Boston is widely recognized for its world-class hospitals and public health institutions, yet for many immigrants and people of color, trauma remains an invisible and persistent reality. Post-traumatic stress disorder (PTSD) affects thousands of residents across neighborhoods such as Roxbury, Dorchester, Mattapan, East Boston, and Chelsea, often shaped by migration, racial discrimination, and legal uncertainty.
Trauma That Travels and Lingers
PTSD is frequently associated with combat veterans, but research shows that immigrants and refugees experience some of the highest rates of trauma-related disorders, often stemming from war, persecution, forced displacement, or violence experienced before migration, during transit, and after resettlement.
“Trauma does not stop at the border,” said Dr. Richard Mollica, professor at Harvard Medical School and director of the Harvard Program in Refugee Trauma. “For many immigrants, trauma is cumulative; what they endured before migration is often compounded by what they face after arrival.”
Systematic reviews estimate PTSD prevalence among refugee populations at 40 percent or higher, far exceeding rates in the general U.S. population.
Racism as a Chronic Stressor
For people of color, whether immigrant or U.S.-born, PTSD is not always linked to a single catastrophic event. Researchers increasingly recognize racial discrimination and systemic racism as chronic stressors that can produce trauma-like symptoms over time.
“Repeated exposure to racism keeps the body in a constant state of threat,” explained Dr. Monnica Williams, a clinical psychologist and leading researcher on racial trauma. “That prolonged hypervigilance mirrors the same physiological and psychological patterns we see in PTSD.”
Research indicates that Black Americans face greater exposure to traumatic events and exhibit a higher propensity for developing PTSD symptoms, especially when economic and social inequities compound racial stressors.
Immigration Status and Psychological Harm
Recently, a public plea shared by Hamdia Ahmed of Portland, Maine, underscored how PTSD can surface during moments of isolation and transition. Her brother, Abdisalan Ahmed, who lives with PTSD, went missing while visiting Boston, a city where he had no family or close connections. For nearly two weeks, his family searched hospitals, shelters, and police departments, fearing that his mental health condition and unfamiliar surroundings had placed him at serious risk.
Her experience illustrates how trauma does not disappear once someone reaches safety or crosses borders. For individuals living with PTSD, stress, disorientation, and isolation can quickly become overwhelming, especially without immediate support. Although her brother was later found alive and safe, the fear her family endured reflects a broader reality many immigrant and PoC families face quietly across New England.
Legal insecurity plays a significant role in immigrant mental health. Undocumented immigrants and asylum seekers often live under constant fear of detention or deportation, a condition researchers describe as chronic trauma rather than a temporary stressor.
“Living with ongoing legal uncertainty keeps people in survival mode,” said Dr. Allen Drexel, a psychiatrist who has worked with immigrant patients in Massachusetts. “That fear doesn’t turn off, and over time it erodes mental health.”
Study shows that restrictive immigration policies are associated with elevated rates of PTSD, anxiety, and depression, even among immigrants who have not been directly detained.
Barriers to Mental Health Care in Boston
Despite Boston’s dense concentration of hospitals and clinics, immigrants and people of color are less likely to receive PTSD treatment. Language barriers, lack of insurance, cultural stigma, and mistrust of institutions often prevent individuals from seeking care.
Many clinicians report that trauma frequently presents through physical symptoms rather than explicit mental health complaints, delaying diagnosis and treatment.
“Patients may come in with headaches, insomnia, or chronic pain,” said a clinician at a Boston community health center. “Only later do we uncover a history of trauma.”
Children and Intergenerational Trauma
The effects of untreated PTSD often extend beyond individuals, impacting families and children. Youth in immigrant households may absorb stress from parents coping with trauma, discrimination, or economic insecurity. Research shows that children exposed to prolonged instability face increased risks of anxiety, depression, and academic challenges.
Boston Public Schools and local nonprofits have expanded trauma-informed services in recent years, but advocates note that demand continues to exceed available resources, particularly in historically marginalized neighborhoods.
Toward Healing and Equity
Experts emphasize that addressing PTSD among immigrants and communities of color requires more than clinical intervention. It demands policy stability, culturally competent care, and sustained investment in community-based mental health services.
“Healing trauma is not only an individual process,” Dr. Mollica said. “It is a collective responsibility. Communities recover when safety, dignity, and belonging are restored.”
In a city as diverse as Boston, recognizing the mental health impact of trauma, racism, and immigration stress is not only a public health necessity, but it is also a measure of equity and inclusion.
Abdullahi Hussein is a community journalist focused on uplifting immigrant voices and local stories in Boston. He is also our director of editorial and development.
