Why Brain Health Must Lead Migration System Reform

Introduction

Against a backdrop of globalization and the complex challenges posed by climate change, political turbulence, and economic instability, migration has emerged as a contentious issue on both national and global fronts. For some, migration is seen as crucial driver for the exchange of ideas, skills, culture, and economic development, but others perceive it as a threat to safety, security, and equitable resource distribution. Unfortunately, practices marked by xenophobia, racism, and discrimination have rendered many of the world’s migration systems inhumane, especially for refugees and asylum seekers. Repairing these systems requires that we shift the narrative on migration and recognize it as a constructive force, guiding us toward a more compassionate, decolonized, and liberatory approach to immigration governance.

In order for this shift to occur, we must design policies that incorporate a holistic understanding of migrant well-being, including their mental, cognitive, and physical health. One perspective that encompasses both the mental and physical aspects of well-being is brain health.[1] The current configuration of global and national migration systems is not optimal for the healthy brain functioning of migrants nor societies as a whole. In fact, most migration policies and processes are actively detrimental to migrant brain health as they do not respect migrants’ physical or psychological wellness. For example, Texas officials on the U.S.-Mexico border recently mandated the installation of razor wire and massive buoys to deter migrants from entering the U.S.[2] Ceasing these hostile deterrent activities and reforming migration systems to prioritize and protect the brain health and well-being of displaced individuals is key for achieving comprehensive health, social stability, and economic prosperity, both nationally and globally.

In this issue brief, we delve into the transformative potential of brain capital, which encompasses the cognitive abilities and mental well-being of a society, within the context of migration.[3] In the following sections, we examine how brain capital can be incorporated at every stage of the migration process, including the processing of migrants at entry points, their assimilation into society, and their integration into the economy. We also explore the incredible resilience demonstrated by migrants in response to traumatic events and underscore the need for individualized approaches to address each migrant’s needs.[4]

Building on the UN’s Sustainable Development Goals

The well-being of forcibly displaced migrants must be a global priority. In 2015, world leaders in the United Nations (UN) adopted the Sustainable Development Goals (SDGs) as a call to action for countries to use their technologies, resources, and knowledge to create a brighter global future.[5] Goal 10.7 urges countries to “Facilitate orderly, safe, regular and responsible migration and mobility of people, including through the implementation of planned and well-managed migration policies.”[6]

More action is needed from national governments to achieve this goal. In particular, there is an urgent need to better consider the well-being of refugees and asylum seekers in the design and implementation of migration policies. Furthermore, it is crucial to include and protect migrants — and their brain health — at every stage of the migration process.

Moving Toward a Personalized Approach

Migration systems must be designed with enough flexibility to adapt to the unique experiences of each migrant. For example, an approach similar to personalized medicine could be adopted to support migrant well-being. Personalized health care is an emerging practice that separates people into different groups based on their genetic profiles to help create customized plans for the prevention, diagnosis, and treatment of disease. Similarly, in the context of migration, cases could be categorized according to different criteria first, and then common problems within each group could be addressed using the most applicable method. This would allow for a customized approach that considers the specific needs of each migrant. It would also better equip government officials to care for migrants’ mental and physical health within their budgetary limitations.

Ensuring Access to Trauma-Informed Care During the Processing Stage

Many refugees and asylum seekers experience high levels of trauma prior to their displacement and across all stages of the migration process. Providing these individuals with access to assessment, services, and trauma-informed care during the processing stage is therefore critical. It is equally vital to ensure that they are not subjected to further trauma throughout the process.

Unfortunately, the majority of the world’s migration systems do not meet these basic standards. Asylum seekers and refugees often experience disruption of family and community networks, harsh living conditions, long periods of uncertainty about migration outcomes, food insecurity, poor nutrition, ill health without access to care, and exposure to violence and abuse.[7] These traumatic experiences are detrimental to their neurological, physical, and mental health. Trauma undermines the preservation and future accumulation of brain capital and therefore must be addressed.

Creating safer and more expedient processes for migration will reduce the trauma inflicted on refugees and asylum seekers and consequently protect their brain health. The National Immigration Justice Center outlines five key recommendations for building more humane migration policies, which we elaborate upon below.[8]

1. Robust channels of communication should be established between all actors involved in the migration process (i.e., federal governments, local governments, and civil society). We would add that this should extend to migrants themselves, so that they are aware of what to expect during the process.
    
