Jorge Rubiano arrived alone in Chicago, but his pain and trauma came with him.
For months, he tried to find steady work. For months, he's been sleeping in a crowded temporary shelter, worrying about his wife and mother back in Colombia. Are they safe? Did I make the right decision?
He recalls a frightening phone call with his wife in Colombia, cut short when the bus she was riding on was being robbed.
Rubiano, 43, is also haunted by memories of his harrowing journey to Chicago, during which he says he was kidnapped for a month, before escaping.
He left his country, he says, over a land dispute in which the government threatened his life.
"I'm still in between two dangers," Rubiano says in Spanish. "If I return it's very possible they kill me, and if I stay I don't know what can happen here."
More than 30,000 migrants and asylum seekers have arrived in Chicago since August of 2022 — most of them from South and Central America. They are fleeing the collapse of their economies, a lack of food and jobs, and violence back home.
Many came here on a bus from Texas, sent by Republican Gov. Greg Abbott, who said Chicago — and other so-called sanctuary cities that embrace immigrants — would provide much-needed relief "to our small, overrun border towns."
The buses haven't stopped since.
Migrants fleeing hardship, danger, fear and loss
Interviews with more than 30 people reveal the emotional toll migrants face, and the efforts of individuals and organizations that are trying to fill the gaps of a frayed mental health system.
Some of those efforts are catching the attention of leaders in other big U.S. cities also coping with large influxes of newly-arrived migrants.
For many, their journeys here were terrifying. A young girl who fell into a river, her pregnant mother struggling to hold her small hand, so the current wouldn't whisk her away. Women who were forced to have sex with gang members to get from country to country. People who walked over the dead in the jungle, or are wracked with guilt over the sick and injured left behind.
Their stories have unfolded across Chicago: in the quiet space of a therapist's office, at an informal healing circle in the back of a store, with a nurse at a folding table propped up outside a police station.
But for many migrants, taking care of their mental health might not be a priority.
"They're in survival mode," says Sharon Davila, a school-based social worker who has screened migrant families. "They need their basic needs met. The number one thing is they're looking for jobs."
Just getting in front of a therapist or a social worker can be extremely difficult for even the most savvy and persistent. With a shortage of mental health workers, wait lists for an appointment can be months long.
Layer on being new to this country, speaking a different language, and having no health insurance. Getting help can seem impossible.
Therapist Susie Moya worries about a mental health crisis brewing for many migrants.
"Right now it's on the back burner," says Moya, who has worked with migrants on Chicago's Lower West Side. "But I'm thinking a year from now when these families are settled in. Who is going to be providing that support?"
Informal support, with a side of soup
It's a Monday night in the back room of an insurance agency on the Southwest Side. About 20 migrants have arranged their chairs in a circle. Each person takes a turn describing how they feel on a scale of one to 10, as social worker Veronica Sanchez gently encourages them to share why.
Warm homemade chicken soup and arepas await them for dinner.
A woman says her husband got deported, and she's heartbroken that she left her children behind. A man says he worked several days that week, but never got paid. Another says he is grateful to God for bringing him to America, but he misses his mom, dad and brothers.
Finding work and reuniting with family is important, Sanchez tells them. But right now she's concerned about their mental health.
"Maybe we have answers. Maybe we don't. But when you open up a safe space where you can share your sorrows... you don't feel so alone," Sanchez says in Spanish.
Sanchez understands the migrants' desperation. She comes from a long line of pottery makers in Mexico. Sanchez was just four years old when her father left to work in Cicero, a suburb outside Chicago. She didn't see her father for almost seven years, until they were reunited as a family in Cicero.
Those memories fuel her work with the healing circle. "When I was talking to them, it really came from the heart," Sanchez says. "I was seeing the migrants' faces, that they were so scared."
Informal support groups like this one have popped up around Chicago in shelters, storefronts, churches and schools, led by volunteers or mental health professionals.
Many of these support groups don't last long. Volunteers get burned out. Migrants prioritize other needs. Or the city moves them from place to place.
The costs of ignoring loss and trauma
Some volunteers and mental health providers emphasize that not every migrant might be experiencing severe trauma.
But for many, trauma can have lasting impact. Trauma can change the wiring in a person's brain and make someone more vulnerable to depression and anxiety.
Daily or ongoing stressors can add up to what Chicago psychologist Laura Pappa calls "little t trauma" — like not feeling welcomed right away.
"A lot of people come here seeking the American dream and they realize that that's not there," says Pappa, who came to the U.S. from Argentina as a teen. "A lot of people were not expecting that, how hard it is on this side. I've had a lot of parents who've come alone and ask themselves, was it worth it?"
It can be hard to persuade migrants to seek help, however. There's a stigma about the need for mental health care in many immigrant communities, particularly among Latino men, Pappa says.
But, she adds, the stigma is easing as talking about emotions becomes more common.
Training the front-line workers in shelters
One effort to provide faster help involves training hundreds of people who don't have a medical background, but work in city-run shelters. These front-line workers, such as case managers and shelter supervisors, are learning to lead support groups called Café y Comunidad charlas — coffee and community talks.
The initiative is led by the Coalition for Immigrant Mental Health, the University of Chicago's Crown Family School, and Lurie Children's Center for Childhood Resilience.
The idea is to help migrants feel less isolated and try to prevent the most extreme outcomes, such as suicide.
"We have to help people the minute they arrive," explains Aimee Hilado, an assistant professor at UC's Crown School and chair of the coalition. "That's actually going to promote healing down the line."
Case manager Albert Ayala has led a charla in the ballroom of a downtown shelter. He recalls moments of joy, such as when a woman said she was searching for love — and hands shot up hoping to catch her attention.
Ayala says he's watched migrants who arrive scared and shy blossom after attending a charla.
"We try to tell them we're no different from you," says Ayala, who is Mexican American. "Your dream is possible."
Leaders in Philadelphia and San Jose have reached out asking how to replicate the effort, Hilado says.
Outside his shelter, Rubiano, the migrant from Colombia, says he hasn't attended one of these support groups. He says he tries to keep busy working on his English skills. And he recently found a full-time job in a supermarket.
He longs for his family, and for the chance to bring them here — once there is a stable life he can offer them.
This story comes from NPR's health reporting partnership with WBEZ and KFF Health News.
WBEZ's Manuel Martinez contributed to this report.
WBEZ is part of the Mental Health Parity Collaborative, a group of newsrooms covering stories on mental health care access and inequities in the U.S. The Collaborative's partners include The Carter Center, the Center for Public Integrity and newsrooms in select states across the country.
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