It Doesn’t End at the Border

University of Houston professors aim to transform immigration policy and advance migrant health research at the Texas-Mexico border.

By Cat Cardenas

at the beginning of 2023. The backlog was compounded by the implementation of Title 42, a public health regulation that went into effect in March 2020 and allowed immigration officials to turn away asylum seekers at the border. Since then, encounters between U.S. Customs and Border Protection and migrants and asylum seekers have been recorded at the highest level in two decades.

the clinic takes on between seven and 13 law students, all of whom are assigned anywhere from three to five cases. Because of the timeline of most asylum cases, students might inherit a case that the clinic has been working on for years. And while the clinic functions as a nonprofit, its structure also allows students and faculty to take on more complex cases than a traditional nonprofit might.

“For most nonprofits, the objective is to provide as much representation as possible,” Sheffy says. “Therefore, the complexity of the cases isn’t necessarily the priority. Because we don’t have those same constraints, and because we’re a teaching institution, we’re able to accept more complex cases.”

Sheffy and his colleagues have provided representation before the Department of Homeland Security, the Department of Justice and even the Supreme Court.

Migration and Mental Health

The Immigration Clinic collaborates closely with UH faculty across other disciplines. Starting in 2013, when the clinic began taking on an increasing number of cases involving unaccompanied minors at the border, Jodi Berger Cardoso, an associate professor of social work at UH, worked with them to provide mental health evaluations.

“Because so many asylum seekers experience extreme trauma, we do a forensic health evaluation,” Cardoso explains. “As a result of that trauma, it makes it very difficult for them to recall their story, which is often the only thing that they have, because there’s no paper evidence; they’re fleeing their country.”

These in-depth assessments were critical to building cases for those children and also laid the groundwork for Cardoso’s interest in studying the effects of family separation. “At the time, there weren’t a lot of people interested in immigration-related trauma,” she says.

In early March 2020, law professor Parker Sheffy was traveling back to the University of Houston from Matamoros, Mexico, when he learned that the world was shutting down.

“I was getting push notifications about everything from the rodeo to the NBA being canceled,” he recalls.

Sheffy and his colleagues from the University of Houston Law Center’s Immigration Clinic were already dealing with a challenging situation: For the past year, the controversial “Remain in Mexico” policy had required asylum seekers to await their court dates in Mexico, leaving thousands of migrants waiting in makeshift tent encampments along the border, with little access to legal aid.

As a top-tier research institution in Texas, just a few hours north of the border, the University of Houston has many professors and researchers equally committed to unveiling and, ultimately, alleviating the many challenges migrants face in the historic situation at the Texas-Mexico border.

As part of the University’s multidimensional efforts at the border, three UH professors have spent their careers focusing on legal representation, mental health and a holistic approach to immigration policy reform.

Houston and the Border

The work of immigration lawyers is often at the mercy of changing policies, as well as changes in migration patterns due to geopolitical crises, natural disasters and, most recently, a global pandemic.

Sheffy and his colleagues at the Immigration Clinic work with students to adapt to the changing needs of their clients, whose cases are part of a mounting backlog.

The clinic provides pro bono legal representation, specializing in representing asylum applicants; immigrants who have been the victims of domestic violence, human trafficking and crime; children; and those fleeing civil war, genocide or political repression.

Over the past decade, the number of pending asylum cases has grown from over 100,000 in 2012 to more than 800,000

Jeronimo Cortina, an associate political science professor at UH, describes the current situation as “very dire,” noting that, even with the ending of Title 42—which effectively closed the U.S. border to almost all asylum seekers while it was in effect, until May 2023—the continuing increase in asylum seekers and migrant arrivals hasn’t corresponded with a significant change in immigration policy.

Cortina has provided commentary on border and national politics for media outlets including The New York Times, Washington Post and Politico.

“If the policy is not responsive to what is happening at the border, then the policy—regardless of the administration—is going to fail,” Cortina says. “Immigration is not something that you can stop, it’s something that you have to manage.”

In Houston, where 1 in 4 individuals are foreign-born, the UH Immigration Clinic’s work is crucial, Sheffy says—in part because that proportion is only going to continue to grow. Each semester,

Cardoso first became interested in the subject when she was in the Peace Corps. Before she was a trained social worker, her time as a volunteer in Ecuador positioned her in a community that was deeply affected by migration. Many of the parents in the town had left to the U.S. or Spain to provide for their children, who were left behind with grandparents or siblings.

After returning to the U.S. for her master’s in social work, Cardoso noticed similarities between the children she met in Ecuador and the children she was working with in clinical settings who had also experienced family separation.

“I saw kids demonstrating symptoms of post-traumatic stress disorder, separation anxiety disorder and depression,” she recalls. “That was the beginning of my interest in migrationrelated factors that contribute to mental health in children; most of my career has focused on them.”

Since then, Cardoso has worked closely with her clinical students in UH’s Graduate College of Social Work to identify the specific circumstances these children face, training them to rethink their treatment methods in response to those challenges.

