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The cycle of injury

After eight days of walking, with blisters and cracks on her legs, SYH finally arrived in Tapachula from El Salvador.

The mother of three, who asked to be identified by her initials to protect her identity, was distressed at leaving her home and family. But she felt she had no choice: after she and her partner refused to continue paying extortion money to a local gang, the gang kidnapped her and attacked her with an aluminum bat, she said. Fearing for her life, she fled.

During her first few days in Tapachula, a sympathetic stranger helped put SYH in touch with Hospitalidad y Solidaridad, a shelter for refugees and asylum seekers. There she underwent a medical examination and two sessions with a psychologist. The very opportunity to talk about what she went through was a catharsis, she says.

“It helped me a lot to get rid of that feeling,” she said.

SYH circumstances are common. Most migrants passing through Tapachula come from El Salvador, Honduras, Venezuela, Cuba, Chile and Haiti, where poverty, government corruption and gang violence are common.

In many migrant cultures, violence and injury are so common that they are considered the norm, experts say. And worldwide, mental illness treatment is often still only considered for people with serious mental illness, such as schizophrenia or severe bipolar disorder, and requires hospitalization. More common symptoms such as depression and anxiety are overlooked.

Contrast these factors with the realities of most migrants who struggle to find work, shelter and support for their families in Mexico, and it is not surprising that relatively few seek psychological help.

“They are busy with other things. They are preoccupied with other things,” said Dr. Ieza Bojorquez, a researcher at the El Colegio de la Frontera Norte Department of Population Research in Tijuana, Mexico. “They’re not going to look for a psychologist because they’re blue.”

This story of untreated trauma, combined with the dangers migrants face on their travels, the hardships they endure once in Mexico, and the sense of loss they experience when they leave their homes, snowballs into what some experts call “migration grief”.

“They decide to leave their countries. They experience mental health problems even before they start the migration process,” said Cesar Infante, a researcher at the National Institute of Public Health of Mexico.

Many migrants expect their situation to improve once they arrive in Mexico, he said, only to sink back into violence, deprivation and lack of food, water and shelter.

“So people end up in crisis after all, don’t they?”

The sluggish migration process, which often leaves migrants trapped in Tapachula for months at a time, could cause these crises to spiral. Multiple migrants have died by suicide in Tapachula in recent years, according to local media reports.

The problem is widespread: according to data and testimony recorded by the global non-governmental organization Médecins Sans Frontières, of the thousands of migrants in Mexico it interviewed during mental health counseling in 2018 and 2019, the majority appeared to have had anxiety, depression, and post-traumatic stress disorder. More than half said they were subjected to violence on their migration routes. Of the women interviewed, a third said they had suicidal thoughts.

And that was before the pandemic. In March 2020, US President Donald Trump enacted Section 42, controversial public health order which has drastically restricted migration from Mexico and Canada in an attempt to stem the spread of COVID-19. This has left many migrants in limbo, unable to move forward with the US asylum process. (The Biden administration tried to terminate Section 42 but was blocked in federal court.)

In the early days of the pandemic, some migrant shelters imposed lockdowns that prevented people from coming and going freely, Bojorquez said, leaving many feeling even more trapped.

“A sense of autonomy is very important for mental health,” she said. “It was lost at the time.”

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