This is the first in a series about the impact of detention on the mental health of immigrant families. This story was produced as a project for the USC Annenberg Center for Health Journalism’s 2026 National Fellowship.
In her last days, Jeronima Quinilla Castro didn’t sleep.
The memory of the detention of her husband, Catarino Castro, by U.S. Immigration and Customs Enforcement in a road-side stop remained fresh, even though he was eventually released.
Jeronima worried he would be re-detained or deported, or that or her three children would be taken away. She stopped working, and cried constantly. She knew he had an upcoming asylum hearing. She went to a community health clinic in New Bedford, explaining her growing depression, and the physical symptoms of it. She wasn’t set up to see a psychologist, psychiatrist or go to an in-patient facility, her husband and advocates said.
“That fear took hold of her — the fear that they were going to come for me and she’d be left alone with the kids. She said, ‘What am I going to do? They’re going to deport you, they’re going to hurt you. And what will I do with the children?”” said Catarino Castro. “That idea got stuck in her head and triggered that anxiety, where she became consumed by fear. That’s how it happened. I took her to the clinic, and they said there was nothing wrong, that everything was fine.”
By July, Jeronima was so depressed she tried to set fire to the family’s trash cans outside their New Bedford apartment. The family decided someone would have to be with her at all times until they came up with a plan to have her hospitalized.
Jeronima died by suicide the next morning.
Immigrant families are facing an unprecedented mental health crisis due to detention. Barriers to getting help are structural and cultural, including lack of access to health insurance that covers behavioral health; the cost of appointments; a shortage of clinicians and those that understand the layers of trauma experienced by immigrants; personal hesitation; and cultural stigma.
These barriers not only affect the detained themselves, but their partners and their children. The Harvard T.H. Chan School of Public Health and the Leah Zallman Center for Immigrant Health Research published a report in March reviewing the range of services available to immigrants, finding some community-led and clinical resources. But a gap remained.
“Despite this foundation of community-led and clinical resources, the landscape remains siloed, under-resourced, and without the durable funding needed to sustain and connect its many strengths,” the report reads.
The heightened ICE enforcement in Massachusetts has created a critical need to address the issue, according to the authors of the report. They said any new framework should acknowledge and “elevate the role of organizations traditionally considered outside of the mental healthcare system that directly mitigate socio-cultural induced trauma, especially those led directly by immigrant communities.”
In Jeronima’s case, the 35-year-old mother had already left a traumatic past behind in Guatemala, as had Catarino.
Jeronima arrived in New Bedford in 2023 with two of the children — Catarino had already immigrated with the eldest. Jeronima got a short-term job at a potato chip factory. The children — now 14, 12, and 9 — went to school, and she was teaching her daughters how to sew Guatemalan huipils (or tunic tops), something for which she became known for in the community.
Before her death, she was in the middle of her asylum claim and had a work permit, and Catarino was awaiting a decision on his own application.
It’s an origin story that echoes across immigrant communities across the state. Like the Castros, many others seeking the American Dream have seen that pursuit interrupted by sudden immigration detention. What comes after is often a cascade — of trauma, of growing behavioral health needs, sudden extreme stress, and the silence, as families left behind bear the burden alone.
‘The harms remain with them’
Organizations and policymakers recognize the necessity of reviewing and formulating a plan to address immigrants’ mental health needs, including those impacted by detention.
“Because of what our immigrant and refugee communities are experiencing right now, we feel that it is our duty to look into what we can do in terms of our advocacy around mental health,” said Maroni Minter, political director at Massachusetts Immigrant and Refugee Advocacy Coalition, a Boston nonprofit that advocates for immigrants. The coalition is leading a task force made up of providers, academics, researchers and immigrants working on potential research and policy solutions.
Congresswoman Ayanna Pressley’s office works with impacted families to connect them with organizations that can provide behavioral health services. Pressley said that many people struggle to re-integrate after detention, suffering from PTSD and inability to sleep and work effectively due to the trauma they experienced.
“It’s a for-profit system that is for child abuse, for child neglect, for childhood trauma, for the separation of families,” said Pressley of the U.S. immigrant detention system. “Truly, the body keeps the score, so even in the many instances where my office has been helpful in reuniting someone with their family and reintegrating them back into community, the harms remain with them.”
Migratory trauma is also compounded by trauma related to detention, according to experts who work with immigrants.
“We’re talking about families who have walked thousands of miles to escape violence and persecution, who have crossed rivers, who have crossed mountains, who have really stared death in the face and like gotten through it and gotten past it and have pushed down their own feelings of anxiety, depression, trauma, PTSD in order to show up for their kids,” said Sarah Sherman-Stokes, clinical professor of law and associate director of the Immigrants’ Rights Clinic at Boston University, which works with immigrants facing detention.
“I think that we really can’t quantify at this point the devastating impact that immigration detention is having on entire families and communities,” she said.
Once a family member is detained, sudden needs arise — like how to pay rent, deal with childcare, find an attorney for their partner or other urgent tasks. Women who had part-time jobs suddenly have to find full-time positions. Addressing behavioral health worries, if they’re even understood, can feel tertiary.
Pietra Adami is the organizing director at Brazilian Women’s Group, which does rapid response work with families impacted by detention. She says the mental health issues faced by immigrants are expected reactions to what they face.