“There are unique stressors that impact immigrant children and their families,” Cardoso says. “How I’ve helped train social workers is to identify those factors and consider how we can think about our intervention and prevention processes in a culturally attuned way.”

For decades, it has been common for many immigrant children to experience a separation from one or both of their parents in the process of migrating. In some cases, the separation is a result of the parent or parents migrating ahead of their children. In others, it’s a result of immigration policy.

“Family separation is typically not one discrete event; it’s a series of multiple separations across different developmental periods for children,” Cardoso says. “I think that is a big deal.

“Kids have ongoing separations from multiple caregivers. Sometimes they reunify with some caregivers, and sometimes they never see others again. What we know about trauma is that it’s cumulative, and the kind of trauma that you experience matters. So the longer children are separated from their caregivers, the more difficult the impact is.”

There currently are no accepted interventions that specifically target the circumstances families are facing— something Cardoso and her colleagues are working to address.

“We’re really starting to think about how we can build an intervention from the bottom up that will address some of the attachment distress that results in many children due to multiple separations,” she says. “I have been identifying this problem for the last 10 years, and there are a whole host of unique challenges that aren’t characteristic of existing interventions.”

Repercussions Past the Border

Cortina says that while attitudes toward immigration have varied over time, conversations about policy should take a holistic view of the issue.

“You can’t just have one side of the equation when you’re thinking about family separation and immigration,” Cortina says. “You have to take into account the push and pull factors. The push factors are going to be, for example, violence, lack of economic growth, insecurity, etc. And the pull factors are going to be the need for migrants to be incorporated into the labor market.”

Regardless of the cause, Cardoso makes one thing clear: “Family separation, especially when forced, can create toxic stress in kids. I hold that very strongly. The American Academy of Pediatrics clearly articulates that forced family separation or any kind of family separation has adverse effects on children’s development.”

Over at UH’s Family Studies Lab, director Amanda Venta is utilizing her background in clinical psychology to better understand how family separation affects the physical and mental health of immigrant children and their parents.

For 12 years, Venta has worked with children and families affected by migrationrelated separation. In that time, she and her colleagues have observed levels of trauma exposure and post-traumatic stress disorder that vastly exceeded the rates observed in youth across the U.S.

“The average level of PTSD symptoms among the kids we’ve seen exceeds the clinical cutoff,” she says. “Their score is higher than what’s [classified] in the published literature as really significant PTSD.”

Venta has observed that these symptoms don’t just end after reunification.

“Being undocumented in a family that is of mixed status, living in a community where you experience discrimination, living in a country where you experience xenophobic attitudes—all of that continues to expose kids and their families to trauma,” she says.

“That is going to have serious consequences for their health.”

In December 2022, the National Institute on Minority Health and Health Disparities awarded Venta a $1.5 million grant to better understand the toll migration can take on the body, in what will be a first-of-its-kind study. Venta and a team of researchers from UH, Rice University, the University of Texas Rio Grande Valley and Northwestern University will begin collecting data this summer.

The study will be an international effort, with the team interviewing 400 adults in Texas and Mexico, whom they will follow for a year as they go through the process of seeking asylum, using connections in the community, “so that people who are going through one of the most difficult moments in their lives will open their hearts and take the time to talk with us,” Venta says—“in a way that will hopefully revolutionize immigration policy and science regarding immigrant health.”

New Insights

By collecting blood from participants in addition to interviewing them, Venta and her colleagues hope to answer questions that haven’t yet been studied in immigrant communities.

“What we suspect is that these experiences of serious and chronic stress lead to an inflammatory state in the body,” she says. “If inflammation is elevated, then the individual will be at higher risk for a variety of physical and mental health conditions.”

In recent years, Venta says she’s seen higher levels of PTSD, health problems such as frostbite and hypothermia due to extreme weather conditions and infectious diseases that are difficult to avoid in the tent encampments. Immigration policies pushing asylum seekers into Mexico have also exposed them to the threat of kidnapping, extortion and violence as they awaited their hearings.

“One of my collaborators in South Texas, Alfonso Mercado [associate professor of psychiatry at UTRGV], has been doing pilot work with these families, conducting interviews in the tent encampments, and hearing stories from parents whose kids suffered sexual abuse living in the camp,” Venta says.

“There have been major weather events—hurricanes and winter storms—and these families have had to weather those events in an informal encampment. What we’re seeing is that, in a way that wasn’t true previously, trauma exposure is now embedded into our U.S. policy.”

A Complete Picture

Ultimately, the researchers in each field are working toward a shared goal: to create a more complete, more accurate picture of what really occurs when people migrate to the U.S.—and how that affects them and the population more broadly.

Venta, whose work aims to recontextualize the trauma immigrants face in their journeys not as an immigration issue but as a health problem, hopes they can put all that data “to one significant take-home message.”

The trauma embedded in the system is negatively affecting the health of people who will ultimately be living and working in our communities,” Venta says. “Ultimately, I think policy needs to reflect that immigrants are an integral part of the U.S. workforce and of the fabric of our nation. Their health should matter to all of us.”