Q&A with Social Worker Diana Diaz Madera

World Mental Health Day, observed each year on October 10, offers an opportunity to explore the particularly acute mental health challenges facing people seeking asylum. Asylum seekers have typically fled devastating situations and suffered persecution in their countries of origin. The resulting fear of returning, or of the inability to return home, can cause lasting trauma. Crossing borders and facing border officials can provoke profound anxiety and re-traumatization. Once in the United States, the pursuit of asylum can take years while those seeking asylum and their families also face food and housing insecurities.  

Diana Diaz Madera, a social worker and mental health provider who consults for Human Rights First, reflects on different ways we can assist asylum seekers as they navigate both legal and social landscapes in the United States.

What inspired you to become a social worker and mental health provider specifically in the immigration space?

My own journey as an immigrant from Ecuador to the United States at the age of fifteen shaped my passion for this work. I experienced firsthand the challenges of navigating a new country alone, the complexities of adapting to a different culture, and the impact of feeling disconnected from home but also from the place I relocated. I know what it is like to need and not have, but I also know what it is like to have somebody open a door for me. I will never forget those who gave me second chances and extended a hand to a perfect stranger. Those experiences gave me a deep sense of empathy and a commitment to creating spaces where other immigrants can feel seen, heard, and supported. I didn’t like that people who have suffered are forced to build resiliency. I wanted to create pathways that foster ease, safety, healing, and opportunities for growth, where individuals don’t have to spend their lives recovering from systemic barriers but instead can thrive.

What are some of the most common mental health challenges asylum seekers face when they arrive in the U.S., and how do you address these in your practice?

The most common diagnoses for people seeking asylum in the U.S. are depression, anxiety, and post-traumatic stress disorder due to what they’ve endured before, during, and after migration. Before coming to the U.S., they may have faced persecution, violence, or torture. During their journey, they might experience dangerous conditions, exploitation, or separation from family. And then, after arriving here, they’re confronted with new challenges: navigating a foreign system, housing insecurity, the inability to work for months while awaiting a decision on their asylum claim, and facing discrimination.

This trifecta of pre-, during-, and post-migration trauma can take a serious toll on mental health. I’ve seen individuals arrive with some hope, only to have their symptoms worsen within the first year due to the stress and lack of support. That’s why I take a “whatever it takes” approach to welcoming and supporting asylum seekers, ensuring their basic needs like food, housing, and community connections are in place before we even begin addressing deeper emotional wounds. You can’t focus on healing when you’re worried about where your next meal comes from or where you’ll sleep at night. So, I often work in partnership with grassroots organizations and community agencies to address these needs and offer emotional first aid. From there, we build a foundation for ongoing mental health support.

As a social worker, what types of mental health support do you provide to people seeking asylum?

At Human Rights First, I am helping develop a peer navigator program along with Nicolas Moritz, a Legal and Social Services Coordinator, to train former clients from Human Rights First who have already navigated the asylum process and secured asylum. These peer navigators, equipped with their own first-hand knowledge of navigating the asylum system, can help support new asylum seekers and provide case management. I am training them to provide case management services to address basic needs, help enroll new arrivals for benefits they may qualify for, and provide emotional support to others that stems from their lived experiences on what it is like to rebuild your life in a new context. I also provide technical assistance to our staff on the intersectionality of immigration and mental health.

Outside of Human Rights First, I provide immigration mental health evaluations that are used in court proceedings to document the trauma caused by torture or persecution that people endure while in their home countries, during migration, and upon arrival in the U.S.

How do cultural differences and language barriers impact the mental health support provided to immigrants, and how do you overcome these challenges?

Cultural differences and language barriers are huge. For many immigrants and asylum seekers, the experience of seeking help can be fraught with fear, mistrust, and shame—especially if they’ve had negative interactions with authorities in the past. Language barriers make it even harder to convey feelings of trauma and despair. If you can’t express what you’re going through in your own language, it’s as if you’re being silenced and disempowered all over again.

