Immigrant and Refugee Mental Health Support

Finding Mental Health Support in the United States

Finding someone to talk with can be harder when you are also learning how a health system works. You may want counseling but need an interpreter, an affordable appointment or help understanding what a clinic will ask you. Those practical needs belong in the conversation about care.

Mental health support can mean treatment and help reaching that treatment. Counseling provides time to discuss concerns with a mental health professional. A medical visit can address symptoms and medication needs. A case manager helps arrange services, such as appointments or referrals. Some immigrant and refugee health programs bring these services together.^[1]

Moving countries does not tell a clinician what diagnosis, if any, you have. Guidance from the Centers for Disease Control and Prevention (CDC) distinguishes screening, which identifies a possible need for further assessment, from diagnosis. A clinician should consider your symptoms and how daily life is affected.^[2]

Where to Find Mental Health and Addiction Care

Start With a Community Health Center

If you do not know where to begin, use the federal health-center locator to find a nearby center. The Health Resources and Services Administration (HRSA) says anyone may use a community health center, with or without insurance. A sliding-fee scale means the amount you pay depends on your income. Ask the center which mental health or addiction services it offers and what a visit would cost.^[3]

You can also ask an existing primary care professional for help. Tell them what is difficult, such as persistent worry, sleep problems or concerns about alcohol. You do not have to choose a diagnosis before asking for an assessment.^[2]

Ask What an Immigrant or Refugee Program Provides

Some programs combine medical treatment with practical support. For example, Boston Medical Center’s Immigrant and Refugee Health Center describes primary care, mental health care, refugee health assessments and case management. Its mental health program includes counseling and medication management. This is a Boston service example, not a promise that the same program is available nationwide.^[1]

When contacting a local organization, ask: “Do you provide counseling or medical care, or do you help me find another provider?” Then confirm eligibility, location and appointment availability. A useful referral should leave you knowing whom to contact next.

In a published Boston Medical Center podcast, social worker Lily Sonis explains that traveling to a distant hospital is not practical for some patients. Connecting them with mental health services in their own communities can make more sense.^[5] Ask for a nearby option if travel would keep you from attending.

For broader questions about cost, scheduling and transportation, explore accessing mental health and addiction care. If you need alcohol or drug treatment, ask what the service provides before choosing among levels of addiction care.

Ask for Care in Your Preferred Language

Tell the clinic which language you want to use when you arrange the visit. A bilingual clinician speaks more than one language. An interpreter helps you and a clinician communicate when you do not share a language. The National Alliance on Mental Illness (NAMI) recommends asking for a qualified interpreter when your provider does not speak your native language.^[4]

Make the arrangement specific. You could ask:

• Can I speak with the clinician in my preferred language?
• If an interpreter is needed, who will arrange one?
• Can the interpreter understand my dialect?
• Will interpretation be in person, by phone or by video?
• Is there a charge, and who pays it?
• Can someone help me understand appointment instructions and forms?

Ask the office to confirm the arrangement before the appointment. If it cannot, ask who can help find an appropriate alternative.

Federal standards for culturally and linguistically appropriate care call on health organizations to offer language assistance at no cost and use competent interpreters. They discourage relying on untrained people or children to interpret. These standards describe good care. Confirm how the clinic provides language assistance rather than assuming every office follows the same process.^[6]

You may also want a clinician familiar with your background. Describe what that means to you: being able to discuss migration, racism, religion, family expectations or a previous difficult care experience. Shared language is one consideration. Experience with your concern, cost and availability matter too.^[4]

Understand Costs and Insurance Eligibility

Being able to get a clinic appointment is different from qualifying for an insurance plan. Ask about both. A clinic’s financial counselor can explain its fees and assistance process. For Marketplace insurance, use the current eligibility information from HealthCare.gov.^[3][7]

HealthCare.gov states that undocumented immigrants cannot get Marketplace coverage, although they may apply on behalf of documented individuals. That restriction does not mean every other route to care is closed. HealthCare.gov also points people who cannot get Marketplace coverage toward community health centers.^[7][8]

Coverage and financial help with premiums are separate questions. As checked in October 2026, HealthCare.gov warns that eligibility for Marketplace savings changes on January 1, 2027. Someone may qualify for coverage without qualifying for those savings. Check the rules for the year you need care instead of relying on an older article or someone else’s experience.^[8]

Before agreeing to an appointment, write down the answers to these questions:

• What will the first visit cost, and what will later visits cost?
• Is there an income-based fee or another assistance program?
• What documents are needed to apply for that assistance?
• Are medication visits, tests or other services charged separately?
• If I have insurance, does this clinician accept my specific plan?

