longer hours, or

families stopped engaging in certain family activities altogether,

such as eating out at restaurants or going to the movies. Even

in the absence of financial hardship or fears of Mexico, family

relationships could disintegrate. One 15-year-old participant

noted, ‘Before we came to Mexico, we were a beautiful family.

It isn’t like it was before. There isn’t the same communication,

like ‘How’s it going? How are you feeling?’ Here, everyone is in

their own world.’

Case B

Like Erika, Adriana’s narrative had multiple themes; and

violence, stressed relation with parents and loss of supportive

school networks figured prominently. Unlike Erika, these

themes did not manifest as a result of parental deportation, but

rather set the stage for that experience. Adriana described that

she ‘always knew my parents were from Mexico. I probably

figured it out when I was very young.’ The circumstances that

led to her father’s detainment and eventual deportation were

related to a domestic violence dispute that occurred when

Adriana was three. She continued to have nightmares about the

incident. As she described, ‘I don’t remember the actual

domestic abuse. I was very little. It kind of became a repetitive

dream. I just remember hiding, and I remember being scared,

and not knowing exactly what was happening.’ Adriana

explained that the domestic abuse had led to a warrant for

her father’s arrest, noting that ‘one day my dad got stopped [by

the police]. They saw that he had a warrant out, and that he

was illegal. So, that’s when all the trouble to make him stay

kind of started.’

Following her father’s detainment, a lengthy legal battle

ensued. Adriana visited her father occasionally in jail and

expressed that the experience was ‘horrible. It was just a really

horrible thing to be able to see your dad, but not like being able

to touch him.’ The family fought the courts for nearly two

years. During this time, Adriana attempted suicide.

‘I knew my dad’s case was coming closer and closer. I had

so much to deal with. Because everything with the legal

issues. So then I felt like nobody really cared about me. So it

was like the last straw when I attempted suicide . . . And the

people in the immigration didn’t care that I tried

committing suicide. They didn’t care.’

After Adriana was released from the hospital following her

suicide attempt, she learned that the courts had ruled to deport

her father. She was never sure how much time she had left with

him because ‘they always postponed it.’ One day she came

home from school, and her father was gone. ‘I came back, and

he was not here. It really hit me. And then, I spent the next day

crying.’ Adriana expressed that after her father’s deportation,

she developed a desire to engage in high-risk behaviours: ‘I

226 L.E. Gulbas et al.

wanna do more things like outside of being safe and stuff since

my dad left. I just wanna forget about everything.’

After Adriana’s father was deported, the family was able to

visit him in Mexico, a journey that was made possible, in part,

by her mother’s status as a U.S. citizen. Yet, for Adriana, these

visits did little to assuage her overall depressed state. As she

noted, ‘It’s not that normalness. That normal feeling of waking

up in the morning and seeing your dad. It’s not that feeling

anymore.’

Adriana’s case reveals the ways in which parental

deportation destabilized relationships between parents and

their children. In other cases, parental detainment or

deportation intensified family stressors that might otherwise

be insignificant. For example, one participant with probable

depression described the ways in which tensions with her

mother escalated after she learned that her father was going

to be deported. The participant, 12 years old, explained that

her father had always been the person to whom she turned

for help and support her with her schoolwork. As she

explained, ‘When I have, like, projects to turn in, he helps

me a lot. And my mom, like, she like wants it perfectly. But

my dad’s like, “Do the best you can.”’ With her father’s

impending detention weighing on her mind, she stopped

doing homework and described that she no longer had a

desire to participate in everyday activities. Without her

father’s supportive parenting style, which she perceived as

mitigating her mother’s demand for perfection, the

participant expressed concern that she would no longer

have her ‘freedom’ once her father was deported.

In addition to stressed relations with parents, children

who stayed in the U.S. following parental deportation

reported a loss of a supportive school networks, but in ways

that were different from their peers who reunited with their

parents in Mexico. In the U.S., school transitions, such as

changing from elementary school to middle school or

transitioning from the school year to the summer, reduced

the availability of school support and were perceived by

participants as contributing to experiences of psychosocial

distress. For example, one 14-year-old participant with

probable depression had credited his teachers with his

ability to remain strong during his father’s deportation case.

As he explained, ‘I talk to all my teachers because they

noticed I’ve been going down, and they noticed my

behaviour was also weird and grew worse. And I talked

to them about it, and they were really supportive.’ Yet at

the time of the interview, school had ended for summer

vacation: ‘I don’t have anyone now that school’s over. I

really don’t.’

Case C

Cecilia, an atypical case, was one of the few participants not

affected by parental deportation, but who screened within the

range of having probable depression. Moreover, Cecilia did not

mention any of the stressors often cited by other participants

even though her mother, father and older sister were all

undocumented. For example, Cecilia described her relation-

ship with both parents as ‘close,’ referencing the fun activities

they did together, like going to the movies or church. Cecilia

explained that her parents were very open about their status as

undocumented, and the family often attended immigrant

rights and advocacy meetings together. Cecilia even described

talking with her ‘two best friends’ about her parents’ status. As

she explained, ‘They are my best friends that I really, really

love. So I talked to them about it.’

Yet, Cecilia’s knowledge about her parents’ status intensified

her worry and fear that her family might one day be deported.

As she reported, ‘I feel frightened that they are gonna come

and deport them.’ In attempt to silence her fears and worries,

Cecilia often refused to think about her family’s undocument-

ed status:

‘I try not to make it come out of my mouth. I try to keep it

shut in there. I try my best not to think about that, or go

near jails because there is this jail close to my school, and I

try not to look at it. Because I think that there might be

deported people there, and I’m like, “I hope that’s not

where my parents go.” I’m like, “oh no, don’t think about

that.” Because then that would really affect me. And make

me more sad or depressed.’