2. Governments should fully fund and better support civil society. This includes lawyers and organizations that provide critical social services. These groups are often overwhelmed and underfunded in current migration systems.[9]
    
3. “Non-custodial, humanitarian” reception centers should be established that care for rather than incarcerate people seeking asylum.
    
4. Funds from national and local budgets should be reallocated from detention and enforcement to effective processing and service provision for migrants.
    
5. Migration systems should actively adhere to national and international conventions on the treatment and reception of migrants.[10]

Establishing a migration system under these guidelines will prevent further trauma from being inflicted upon refugees and asylum seekers, thereby protecting their brain capital.

Supporting Social Cohesion

Poor mental health can isolate individuals and prevent them from engaging with their communities. Therefore, it is essential to build inclusive communities for migrants while considering and caring for their mental well-being. Supporting initiatives to improve migrant mental health will also promote social cohesion.

Once migrants have arrived, it is important for them to have opportunities to engage in the community and receive mental health support. However, this can be difficult for refugees and asylum seekers who may have faced compounding trauma and hardships on their journey. A recent study provides evidence that undocumented Latino immigrants who experienced traumatic events en route to the U.S. also experienced prolonged anxiety and depression upon arrival.[11] Affordable and accessible mental health care is therefore undeniably important.

Beyond mental health care, receiving communities can provide additional services to support social inclusion, such as language education and programs that promote cross-cultural interaction and learning.

Providing Opportunities for Economic Integration

Just as social integration is critical for the mental and physical well-being of migrants, so too is economic integration. The economic opportunities available for migrants in their destination countries are a pivotal determinant of their quality of life. At present, the labor market options for migrants are disproportionately unsafe. According to a report by the International Organization of Migration (IOM), migrant workers are highly over-represented in hazardous occupations, such as agriculture, mining, manufacturing, and construction.[12] Exposure to pollution, chemicals, and pesticides associated with these types of jobs can be detrimental to brain health. Fatigue from hard physical labor is also known to have an adverse effect on mental health and agility.[13]

In addition to disproportionately high employment in hazardous jobs, migrants experience a higher likelihood of participation in informal economic activities.[14] Without the legal right to work, many migrants are compelled to engage in occupations not registered or recognized by the labor laws of their destination countries.[15] This can leave them without access to social services such as health care and mental health care.

Furthermore, undocumented migrants underpin many key economic sectors such as agriculture, hospitality, construction, business services, and manufacturing.[16] In the United States, the chief actuary of the Social Security Administration reported that migrants working without legal status offer a net contribution of $12 billion to social security each year but only receive approximately $1 billion dollars back.[17] This phenomenon is deeply unjust, and to rectify it, reform must happen on two fronts: First, under current systems, governments must cease to exclude undocumented workers from social services. Second, policy should reflect the essential nature of the work many undocumented migrants engage in and provide safe and secure pathways to legal employment. To do so is crucial for the protection of the mental and physical well-being of migrants.

Understanding Migrant Resilience

Despite undergoing many traumatic experiences before, during, and after the migration process, most migrants display incredible resilience. Learning how migrants develop this resilience could help improve the quality of services provided to different migrant populations.

One study of undocumented migrants to the U.S. identified several strategies that migrants use to remain resilient in the face of hardship. The strategies included cognitive reframing, behavioral adaptability, acceptance, sociability, courage, and ancestral or cultural pride.[18] Creating education systems and implementing policy interventions that foster these traits could help build more resilient communities.

Furthermore, the ability to execute these strategies is a sign of well-developed brain capital. Adaptability, for example, is a key brain skill needed to tackle modern societal challenges. Even though migrant brain capital is under siege from compounding traumatic experiences, it is clear that their resilience is something we can all learn from as we strive to create more inclusive, healthy environments.

Conclusion

In the fields of neuroscience and economics, there is a general consensus that both resilience and adaptability are essential tools for navigating the modern world. Migrants of all backgrounds display consistent resilience in their journeys and throughout their lives. As policymakers and individuals, it is therefore important to consider what we can learn from migrants and how we can make our countries and communities more welcoming for them. Incorporating the concept of brain capital at every stage of the migration process — from initial processing to integration into society and the economy — is a crucial step for reforming our migration systems. By respecting, valuing, and nurturing the brain health of migrants, we can build healthier, more resilient communities.

