Imagine you have just stepped foot in a strange land.

You are tired, hungry, and relieved but most of all you are scared. Very scared.

You gather your small bundle of things together and take a deep breath, ready to begin the next stage of your journey.

However, everything is foreign to you: the sounds, the smells, the landscape… Even the air tastes different.

You have made it this far, farther than most, but now the real challenge begins.

Only time will tell what will happen to but you know that nothing is going to be easy.

Upon their arrival in the United States, undocumented immigrants face endless obstacles, from the ever-present threats brought about by inherent flaws in the American legal system and cold-blooded ICE agents, to everyday difficulties such as communication barriers and difficulties finding adequate housing and employment.

Amidst the numerous hurdles undocumented immigrants must face day in day out, the toll on their psychological health may be the most damaging and, worse still, least discussed aspect.

This is something Monica Posada knows all too well.

As the person in charge of behavioral health services at “Puentes de Salud,” a nonprofit organization that deals with the health and well-being of Latino immigrants in Philadelphia, she is well aware of the numerous issues affecting the mental health of this community.

Discussing the precarious situation that undocumented Latino immigrants find themselves in upon reaching America, Monica says that “the root cause of all of these problems is fear.”

“These individuals are forced to live in a constant state of anxiety and apprehension, and this state of mind is passed on from parents to their children.”

Monica gave a name to how they feel: espantados (sick with fear)

This constant espanto felt by the Latino community as they face prejudice and threats from the United States government is difficult, if not impossible, to manage.

To truly grasp the extent of the issues facing the Latino population in the United States, both documented and undocumented, one has to understand the multiple aspects that define the problem.

Though the office of the Surgeon General has determined that the Mexican-American population is at a particularly high risk of poor health as a result of the societal pressures that often lead to incomplete education and some of the lowest per capita incomes of any minority group in the United States, these issues stretch beyond just the Mexican-American population and the effect can be seen in other Latin American immigrant communities.

One of the largest underlying factors for many health issues is stress, and unfortunately undocumented immigrants in particular are forced to live an incredibly stressful existence.

They work long hours in demanding positions for insubstantial and unfair wages. On top of that, they are threatened with deportation or legal action at nearly every turn, and must walk on eggshells knowing that any wrong move could be their last.

Given that they also have very inadequate access to proper healthcare services, these risk factors that impact on their health and emotional wellbeing should be cause for concern and action.

On an individual level, this can be difficult to tackle – when the most terrifying threat comes from external sources such as law enforcement and other government forces it can be very difficult to find personal solutions.

The way in which customs agents handle interactions with undocumented immigrants is a source of constant concern, and Monica has heard countless horror stories from the people she helps about the treatment by these officials.

“Fear is not simply a byproduct of the way in which they handle these matters,” she says. “It is part of their strategy for accomplishing their goals.”

In order to directly combat this problem, Monica and her co-workers at “Puentes de Salud” provide practical remedies such as prompt cards and leaflets in Spanish that clearly lay out their individual rights and offer suggestions on to how to behave when they encounter ICE agents or are threatened with deportation.

These practical methods are supplemented by therapeutic approaches that tackle the need for emotional expression and healing. However one unique aspect of mental health issues in the Latino community that Monica also notes is the cultural taboo regarding therapy and psychological problems in general.

In many of these communities, going to a psychologist or struggling with psychological problems is viewed as a sign of extreme weakness or craziness, and is met with disdain.

Monica and her team work to demonstrate the importance of good mental health care to overall well-being.