As a Psychiatric-Mental Health Nurse Practitioner (PMHNP), I often observe the intersection of mental health, social injustice, and citizenship rights in my practice. Birthright citizenship, established by the 14th Amendment, grants citizenship to anyone born on U.S. soil. Ratified in 1868, the 14th Amendment was pivotal in addressing injustices faced by formerly enslaved individuals. It represented belonging and a foundation for civil rights, providing Black Americans with access to legal protections and the ability to challenge systemic discrimination. During the Civil Rights Movement, birthright citizenship served as a cornerstone for fighting oppressive laws, shaping the mental health landscape for Black Americans today.
Currently, birthright citizenship remains a contentious issue. Debates surrounding immigration often overlook its implications for Black Americans. The potential loss of this status poses significant risks, making individuals vulnerable to deportation and legal discrimination while stripping them of essential rights like voting and access to public services. This loss could exacerbate socioeconomic disparities in education, healthcare, and employment, destabilizing communities and increasing poverty. Furthermore, a reduction in citizenship rights could undermine political representation for Black Americans, limiting their ability to advocate for systemic change.
Notably, the Supreme Court is expected to make a decision around June 2026 regarding immigration rights—an ironic timeline as it coincides with Juneteenth, celebrating the emancipation of enslaved individuals. This juxtaposition highlights the ongoing struggle for true freedom and equality, as the implications of the Court’s decision may further complicate citizenship rights for Black Americans. The historical context of the Dred Scott v. Sandford decision, which viewed Black Americans as property and thus denied citizenship, serves as a stark reminder of the fragility of these rights (Dred Scott v. Sandford, 1857).
The potential removal of birthright citizenship can exacerbate the effects of Post-Traumatic Slave Syndrome (PTSS), a theory that suggests the historical trauma of slavery continues to affect the mental health of Black individuals today. Feelings of disenfranchisement and anxiety about citizenship status can trigger symptoms unique to this population, including heightened vigilance, chronic stress, sleep and appetite disturbances, apathy, and a pervasive sense of hopelessness. These mental health challenges are compounded by systemic inequalities that Black Americans face, making it essential for healthcare providers to address these intersections in their practice.
As healthcare providers, PMHNPs have a responsibility to advocate for patients beyond clinical settings. Recognizing how social determinants of health, including citizenship status, influence mental health outcomes is crucial. By addressing these intersections, we can better support the mental health of Black Americans and foster a more inclusive society for all.
Citations
Kam, B. (2025). Cornell Journal of Law and Public Policy. McKanders, K. (2025). Citizenship Denied: From Dred Scott to Deportation. ■