Trump’s Immigration Crackdown Fuels Health Crisis: Detention, Depression, Deportation, and Disease

Strict changes to immigration policies nationwide create a public health crisis in overcrowded detention centers, draining taxpayer dollars and diminishing undocumented immigrants' contributions to subsidies. | Image Credit: Brad - stock.adobe.com

The Trump administration's stringent immigration policies are causing a public health crisis, marked by severe mental and physical health consequences for detained immigrants in overcrowded and unsafe detention centers, which places a substantial financial burden on the US health care system.¹

With the spike in arrests against undocumented immigrants, overcrowding has forced US Immigration and Customs Enforcement (ICE) detention centers to release detainees, according to internal government statistics obtained by CBS News show.² Earlier last month, ICE detention facilities reached 109% capacity, holding almost 42,000 detainees, despite the 38,521 bed capacity in its network of for-profit prisons and county jails.

Previously, the Trump administration deterred border crossings in 2017 by forcibly removing children from their refugee parents and housing them separately.³ During his second term, President Donald J. Trump signed an executive order that suspends the physical entry of aliens engaged in an invasion of the US through the southern border, including individuals seeking asylum.⁴ The order declared a national emergency and ordered the military to expand detention space and transport migrants, using Department of Defense funding for deportations.⁵

Mental Health Consequences of Anti-Immigration Policies

Trump's previous anti-immigration policies caused significant health impacts, and his continued strict policies will likely trigger further harm.³ Reports indicate children experienced "intense trauma" in their homelands, during their journey to the US, and/or after arriving. Staff from various facilities reported on children who endured kidnapping, torture, or sexual assault in their home countries or were held captive. Some reports included children forced to witness the sexual assault or murder of family members before fleeing. The unexpected separation from parents or guardians inflicted further trauma on these children, according to a 2019 report from the HHS Office of the Inspector General. These experiences often caused stress, anxiety, behavioral issues, and severe mental anguish.

Detention facilities contribute to high levels of anxiety, depression, posttraumatic stress disorder (PTSD), poor quality of life, self-harm, and suicidal ideation among adults, adolescents, and children, according to the US Committee for Refugees and Immigrants.⁶ Detained asylum seekers develop significant symptoms of depression (86%), anxiety (77%), and PTSD (50%), according to a 2003 report from Physicians for Human Rights and the Bellevue Program for Survivors of Torture.⁷

These impacts heightened fears in children, causing behavioral changes, sleep and eating problems, psychosomatic symptoms, and mental health issues.¹ Both parents and pediatricians reported that these fears negatively affected children’s behavior and school performance. Toxic stress can damage physical and mental health throughout life, hinder child development, and worsen social and environmental challenges, all of which negatively impact public health.

Detained immigrants experienced an elevated prevalence of mental illness, poor self-rated health, and PTSD after their release, with significantly higher rates among those imprisoned for 6 months or longer.⁸ Additionally, immigrant detention centers have revealed gaps in care for pregnant Hispanic migrants and higher rates of harassment for LGBTQ detainees compared with non-LGBTQ detainees.¹

Physical Health Impacts of Detention Centers on Immigrants

Flu outbreaks took a major toll on children placed in detention centers during Trump’s first term.⁹ Influenza B viruses caused 45 of the 68 pediatric flu deaths in 2019, according to the CDC.

“Detention centers have become tinderboxes for infectious-disease outbreaks,” Mark Travassos, MD, an assistant professor of pediatrics and a pediatric infectious disease specialist at the University of Maryland School Of Medicine Center for Vaccine Development and Global Health, said in a statement.

A qualitative study conducted between July 2020 and February 2021 found participants reported unpalatable and unhealthy food and crowded dorms that lacked proper ventilation and facilitated the rapid spread of infections.¹⁰ Additionally, freezing temperatures made it difficult for detainees to receive adequate rest. Reports included lack of soap, toilet paper, and unclean conditions.

