As a licensed clinical psychologist, I have evaluated many immigrants and U.S. citizens affected by actual or threatened deportation. This includes individuals in removal proceedings and family members living in prolonged uncertainty about a spouse’s or parent’s immigration status. Across these evaluations, one clinical pattern recurs repeatedly: the onset or significant worsening of Major Depressive Disorder (MDD).
Major Depressive Disorder is not ordinary stress or sadness. It is a serious psychiatric illness that interferes with basic functioning. Common symptoms include persistent hopelessness, impaired concentration, disrupted sleep, changes in appetite, and a reduced ability to work, parent, or manage daily life. In immigration-related cases, these symptoms are not brief reactions to bad news. They are sustained, worsening, and clinically significant.
The ongoing threat of deportation or forced family separation is a well-established risk factor for depression. Individuals often report an overwhelming sense of helplessness, compounded by financial instability, housing insecurity, and the sudden disruption of family roles. The stress rarely affects just one person. Entire family systems destabilize, and depressive symptoms frequently emerge among U.S. citizen spouses, children, and other dependents—not only in the individual facing removal.
Major Depressive Disorder is the diagnosis most commonly linked to suicide. In my evaluations, immigrants and their U.S. citizen family members often describe an inability to imagine life continuing after the loss of a spouse or parent to deportation. Many are in long-term marriages, raising U.S.-born children, working steadily, and deeply rooted in their communities. Others express intense fear of being returned to countries they fled because of violence, persecution, incarceration, or harassment. For these individuals, deportation represents not only separation from family but also a return to trauma and danger.
As removal becomes more likely, depressive symptoms often intensify. Suicidal thoughts are frequently reported and, in some cases, expressed clearly and repeatedly. In these situations, the psychological harm associated with deportation is not hypothetical. It is immediate, foreseeable, and potentially life-threatening.
The following clinical examples illustrate these risks.
Mr. M. is a 40-year-old United States citizen with a history of childhood depression following his father’s death. He reported significant emotional improvement following his meeting with his wife, noting greater stability, purpose, and hope. The couple married in 2021 and has a young daughter. They function as a close family unit and also assist in caring for Mr. M.’s aging, ill mother.
After his wife’s immigration status became uncertain, Mr. M. experienced a relapse of depressive symptoms and now meets full diagnostic criteria for Major Depressive Disorder. During his psychological evaluation, he repeatedly stated that he would “kill himself without his wife,” explaining that separation would be psychologically unbearable and an impossible hardship.
Ms. L. is a United States citizen who reports that she sees no viable alternative to suicide if her husband were deported. She describes herself as emotionally, financially, and logistically dependent on her husband. The couple married in 2002 and has two children. She describes their relationship as stable, loving, and deeply supportive.
Ms. L. has been unable to work for years due to declining physical and emotional health. After a severe case of COVID-19, she continues to experience chronic cardiac complications, fatigue, and weakness. Her husband has assumed full financial responsibility for the family while supporting her recovery. Ms. L. reports spending much of her day lying down because of limited stamina. The threat of her husband’s deportation has significantly worsened her depression and suicidal ideation. She stated that she would “have no choice but to kill herself” if he were removed.
Conclusion and Implications for Legal Practice
Clinical evidence makes clear that the threat of deportation and forced family separation poses a serious and foreseeable risk to mental health, including the development or worsening of Major Depressive Disorder and the emergence of suicidal ideation. For many families, deportation is not merely a legal consequence—it is a psychologically catastrophic event with potentially fatal outcomes.
Mental health evaluations in immigration proceedings provide critical insight into the real-world consequences of removal, particularly when U.S. citizen spouses or children are involved. Psychological Evaluations and careful consideration of these clinical realities are essential for assessing extreme hardship and for understanding the true human cost of deportation.