As a bilingual, bicultural therapist, I understand the importance of providing services in someone’s native language and through a culturally responsive lens. That’s one of the reasons why at Human Rights First we are implementing a peer navigator model to connect people who have lived experiences seeking asylum and may share the cultural background of our clients. 

In the past we have also used art, storytelling, and community-based workshops to create spaces that feel welcoming and familiar to clients, and we plan on building those spaces again with the Peer Navigator program that is launching next week. So in short,  it’s about more than just translation—it’s creating a healing space that affirms someone’s identity and values.

How can we offer psychological support and build a sense of community for individuals during and after the asylum process?

I believe we have to start by creating spaces with people on the move in mind, welcoming spaces built WITH and FOR  for the needs of asylum seekers. This means going beyond traditional mental health services. For example, in my practice, we’ve used art classes, storytelling, poetry, weaving, and clay work as therapeutic tools. These culturally-rooted practices allow people to express emotions that are difficult to articulate through conventional means. Creating navigational guidebooks, introducing new arrivals to community resources, and even organizing simple meet-and-greets with welcoming Americans over coffee can make a big difference.

It’s not just about providing clinical support but fostering a community that says, “Hey, you belong here. This place is better because you are here.” It’s about giving people a sense of agency and the opportunity to take up space with pride and dignity.

How can we promote equity and a sense of belonging when welcoming immigrants to the U.S.?

To promote equity and a sense of belonging when welcoming immigrants to the U.S., we must advocate for humane and streamlined immigration processes and push for policies at the county, state, and federal levels that expand access to essential resources like Medicaid and SNAP benefits in states where these are not yet available to immigrants. True equity at a systemic level means ensuring that immigrants have access to quality healthcare, food and housing security, and educational opportunities.

It’s crucial to address all social determinants of health—including immigration status—and recognize how long processing times for asylum cases and work permits significantly impact individuals’ quality of life and sense of belonging. I believe in the principle that “none of us are well until all of us are well,” so whether through advocacy, policy development, or direct care, we must continue to push for systems that support the well-being of everyone in our communities.

What can the average person do to support new arrivals to the U.S.?

I understand how overwhelming it can feel to see the constant news about war, violence, and displacement—especially when we’re inundated with images and stories through social media. It’s easy to feel hopeless and wonder, “What can I possibly do to help?” That sense of overwhelm can leave us feeling paralyzed, thinking we have nothing to offer. But the truth is, we all have something to give.

I tell people all the time—start small and start where you are. You don’t have to be a social worker or a lawyer to make an impact. Whether you’re a teacher, an artist, a business owner, or simply a neighbor, you have skills and resources that can be put to use in supporting immigrants and refugees. I often tell people: use what you already love to do to make a difference. Some acts might seem small, but they’re incredibly meaningful. Even a seemingly simple gesture like helping someone navigate public transportation or lending a listening ear can make a profound impact.

We can welcome those who have been forcibly displaced, encourage someone on their healing journey, share bread (literally and figuratively) with a new arrival, or simply recognize and honor someone’s humanity—and by doing so, honor our own. Even a small gesture can create a multiplier effect, contributing to a kinder, more equitable world. If you do not know where to start, contact us at Human Rights First and we will gladly use your heart and skills for good.

So, to anyone wondering if they can make a difference, I would say: you can, and you are needed. Start where you are, do what you can, and know that your effort—no matter how small it feels—could be exactly what someone needs to feel seen, valued, and hopeful again. We can build a community that lets every new arrival know, “You belong here. You are free to take up space.”

Is there anything else you’d like to add?

If you are compelled to support those seeking asylum, please consider donating to Human Rights First’s Client Emergency Fund, which helps provide food security, warm meals, blankets and pillows, and clothing for those recently released from detention centers and recent arrivals to the United States. We also have a holiday gift drive where we enlist all hands and hearts to sponsor a family or individuals and provide gifts or groceries. Please reach out if you would like to make a difference.