Abstract
In this commentary, the authors argue that discriminatory US immigration institutions and policies have a direct negative impact on immigrant and refugee mental health. A close examination of these polices reveal a pattern of systematized racism and discrimination in the handling of immigrant arrivals to the US. The authors further argue that a comprehensive and culturally responsive approach towards the psychological care of immigrant individuals in the US must incorporate the traumatic effects of experiences of post-migration discrimination and racism, not only pre-migration traumas. Finally, a case is made for training mental health care workers to reflect on and examine how institutions and policies, as well as current health care approaches, may result in moral injury and institutional betrayal which can further exacerbate symptoms of PTSD, and experiences of discrimination, health inequities, and social isolation.
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