This brief was prepared for the Baker Institute Migration Initiative. Fellow in Brain Health Harris A. Eyre presented on this topic on May 30, 2023, and this brief is a summary of his presentation with further refinements from co-authors.

Notes

[1] World Health Organization (WHO), “Optimizing Brain Health Across the Life Course: WHO Position Paper,” August 9, 2022, https://www.who.int/publications/i/item/9789240054561.

[2] Valerie Gonzalez and Acacia Coronado, “Texas is Using Disaster Declarations to Install Buoys and Razor Wire on the US-Mexico Border,” AP News, July 24, 2023, https://apnews.com/article/immigration-texas-border-buoys-wire-abbott-5f138e354e88fc319f46c55344d7335c.

[3] Lundbeck, “Our Position on Brain Health: Brain Health — A Global Priority,” https://www.lundbeck.com/global/about-us/our-commitment/our-position-on-brain-health.

[4] Brain capital is a key consideration for both forced and voluntary migrants. However, in this brief, we focus on migrants who have been forcibly displaced from their homes, namely refugees and asylum seekers, whose brain capital is particularly vulnerable in current migration systems.

[5] United Nations (UN), “Sustainable Development Goals,” https://www.un.org/sustainabledevelopment/.

[6] UN, “Goal 10: Reduce Inequality Within and Among Countries,” United Nations Sustainable Development Goals, https://sdgs.un.org/goals/goal10.

[7] Loprespub, “Mental Health Needs of Refugees in Canada,” HillNotes, June 20, 2022, https://hillnotes.ca/2022/06/20/mental-health-needs-of-refugees-in-canada/.

[8] National Immigrant Justice Center (NIJC) Policy Team, “Solutions for a Humane Border Policy,” January 17, 2023, https://immigrantjustice.org/staff/blog/solutions-humane-border-policy.

[9] American Immigration Council, “Beyond a Border Solution: How to Build a Humanitarian Protection System That Won’t Break,” May 3, 2023, https://www.americanimmigrationcouncil.org/research/beyond-border-solutions.

[10] NIJC Policy Team, “Solutions for a Humane Border Policy.”

[11] Luz M. Garcini, et al., “More Humane Immigration Policies Will Reduce Migrant Trauma: A Conversation with Dr. Alfonso Mercado” (Houston: Rice University’s Baker Institute for Public Policy, May 25, 2023), https://doi.org/10.25613/D2QT-4J30. 

[12] Tara Brian, “Occupational Fatalities Among International Migrant Workers: A Global Review of Data Sources,” International Organization for Migration, 2021, https://publications.iom.int/system/files/pdf/Occupational-Fatalities.pdf.

[13] Xuejiao Xing et al., “Effects of Physical Fatigue on the Induction of Mental Fatigue of Construction Workers: A Pilot Study Based on a Neurophysiological Approach,” Automation in Construction 120 (December 2020), https://doi.org/10.1016/j.autcon.2020.103381.

[14] Brian, “Occupational Fatalities Among International Migrant Workers.”

[15] International Labour Organization, “Informal Economy,” https://www.ilo.org/global/topics/dw4sd/themes/informal-economy/lang--en/index.htm. 

[16] Jeffrey S. Passel and D’vera Cohn, “Industries of Unauthorized Immigrant Workers,” Pew Research Center, November 3, 2016, https://www.pewresearch.org/hispanic/2016/11/03/industries-of-unauthorized-immigrant-workers/. 

[17] Roy Germano, “Unauthorized Immigrants Paid $100 Billion Into Social Security Over Last Decade,” Vice News, August 4, 2014, https://www.vice.com/en/article/zm5k8j/unauthorized-immigrants-paid-100-billion-into-social-security-over-last-decade; Stephen Goss et al., “Effects Of Unauthorized Immigration On The Actuarial Status Of The Social Security Trust Funds,” Social Security Administration, Actuarial Note 151, April 2013, https://www.ssa.gov/oact/NOTES/pdf_notes/note151.pdf.  

[18] Garcini et al., “Lessons Learned from Undocumented Latinx Immigrants: How to Build Resilience and Overcome Distress in the Face of Adversity,” Psychological Services 19 (2022): 62, https://doi.org/10.1037/ser0000603.

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