Social services and mental health care are difficult enough for many Americans to access, but a unique set of challenges arise for recent migrants in need of care.

New arrivals may be unfamiliar with the country, may speak different languages and may not have money or insurance. As the U.S. grapples with a shortage of social and mental health workers, more refugees are arriving in the country, fleeing violence, poverty and persecution from their homelands.

“They’re leaving their home country because they feel they have no choice if they want to survive,” said Aimee Hilado, an assistant professor at the University of Chicago Crown Family School of Social Work, Policy and Practice. “Oftentimes, their journeys are filled with trauma and a great deal of stress. So many of them talk about never feeling safe and never knowing when the fear is going to subside.”

Hilado is the chair of the Coalition for Immigrant Mental Health and has been on the frontlines welcoming new arrivals to Chicago since Texas Gov. Greg Abbott began bussing them to sanctuary cities across the country as part of “Operation Lone Star.” More than 105,000 migrants have been transported since 2022, Abbott said Friday in an update marking the three-year anniversary of the initiative.

For those who work with refugees and migrant new arrivals, the last couple years have taken a harder toll on workers in an already difficult field. That could explain why, for Social Workers Month this March, this year’s campaign is “Empowering Social Workers.” That means providing more support — including better compensation — according to the National Association of Social Workers.

“The work is not easy,” Hilado said. “In my 17 years of practice, I’ve been witness to the darkest sides of what human beings can do to one another.”

An exploratory study available through PubMed Central found that social workers who work with immigrants see their practice as an important response to defend human rights concerns, including due process, right to asylum, access to legal representation and freedom from detention, persecution and torture.

Social workers have increasingly needed to address racism, xenophobia and rising anti-immigrant rhetoric against their clients in the last few years. They may also be restricted in the aid they can offer families due to their mixed immigration status. Furthermore, migrants, refugees and their children may hesitate to report employer exploitation, domestic violence and child abuse because they fear deportation, according to a report by the Crown School.

Cathi Tillman is the executive director of La Puerta Abierta, a nonprofit organization based in Philadelphia that helps Latino immigrant and refugee communities gain access to mental health care. Tillman found that social workers are struggling to “provide sufficient attention to the needs of our immigrant neighbors, due in part to the massive amount of ‘other’ needs identified in our community.”

Hilado said the workforce has to adjust how they speak and engage with recent arrivals so they do not activate past trauma. When she visits the emergency shelters, migrants talk to her about their grief: the loss of their home country, the family left behind and the people who couldn’t complete the journey. Migrant parents especially struggle knowing that their children were put through horrific experiences in pursuit of a better life.

Social work is among the professions with the highest risk of chronic stress and burnout. Hilado said people in this field could also experience second-hand trauma if the workforce does not address the impacts or regularly check in with staff. She said her team practices reflective self-care strategies and takes preventative measures to get ahead of burnout.

“For people to live to their fullest potential, sometimes they need additional supports that simply aren’t available. Social workers create pathways for opportunity,” Hilado said. “Oftentimes, people don’t come to us because they’re doing well. It’s because there’s internal suffering and a desire to heal. It’s a wonderful opportunity to be in a position to give reprieve.”