Ask the clinic for a written estimate and confirm which charges it includes.

Discuss Privacy and Immigration Concerns

It is reasonable to want to understand a form before completing it. You can ask the clinic: “Why do you need this information, who can see it, and is it required for this service?” You can also ask how reminders, bills and messages will reach you.

Health privacy protections have limits. Federal privacy rules allow certain sharing of mental health information, including for treatment. Ask the clinic to explain when it may share your information, whether family members can access it and how you can communicate privately. Do not assume that “confidential” means information can never be shared.^[9]

Keep clinical and legal questions separate. A clinician can explain treatment. A financial counselor can explain a program’s application process. If you are concerned about an immigration application or the consequences of using a particular benefit, seek qualified immigration-law advice about your circumstances. Do not treat a general health article as an individualized legal answer.

An organization may be able to help connect you with legal assistance. Boston Medical Center’s current service description, for example, includes referrals for legal consultations for asylum seekers.^[1] Ask locally what is available and whether there is a cost or waiting list. A referral does not itself mean that someone has agreed to represent you.

The Justice Department’s Find Legal Representation resources link to recognized organizations, accredited representatives and providers offering free legal services. Check whether a listed service handles your type of case and can accept you. Being listed does not guarantee that it can represent you.^[10]

Prepare for Your First Appointment

An appointment can begin with what you are experiencing now. Write down the main concern, how long it has been happening and what it makes harder to do. If you already receive treatment, bring the names of medicines and contact details for your care team when available. CDC guidance emphasizes connecting refugees with ongoing care and avoiding gaps in treatment.^[2]

The example below is an illustrative script. Change the details to fit your situation:

“I am looking for help with worry and sleep. I would like to speak in my preferred language, and I need to understand the cost before booking. Are you accepting patients? If you cannot see me, who can help me find another service?”

Before ending the call, aim to have four things written down:

1. The service: who you will see and what the appointment is for.
2. The language arrangement: how you and the clinician will communicate.
3. The cost: the estimate and any assistance still to be arranged.
4. The next step: when the visit happens, who will call whom, or which service you should contact next.

If the conversation ends with a referral, ask whether you should call the next service yourself. If you cannot reach it, return to the referring office for help.

Consider Online Care and Local Follow-up

Online care may be an option, but ask what the provider can treat remotely and whether it is suitable for your concern. Federal telehealth guidance recommends checking what appointments are offered, how to arrange them, whether insurance pays and what costs you must cover.^[11]

Tell the provider where you will be during appointments. Ask whether it can serve you there and arrange any needed interpreter. Also consider whether you have a private place to talk and a workable phone or internet connection. These are questions to resolve with the service before booking.

Your location matters because a telehealth professional generally must be licensed or otherwise legally permitted to practice where you are receiving care. Ask again before an appointment if you travel to another state.^[12]

A provider’s online booking page does not answer every question about your needs. If counseling alone does not address your alcohol or drug concerns, ask what additional assessment or care is available. Use the online addiction treatment guide to prepare further questions about the services a program offers.

Getting Crisis Support in Your Language

For emotional distress or a suicide crisis in the United States, call or text 988. For Spanish-speaking support, call 988 and press 2, or text “Ayuda” to 988. For other languages, call and say the language you need. The 988 Lifeline provides interpretation in more than 240 additional languages through voice calls. That interpretation service is not the same as multilingual text support.^[13]

A medical emergency needs immediate help. If you suspect an opioid overdose, give naloxone if available and call 911. Naloxone is a medicine that can reverse an opioid overdose. Stay with the person until emergency help arrives.^[14]

If you drink heavily on a regular basis, ask a medical professional about stopping safely. Alcohol withdrawal can become life-threatening. Seek urgent medical help if you think you are in withdrawal. Call 911 for a seizure or severe confusion.^[15]

If you regularly take a benzodiazepine, such as Xanax® or Valium®, do not stop suddenly without speaking with your prescriber. These medicines can cause dangerous withdrawal even when taken as prescribed. Ask for a plan you understand, with an interpreter if needed.^[16]

Start Finding Mental Health Care

You can begin with one call and one practical need: finding someone who can help in your preferred language, at a cost and location you can manage. Ask for help arranging the next step if the process is unfamiliar. Preparing for cost, scheduling and transportation barriers can help you decide what to ask.

If you need crisis support while looking for ongoing care, call or text 988. Call for interpretation in a language other than English or Spanish.^[13]