Respondents who were detained at the beginning of the COVID-19 pandemic claimed they had little ability to socially distance due to the overcrowding, and they felt more isolated once facilities implemented measures confining them to their cells for the majority of the day. Respondents recounted witnessing or experiencing violence, usually without intervention by the corrections officers. Corrections officers reportedly deprived detainees of their rights either by retaliatory use of solitary confinement, withholding of commissary funds, and subjecting them to humiliating treatment.

Confined conditions, inhumane treatment, distress associated with the injustice of detention, and the multiple barriers encountered when seeking care all contributed to negative impacts on their health. Additionally, previously healthy participants directly attributed the development of obesity, high cholesterol, and/or high blood pressure to the unhealthy food and lack of physical activity in detention.

The study findings highlighted it was the immigration officials who prioritized incarceration over health and failed to allocate necessary resources to reduce the spread of infections. Many detainees were exposed to COVID-19 and developed symptoms, but only a few were tested. Participants expressed they were only able to protect themselves against COVID-19 after their release.

Previously, immigrant families reported they viewed hospitals and doctors’ offices as safe spaces.¹ However, KFF found reports of changes in health care use, including decreased use of some care and decreased participation in Medicaid and Children’s Health Insurance Programs, due to immigration-related fears.

About a quarter (27%) of likely undocumented immigrants and nearly 1 in 10 (8%) lawfully present immigrants said they avoided applying for food, housing, or health care assistance in the past year due to immigration-related fears.

Fear surrounding health care access may be heightened under the second Trump administration based on the rescission of a policy from 2011 that protects enforcement activity in areas like health care facilities, according to KFF. These policy changes could force health care providers to confront new challenges, such as helping families feel safe accessing care, protecting patient information, and developing protocols for potential encounters with ICE agents. Florida and Texas have implemented policies requiring hospitals to request patients' immigration status, potentially increasing fears about accessing care.¹¹

Fear of immigration and ICE detention worsened chronic health conditions in some families. Fear and financial challenges led to a loss of health care coverage and created additional barriers to care for some families. ICE's violation of its own medical standards contributed to the deaths of mostly young and healthy men in detention, according to a study analysis published in JAMA Network Open.¹²

Effects Across the US

In the 65 and older US population, deportation of immigrants can exacerbate the health care workforce shortage.¹ Immigrants and their adult children comprise a significant portion of physicians, surgeons, and other health care practitioners, playing a vital role as direct care workers in home and community-based settings.

Increased deportations reduce the billions of dollars that immigrants contribute to federal, state, and local taxes, directly impacting funding for health care. Over a third of US tax dollars come from payroll taxes, which fund programs like Social Security and Medicare that undocumented immigrants cannot access despite contributing to, based on data from the Institute on Taxation and Economic Policy.¹³ Children of immigrants contribute more to taxes on average than their US-born counterparts, according to KFF.¹

Immigrants contribute more to the health care system through taxes and premiums than they use, effectively subsidizing health care for US-born citizens, according to a study published in the International Journal of Health Services.¹⁴ Undocumented immigrants' contributions to the Medicare Trust Fund delay its insolvency and bolster the financial health of Social Security as well, based on a study published in the Journal of General Internal Medicine.¹⁵

Mass deportations cause financial losses and necessitate large investments in infrastructure to expand detention facilities, court capacity, and the use of private contractors, along with expenses for deportation flights.¹ The government incurs financial losses from mass deportations, including investments in detention facilities, court expansion, private contractors, and deportation flights. It costs an average of $19,599 to deport one person over the last 5 fiscal years, according to a CBS News analysis of federal data.¹⁶

The Trump administration's strict immigration policies inflict a heavy toll on the health and well-being of undocumented immigrants, particularly within overcrowded detention centers.¹ These policies not only cause severe mental and physical health issues but also strain resources, exacerbate health care disparities, and impose significant financial burdens on the US health care system. As the US grapples with the consequences of these actions, the urgent need for humane and equitable immigration reform becomes increasingly clear.

