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Living Undocumented: an Ethnographic Study of the Mental Health and Wellbeing of Undocumented Mexican Migrant Men

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Living Undocumented: an Ethnographic Study of the Mental Health and Wellbeing of Undocumented Mexican Migrant Men LIVING UNDOCUMENTED: AN ETHNOGRAPHIC STUDY OF THE MENTAL HEALTH AND WELLBEING OF UNDOCUMENTED MEXICAN MIGRANT MEN Laura Patricia Villa Torres A dissertation submitted to the faculty at the University of North Carolina at Chapel Hill in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Health Behavior in the Gillings School of Global Public Health. Chapel Hill 2018 Approved by: Clare Barrington Kate Muessig Geni Eng Jocelyn Chua Edna Viruell-Fuentes © 2018 Laura Patricia Villa Torres ALL RIGHTS RESERVED ii ABSTRACT Laura Patricia Villa Torres: Living Undocumented: An Ethnographic Study of the Mental Health and Wellbeing of Undocumented Mexican Migrant Men (Under the direction of Clare Barrington) Background: Documentation status is a social determinant of migrants’ health, although existing research is limited. Migrant health research has utilized cultural frameworks, such as acculturation and assimilation, to explain the health effects of restrictive migration policies. This dissertation aimed to explore the lived experiences of migrant Mexican men that lived undocumented in the US and understand how living undocumented affected their mental health and well-being. Methods: I conducted a transnational ethnographic and phenomenological study including in- depth interviews with Mexican men in North Carolina and Mexican who were living or had lived undocumented, their family members, and service providers. I also analyzed existing oral histories and engaged in participant observation at a workers’ center for day laborers. Analysis entailed writing analytical summaries, coding, memoing, and generating matrices to summarize and interpret data. Results: Living undocumented for Mexican men meant feeling like nobody, enacting pride to protect themselves from constant abuses, living surveilled and criminalized, and feeling socially disabled by the multiple everyday challenges. Living undocumented affected their mental and physical health. Men expressed that their undocumentedness was always present in their minds, and generated negative feelings, depression and anxiety. Undocumentedness was embodied through somatic symptoms, experiences of injury at work, chronic diseases, and disability. Men implemented coping strategies to deal with the effects of their migration status on their mental and physical health, mainly avoidance. Other ways of coping and getting some control back in their lives included reaching out for community services and resources, and preparing to return to Mexico in case of deportation. iii Conclusion: Undocumentedness is a complex phenomenon that affects the lives and health of Mexican men in multiple ways. The multiple challenges they experience in their everyday activities and the effects of living undocumented on their bodies make avoidance difficult to sustain. Interventions need to help men living undocumented deal with daily stressors, connect men to local community resources, develop strategies to deal with daily challenges related to be undocumented, and develop a plan in case the case of voluntary or forced return to their countries of origin. Community and structural interventions are also needed. iv TABLE OF CONTENTS LIST OF TABLES ............................................................................................................................................. ix LIST OF FIGURES ............................................................................................................................................ x LIST OF ABBREVIATIONS .............................................................................................................................. xi CHAPTER 1. INTRODUCTION AND AIMS ....................................................................................................... 1 CHAPTER 2. CONTEXTUAL AND EPIDEMIOLOGICAL BACKGROUND FOR AIMS ............................................ 6 2.1 Globalization and migration....................................................................................................... 7 2.1.1 Undocumented migration globally and in the United States ....................................... 11 2.1.2 Immigration policies ...................................................................................................... 12 2.2 Mental health among undocumented migrants ...................................................................... 17 2.2.1 Mental health among undocumented migrants globally ............................................. 20 2.2.2 Mental health among undocumented migrants in the US ........................................... 22 2.2.3 Access to mental health care services and mental health providers perspectives ........................................................................................................................... 24 2.2.4 Wellbeing among undocumented immigrants ............................................................. 27 2.2.5 Stress and allostatic load among undocumented immigrants ..................................... 28 2.3 Current research limitations and research gaps ...................................................................... 32 CHAPTER 3. THEORETICAL FRAMEWORK ................................................................................................... 37 3.1 Intersectionality ....................................................................................................................... 37 3.2 Embodiment and social suffering ............................................................................................ 40 3.2.1 Embodiment .................................................................................................................. 40 3.2.2 Social suffering .............................................................................................................. 41 CHAPTER 4. STUDY DESIGN AND METHODOLOGY ..................................................................................... 44 v 4.1 Research questions and research aims .................................................................................... 44 4.2 Epistemology and reflexivity .................................................................................................... 44 4.3 Study settings ........................................................................................................................... 49 4.3.1 North Carolina ............................................................................................................... 49 4.3.2 Guanajuato and Hidalgo................................................................................................ 53 4.4 Methodologies ......................................................................................................................... 55 4.4.1 Ethnography .................................................................................................................. 55 4.4.2 Phenomenology ............................................................................................................ 57 4.5 Sample and ethnographic fieldwork ........................................................................................ 58 4.6 Data analysis ............................................................................................................................ 63 CHAPTER 5. LIVING UNDOCUMENTED: A PHENOMENOLOGICAL STUDY OF MEXICAN MEN WHO MIGRATED TO THE UNITED STATES (PAPER 1) ......................................................................... 66 5.1 Introduction ............................................................................................................................. 66 5.2 Study design and methodology ............................................................................................... 69 5.2.1 Study settings and participants ..................................................................................... 69 5.2.2 Data analysis ................................................................................................................. 72 5.3 Results ...................................................................................................................................... 73 5.3.1 “If you are undocumented, you are nobody” ............................................................... 73 5.3.2 Enacting pride and living abused .................................................................................. 76 5.3.3 Living surveilled and criminalized ................................................................................. 83 5.3.4 Living socially disabled .................................................................................................. 87 5.4 Discussion................................................................................................................................. 91 5.4.1 Study limitations ........................................................................................................... 97 5.4.2 Future directions and conclusion .................................................................................. 97 CHAPTER 6. THE MENTAL AND PHYSICAL HEALTH IMPACTS OF LIVING UNDOCUMENTED AMONG MEXICAN MEN THAT HAVE MIGRATED TO THE UNITED STATES ................................................. 99 vi 6.1 Introduction ............................................................................................................................. 99 6.2 Study design and methodology ............................................................................................
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