More than 7,000 immigrants were arrested in Massachusetts in the first 15 months of the second Trump administration, but the reverberations of those detentions affect thousands more family members.
Despite what many say is a demonstrated need to address the behavioral health needs of immigrants in Massachusetts — especially those affected by forced separation — there is no coordinated system to do so. While community groups often help in the immediate aftermath of a detention with direct aid and support groups, it's rare for a social worker or therapist to be on staff. Case managers and volunteers do the best they can with limited resources.
"Accessing emotional and mental health support is especially challenging. It's just not feasible," said Reina Reyes, a community health worker and founder of the Community Healing Center Project. "People come to me saying they have to wait two months just to get an appointment with a psychologist. And health insurance is often just out of reach to many in the community."
Based in East Boston, the group works with local families touched by detention. But Reyes said many immigrants are skeptical of clinical support because of worries of information sharing, as well as cultural stigma.
Some hospital systems, especially those in urban hubs, have health clinics with multilingual support. But immigrants often don't know about, can't afford, or deal with the labyrinth of paperwork and insurance they must fill out to apply for low-cost care. And for some immigrants, any cost at all is out of the question when a two-income household becomes one.
A 2026 report from the Harvard T.H. Chan School of Public Health and the Leah Zallman Center for Immigrant Health Research described the situation as "siloed, under-resourced, and without the durable funding needed to sustain and connect its many strengths."
Barriers to clinical help
Juanita Namina is a volunteer with Casa del Trabajador, connecting families like her own that have been impacted by detention with housing, legal assistance, and support.
Originally from Ecuador, she and her husband are both asylum-seekers with pending hearing dates. Her husband was detained in October 2025 during a traffic stop where ICE was looking for someone else, leaving her solely responsible for a baby, their 3-year-old and her two teenaged sisters.
Namina went to a pediatrician to ask for a referral to a therapist for her daughter, who was becoming increasingly frantic, saying she was lonely, missing her father, and not sleeping or eating much.
"[The pediatrician] kept saying my daughter didn't need it. I told her she couldn't sleep, she was desperate and just couldn't cope. Whenever she saw or heard police, she'd always say, 'Mommy, immigration might come!' That is the state she was in."
Still, the pediatrician refused give the referral, telling her to just reassure the child, Namina said. But the mother wouldn't give up. With the help of an attorney, she connected to and paid for a psychological evaluation of her daughter. She also sought help for herself, but encountered a new barrier after a few sessions: the cost.
"Our coverage is limited — I spoke with a counselor in March and it helped me a lot, but I had to pay $1,500. I needed an evaluation. I was in turmoil."
She also had an upcoming asylum hearing and couldn't sleep or eat much. Her husband was released soon after on a $4,500 bond, which further cash-strapped the family. Namina said the psychologist recommended continuing treatment, but she had to stop.
Often, immigrants don't even have primary care providers for referrals, says Leela Ramachandran, co-director of Casa del Trabajador en Framingham.
"That kind of system of multiple steps feels very inaccessible for people who are working upwards of 12 hours a day, many days a week," she said. "We've also been trying to find psychologists and clinical social workers who might be able to provide those services, but often there's a barrier around language or just clinical understanding of what detention means, especially in this moment."
Nonprofits provide support
Through the first Trump administration and now the second, the Asian American Resource Workshop — a social justice-oriented nonprofit — has led support groups for families impacted by detention. They're often involving both case discussion, but also having a therapist who helps people process their experiences and imparts skills on how to regulate emotions during the second part of the discussion.
"Folks were coming in and in some ways, there was just so much emotion that they had to let out that we couldn't get through a session without everybody kind of being in tears by the end of it," said Teresa Tran, organizing director at the organization. "The past few sessions we've had, I think there has been a shift in trying to do more somatic practices while thinking about verbalizing what's going on, that folks have been able to go through the session without having kind of like a mental breakdown."
In New Bedford, the Community Economic Development Center has become a one-stop shop for help of all sorts for families touched by detention, offering legal and health insurance help as well as mental health support.
"I think especially local communities that have limited resources are having real difficulty in trying to find therapists who can address this issue," said Corinn Williams, executive director of the CEDC.
CEDC partners with domestic-violence focused The Women's Center to hold wellness groups to support immigrant women, and a bilingual counselor comes by once a week.
She recounted the story of a woman who was briefly detained at Burlington's ICE processing center, but was released with an ankle bracelet because she had an infant. The woman's 11-year-old, who had never had behavioral issues before, started acting out in school. It was recommended the mother look for clinical support, but her health insurance had expired.