References

1. Pillai A, Pillai D, Artiga S. Potential impacts of mass detention and deportation efforts on the health and well-being of immigrant families. KFF. February 5, 2025. Accessed March 3, 2025. https://www.kff.org/racial-equity-and-health-policy/issue-brief/potential-impacts-of-mass-detention-and-deportation-efforts-on-the-health-and-well-being-of-immigrant-families/

2. Montoya-Galvez C. ICE releases some migrant detainees as its detention facilities reach 109% capacity. CBS News. February 4, 2025. Accessed March 3, 2025. https://www.cbsnews.com/news/ice-releases-some-migrant-detainees-detention-facilities-reach-109-percent-capacity/

3. Inserro A. Separated children in immigrant shelters suffering from extreme mental health distress, OIG says. The American Journal of Managed Care^®. September 4, 2019. Accessed March 3, 2025. https://www.ajmc.com/view/separated-children-in-immigrant-shelters-suffering-from-extreme-mental-health-distress-oig-says

4. Fact sheet: President Donald J. Trump protects the states and the American people by closing the border to illegals via proclamation. The White House. January 22, 2025. Accessed March 3, 2025. http://whitehouse.gov/fact-sheets/2025/01/fact-sheet-president-donald-j-trump-protects-the-states-and-the-american-people-by-closing-the-border-to-illegals-via-proclamation/

5. Ainsley J, Martinez D, Dilanian K. What we know about Trump’s mass deportation plans and ICE raids after immigration orders. NBC News. January 21, 2025. Accessed March 3, 2025. https://www.nbcnews.com/news/investigations/trump-mass-deportations-ice-raids-executive-immigration-rcna188620

6. Rogers RG. Mental health effects of restrictive immigration policies. USCRI. February 5, 2025. Accessed March 3, 2025. https://refugees.org/the-dire-mental-health-effects-of-restrictive-immigration-policies/

7. Physicians for Human Rights and Bellevue/NYU Program for Survivors of Torture. From persecution to prison: the health consequences of detention for asylum seekers. June 2003. Accessed March 5, 2025. https://phr.org/wp-content/uploads/2003/06/persecution-to-prison-US-2003.pdf

8. McCormick B. Prolonged immigration detention tied to poor health, PTSD, and mental illness. AJMC^®. January 28, 2025. Accessed March 4, 2025. https://www.ajmc.com/view/prolonged-immigration-detention-tied-to-poor-health-ptsd-and-mental-illness

9. Melillo G. Experts warn of child flu outbreak in detention centers. AJMC. February 4, 2020. Accessed March 4, 2025. https://www.ajmc.com/view/experts-warn-of-child-flu-outbreak-in-detention-centers

10. Diaz C, Ortiz V, Sanchez L, et al. Harmful by design-a qualitative study of the health impacts of immigration detention. J Gen Intern Med. 2023;38(9):2030-2037. doi:10.1007/s11606-022-07914-6

11. Pillai D and Artiga S. Potential impacts of new requirements in Florida and Texas for hospitals to request patient immigration status. KFF. August 26, 2024. Accessed March 5, 2025. https://www.kff.org/racial-equity-and-health-policy/issue-brief/potential-impacts-of-new-requirements-in-florida-and-texas-for-hospitals-to-request-patient-immigration-status/

12. Grassini M, Terp S, Fischer B, et al. Characteristics of deaths among individuals in US Immigration and Customs Enforcement Detention Facilities. JAMA Netw Open. 2021;4(7):e2116019. doi:10.1001/jamanetworkopen.2021.16019

13. Tax payments by undocumented immigrants. Institute on Taxation and Economic Policy. July 30, 2024. Accessed March 5, 2025. https://itep.org/undocumented-immigrants-taxes-2024/

14. Flavin L, Zallman L, McCormick D, Wesley Boyd J. Medical expenditures on and by immigrant populations in the United States: a systematic review. Int J Health Serv. 2018;48(4):601-621. doi:10.1177/0020731418791963

15. Zallman L, Wilson FA, Stimpson JP, et al. Unauthorized immigrants prolong the life of Medicare's trust fund. J Gen Intern Med. 2016;31(1):122-127. doi:10.1007/s11606-015-3418-z

16. Ingram J. Trump’s plan to deport millions of immigrants would cost hundreds of billions, CBS News analysis shows. CBS News. October 17, 2024. Accessed March 5, 2025. https://www.cbsnews.com/news/trump-plan-deport-immigrants-cost/