In contrast to many participants in the sample who

experienced probable depression, Cecilia described a support-

ive dynamic with her family and open, communicative

relationships with her friends about her parents’ status.

Moreover, she had visited Mexico and reflected on those

experiences positively, noting, ‘I liked it there!’ Ultimately, as

Cecilia described it, her depressed affect was linked to the

status of her parents and sister as undocumented and the

potential threat that she could one day be separated from

them.

Discussion

In this article, we incorporate a quantitative evaluation of

depression symptoms alongside qualitative narratives that

prioritize the voices of citizen-children to identify psychosocial

factors that distinguish U.S. citizen-children with probable

Citizen-children and depression 227

depression from those with no depression. Previous studies

have demonstrated that the accumulation of psychosocial

stressors can produce formidable effects on mental health

status, particularly among children experiencing parental

deportation (Allen et al. 2013; Brabeck et al. 2014; Zuñiga

and Hamann 2006). Our results build on these studies by

demonstrating the potential for psychosocial stressors, such as

stressed relationships with parents, the loss of supportive

school networks and experiences of violence, to compromise

the mental health strengths of citizen-children with parents

who are undocumented. For example, supportive school

networks were vulnerable to disruption through family

reunification in Mexico following parental deportation. For

those participants in the U.S., summer vacation or transitions

from elementary to middle school could similarly dislocate

children from the support they received from school

administrators, counselors and classmates. Experiences of

probable depression also reflected the ways in which having

a parent who was undocumented exacerbated tensions that

might otherwise be minimal in families not threatened by or

experiencing parental deportation. Probable depression was

also shaped by experiences of family violence that occurred

prior to immigration enforcement, and participants often cited

such experiences as contributing to legal processes that resulted

in parental detainment.

In our sample, citizen-children affected by parental

deportation reported a greater burden of stressors in their

lives, a finding that has been supported in previous research

(Allen et al. 2013; Dreby 2014; Suárez-Orozco et al. 2010;

Suárez-Orozco et al. 2011). However, straightforward associ-

ations between depressive symptoms and being ‘affected’ or

‘not affected’ by parental deportation sometimes break down,

as revealed by the contrasting experiences between Erika and

Adriana (affected by deportation) and Cecilia (not affected by

deportation). To be clear, children in our sample who

experienced parental deportation reported it as a major life

trauma, which often generated or exacerbated the stressors

mentioned above. Our research also shows that psychological

hardship could be induced by the perceived threat of parental

deportation (Brabeck and Xu 2010; Chaudry et al. 2010; Delva

et al. 2013; Dreby 2010; Dreby 2012; Perreira and Ornelas

2011; Sullivan and Rehm 2005). Thus, while citizen-children

who suffer parental deportation experience the most severe

consequences associated with immigration enforcement, our

findings also suggest that the burden of mental health issues

extends to those children who are concomitantly affected by

immigration enforcement policies that target their undocu-

mented parents (Chaudry et al. 2010; Dreby 2010; Dreby

2012; Dreby 2014; Sánchez-Huesca et al. 2008; Suárez-Orozco

et al. 2010).

Strengths and limitations

Our study demonstrates the strengths of documenting mental

health issues experienced by citizen-children through an

integrative, mixed-method research design. Such a design

facilitates an objective assessment of mental health status in

ways that attend to the meanings, experiences and perceived

causes of poor mental health. Despite the strengths of our

research design, it is important to note the limitations of our

study. Our analysis is based on data gathered with mixed-status

Mexican families. This limits the ability to generalize our

findings across immigrant groups or individuals living outside

the study area. Given the cross-sectional nature of our data, we

cannot make claims about the causality of mental health

outcomes. Instead, our results provide a description of those

factors that children deemed as salient. There is continued

need for longitudinal research to try to ascertain modes of

causality, although we acknowledge the difficulties associated

with accessing this vulnerable and highly mobile population

over time. These challenges could be met through long-term

engagements and development of trust in communities most

affected by immigration enforcement, in addition to the

development of collaborative research relationships that bypass

disciplinary and national boundaries.

Conclusions

Despite the limitations of this study, our findings offer several

implications for future research. Recently, scholars have begun

to consider immigration status as a social determinant of

health (Casteñeda et al. 2015). To date, this research has

focused primarily on physical health and access to healthcare.

Our research extends this body of work to show the continued

need to monitor the prevalence and severity of effects of

immigration policies on mental health, and it is crucial that we

identify how fears of or direct encounters with immigration

enforcement contribute to poor mental health across the life

span. Ultimately, the empirical documentation of mental

health issues experienced by citizen-children in mixed-status

families is vital to the development of informed health services

and policy. The significance of this research is underscored by

the potential to highlight broader health impacts associated

with policies that support parental deportation, including

attention to the more widespread and potentially long-term

suffering incurred by living with an undocumented parent.

228 L.E. Gulbas et al.

Key messages

• There is a critical need to document the mental health

effects of immigration policies and practices on children

vulnerable to parental deportation.

• The empirical documentation of mental health issues

experienced by citizen-children in mixed-status families is

vital to the development of informed health services and

policy.

• In our study, U.S. citizen-children affected by parental

deportation reported a greater burden of stressors in their

lives, although our research also shows that psychological

hardship could be induced by the perceived threat of

parental deportation.

• This study lends support to research that considers

immigration status to be a social determinant of health.

Acknowledgements

Support for this research was provided by National Institute

for Child Health and Human Development grant HD068874

to Luis H. Zayas. We express our gratitude to the families who

participated in this study.

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