Fortunately, the organization has a person who helps with reactivation in-house — but this isn't the case for all immigrants.
Healing Center Project in East Boston works with people who usually don't have insurance, with what Reyes calls "alternative therapies."
"We use that term because we aren't psychologists, yet we do work with the mind, body and spirit to help the individual find a measure of relief from their trauma," she said.
La Colaborativa is a social services nonprofit that operates the Chelsea Survival Center, where staff help with issues ranging from food insecurity, to domestic violence assistance and triaging immigrants' needs.
The organization also supports people — including immigrants touched by detention — with wellness and mental health-focused activities like Zumba and knitting.
"It's a time for community members to bond with each other and try not to think of what has happened even if they have been separated from a family member," said Angie Coronado, director of health equity there.
Coronado says the scarves that participants produce are sometimes flawed, but that's OK.
"Our scarves have little holes, but those holes are very meaningful, because they mean people are having meaningful conversations, causing them to forget one of the stitches." People are quiet at first, but little by little, they open up, often helping each other with grocery shopping, and picking kids up after school as a loved one continues to be detained.
The organization's front desk team also triages clients. If they express mental health concerns, they can speak with a caseworker, who will connect many to NeighborHealth's behavioral health urgent care in East Boston. Sometimes that means putting the impacted community member in an Uber to get there.
"When people go to NeighborHealth, they do an assessment and they do get to talk to someone that same day. They can get medication there, but if it's like self-harm, they get transferred to Boston Medical Center," said Coronado.
They also work with North Suffolk Community Services. The families who go to La Colaborativa tend to have MassHealth Limited, which can limit to how many therapy sessions they have. La Colaborativa is working to get a staff psychologist with a medical partner, and its first in-house physician just started.
Local hospital network commits to help
Cambridge Health Alliance runs an urgent care community behavioral health center. The two clinics in Cambridge and Malden accept walk-ins any day of the week and weekend. CHA is part of a statewide network of Community Behavioral Health Centers that offer immediate care for substance use disorder and mental health, and are increasingly seeing immigrant needs increase.
"Unfortunately we have seen an increase of families with increased mental health needs due to the trauma and the pain that they've been experiencing due to the unfairness of the situation of immigration," said Kevin Salazar, who manages the center and is a clinical social worker.
Salazar says the clinic has seen an uptick in major depressive disorder, post-traumatic stress disorder, anxiety, and agoraphobia among immigrant patients.
"I will say that there has been more even what we call passive suicidal ideation, or like the thought of being better off dead rather than wanting to kill oneself," he said.
"People can actually come in and process these levels of trauma and these situations that unfortunately they have been forced to live [with]," he said. "I think that one of the most important messages that we as CHA want our community to hear is that no one, absolutely no one, should face this level of emotional distress by themselves."
Patients are initially assessed by a registered nurse for vitals, and get a safety assessment. Eventually, they can see a behavioral health clinician who will conduct a crisis evaluation. If mothers and children come in, both can be assessed the same day. If there's a psychiatric evaluation for medication management, patients can often acquire medicine at the hospital pharmacy.
"We'll focus more on the persistent crisis, to hopefully provide services that will stabilize you. And from that visit, you may walk away with a follow-up if needed — if it requires for you to come back the following day, then you can come back the following day," said Salazar.
CHA is able to provide services to people with limited insurance coverage, and its behavioral health clinics can provide some stabilization services for uninsured immigrants.
If an immigrant doesn't live in the area the clinic serves, staff will connect them with a CBHC in their area, and a caseworker who can help them navigate health insurance applications and find sustainable ways to find ongoing. mental health services. They often partner with Elliott Pearson Department of Child Study and Human Development at Tufts University and North Suffolk Community Services.
Some organizations are starting to connect with immigrants impacted by changing immigration policies.
Kiara Hernandez-De Assis, manager of quality planning and assurance at Samaritans, monitoring crisis lines. Supporting people in a crisis is personal for Hernandez-De Assis— her family has roots in El Salvador, and she sees the impact immigration policy changes are having in her community.
She wants people to know about the free 988 crisis hotline, with interpretation available. Volunteers and staff don't involve emergency services unless it's a last resort, and have the simple goal of providing a safe space for people to talk. If the individual does express suicidal ideation, they work on coping skills, a safety plan and ask the individual about personal and medical supportive contacts.
"Samaritans is there to provide that safe space for them to feel heard, to feel validated, to feel listened to, um, especially in those moments where people may feel alone," she said.
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