Central American migrants are suffering from record levels of mental health problems, amid a rise in violent attacks after a US-sponsored immigration crackdown forced them to use more perilous routes through Mexico.



Two-thirds of migrants interviewed at shelters across the country reported suffering at least one violent attack – such as assault, rape or kidnapping – during their journey, according to a survey conducted by Médecins Sans Frontières (MSF) and shared exclusively with the Guardian.

MSF runs three clinics in Mexico, providing care to injured and traumatized migrants with a team of doctors, psychologists and social workers.

Nine out of 10 migrants seen by MSF psychologists this year showed symptoms of anxiety or depression caused by violence and threats suffered during the journey – a three-fold increase since 2014.

The increase in violence against Central American migrants in Mexico is largely down to the Southern Border Plan, an immigration clampdown launched in July 2014 after a surge of unaccompanied minors and families at the US border.

American aid supported the deployment of thousands of Mexican troops to patrol alongside immigration agents. Checkpoints were set up along established migrant routes, forcing people to take even greater risks on their journey north.

Instead of traveling through southern Mexico by catching a ride on top of a freight train known as “La Bestia”, most now journey by bus, on foot or by sea along isolated routes where armed bandits, kidnappers and human traffickers operate with almost total impunity.

“Since the Southern Border Plan, it’s much harder for us to reach people, but the level of violence is even higher than before,” Bertrand Rossier, MSF’s head of mission in Mexico, told the Guardian. “We’re concerned about the humanitarian impact of the plan.”

Mariano Martínez, 39, from El Salvador, is receiving medical and psychological treatment in MSF’s Mexico City clinic.

Martínez was stripped and robbed at gunpoint in August on the outskirts of Chahuites, Oaxaca, where rising numbers of migrants have been violently attacked in the past two years. Most arrive here on foot from Arriaga, a 12-hour walk through isolated orchards and forests; before the Southern Border Plan they sped past the dusty town on top of the train.

Martínez, a truck driver who was trying to get back to New Jersey where he lived undocumented since the age of 17 before being deported, dislocated a shoulder and elbow when he was thrown to the ground by one of the assailants. He has been left with permanent nerve damage and restricted movement in his fingers.

“I feel sad, I can’t sleep, I’ve worked hard all my life, but now I can’t work, what’s going to happen to me?” Martínez said.

According to the MSF study, 54% of those who suffered serious physical violence did not seek medical help because they feared arrest or deportation. The survey is based on interviews with 467 Honduran and Salvadoran migrants conducted in September.

Just over 198,000 migrants were detained by Mexican immigration agents last year, a rise of 130% from 2013. Nine out of 10 of those detained were from the violent northern triangle of El Salvador, Honduras and Guatemala where record numbers are fleeing a relentless war between gangs, organized criminal groups and security forces.

Of those questioned by MSF, 57% said they were fleeing direct threats and violence targeting themselves or their families; half had lost a relative through violence in the past two years. Yet only a tiny proportion of migrants seek refuge in Mexico.

The vast majority of migrants treated by MSF psychologists suffer symptoms such as poor sleep and concentration, low morale, anxiety and difficulties making decisions.

According to MSF psychologist Dora Morales, constant exposure to violence and persecution – both before and after migrants are forced to leave their homes – can lead to serious long-term mental health problems.

Morales said: “The normalization of violence is a symptom in itself, which diminishes a person’s capacity to accurately interpret danger. This can be very dangerous if left untreated as the symptoms can convert into pathologies like PTSD, paranoia and profound depression.”