“The behavioral health impacts we are seeing aren’t isolated incidents. They are predictable consequences of policies that separate families, create chronic fear, and make an entire community feel unsafe,” she said. “This is not just about immigration. It’s about public health.”
Constant worry of ICE arrests in the community, government sharing of information with immigration enforcement and hesitation describe their trauma to strangers make immigrants hesitant to try and find help,
“This very scary time trying to provide mental health services, trying to provide crisis intervention, safety planning, and you’re trying to really connect them to resources when there’s a lot of resistance there,” said Tracey Taldon, a social worker and deputy director of Haitian Mental Health Network. “You’re trying to sometimes build safety nets for folks in a time where they really can’t trust people outside their family.”
Churrascos—or barbecues—and large get-togethers are ways that immigrant families often created their own sense of community. But now, they often don’t feel safe going out.
“A lot of what we’ve been talking about as we try to kind of conceptualize this moment is the way that the immigration enforcement has robbed people of feeling safe and feeling safe in community,” said Leela Ramachandran, co-director of Casa del Trabajador en Framingham. “How can we create spaces, physical spaces, but also kind of places where people feel like they can just be and be in community?”
Immigrant Family Services Institute in Mattapan is well-known to many Haitian immigrants as lifeline to find legal help, workforce support, and assistance with health insurance. The center also has a staff member, Carlot Celestin, on-site to conduct therapeutic discussions, increasingly needed with those impacted by detention. Celestin is also assistant pastor at Tabernacle Baptist Congregation, where he hears many of the same concerns.
There’s a strong cultural stigma to therapy, he said.
“In the Haitian community, a psychologist is only somebody who’s there to see crazy people. But what we have been able to do is to help people to understand stress and distress.”
Many immigrants, he said, come in with a “somatic reaction,” where they feel ill but don’t understand why. Only after a psychological evaluation do they begin to understand the extent of their psychological distress — or what that even is.
The science of trauma
Under sudden extreme trauma and stress, the brain goes into survival mode.
Norepinephrine, a hormone and neurotransmitter, will control the body’s “fight-or-flight” response by increasing alertness and raising blood pressure. Another hormone — cortisol— will flood the system quickly, boosting energy, focus and blood sugar.
But after the initial catalyzing event has passed, chronic stress and high cortisol and norepinephrine levels can cause sleeplessness, reshape brain functionality and impact memory and decision-making.
Jim Recht, a physician and lecturer on psychiatry at Harvard Medical School, said instances in detention for a family can compound longer histories of trauma, including forced migration and the issues that sent a person out of their country of origin to begin with.
The sustained stress and anxiety detainees and family members feel have long-term health impacts.
“It exhausts you. It burns you out. I think in many cases it leaves you with permanent harm, permanent damage,” said Recht. “Because long-term exposure to high levels of these stress hormones really does cause cellular damage, and that translates into handicaps, functional impairments that people struggle with for the rest of their lives.”
High levels of cortisol can wear the body down, said Tiffany Joseph, associate professor of sociology at Northeastern University. She pointed to research about how racism impacts the body.
“There’s related research that’s also increasingly starting to talk about the role of legal status, but also concerns around immigration enforcement, concerns around detention and deportation that can have a similar impact on the body,” she said.
‘Brutal nature’
Children don’t understand the complexities of immigrant detention, but they feel its impacts. The trauma from a detention can lead to developmental disruption and changes to their behavior.
“The brutal nature of having a parent just taken away from you immediately, without any warning, without any ability to plan, without any ability to protect children, is particularly troublesome for youth,” said Dr. Melinda Macht-Greenberg, a clinical psychologist on faculty at the Elliott Pearson Department of Child Study and Human Development at Tufts University.
She runs a training rotation for advanced psychiatry fellows at the Elliott Pearson School, and oversees fellows working at a local school district. Those individuals work with immigrant children.
“There’s the sadness, that’s a lot of the grief part. There’s the fear and the anxiety. Then there’s this tremendous difficulty in functioning,” she said, noting that children experience difficulty sleeping, nightmares and fear of leaving home.
Lesly Garcia Natareno’s husband, Pedro Baltazar Tercero, has been detained for nearly 11 months after he and his brother-in-law were pulled over and found without legal documents. He was transferred several times and put on a deportation flight just before he was allowed to remain in the US., but in a New York detention center.
Garcia Natareno said their 10-year-old daughter Dayelin has been deeply affected.
“The teachers called me early on, asking what was wrong with her because she kept crying. She wouldn’t say anything at first, until a teacher finally spoke with her and she explained what had happened to her father,” said Garcia Natareno.
Family milestones have had to be celebrated — apart. Tercero sang Dayelin “Las Mañanitas,” a Mexican birthday song, on the phone from detention. Her mother says she’s calmer than when the detention first happened. But recently, Tercero’s release on bond was denied.
“Honestly, I’m not in a good place mentally. I feel very sad. Sometimes I feel like I’m running out of strength, like I just can’t go on, because I have to handle school, my job, and my husband’s legal process,” said Garcia Natareno.
“Whenever he talks to me, instead of me telling him to be strong, he’s the one who stays positive. He tells me not to give up, to be strong,” she said. ”He says, ‘If I were in your shoes, I don’t think I’d be strong. If God left you out there and me in here, well, God knows why.’”
