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Although the citizenship clause of the fourteenth amendment guarantees citizenship to persons born in the United States, the 1996 Immigration Act does not allow illegal immigrant parents to avoid deportation unless such deportation would cause extreme and exceptional hardship to a U.S. citizen relative. This paper reviews the potential adverse effects of such deportation on a child. It presents 12 cases where child and adolescent forensic psychiatric evaluations of U.S. citizen children supported their immigrant parents' petitions for legal resident status. Parent-child attachment, as well as the child's educational status, language proficiencies, acculturation to U.S. culture, and psychiatric distress at the potential deportation, are the factors most helpful in elucidating a child's reaction to this threatened deportation. During the child and adolescent psychiatry evaluations, the parents were interviewed, school records were reviewed and, where appropriate, pediatric records were considered. All the children were examined alone and then as a family unit with their parents using standard DSM-IV-TR diagnostic criteria [1]. Firstly, considering their clinical diagnoses, a clinical prognosis was made for the possibility if the child were to be forced to go to their parents' country of origin with their deported illegal immigrant parent(s). Secondly, each case was examined and analyzed individually to determine the clinical prognosis of the U.S. citizen child if they were to stay in the United States while the illegal immigrant parent(s) was forced to leave. In all of the 12 cases, there was already pre-existing anxiety in the children secondary to the fear of a negative outcome for the parents in the immigration legal cases. In all of the 12 cases it was also determined that the prognosis for the child's adjustment to being without their parent but remaining in the US would have produced a significant exacerbation of the psychopathology already seen. Furthermore, in all of the 12 cases, were the children to be relocated to their parental culture, unfamiliar to the child's American culture, again, the prognosis was made that a significant exacerbation of psychopathology would occur. On the basis of the findings of the child and adolescent psychiatric evaluations and analyses presented to the court, all of the illegal immigrant parents were permitted to receive permanent resident status.

Mental illness and disability affect millions of individuals yearly in the U.S. The most important legislation protecting the mentally disabled in the workplace in the U.S. over the last half century has been the Americans with Disabilities Act (ADA) and its associated legislation and guidance. Although the employee should first request reasonable accommodation with the employer, evaluation by a mental health professional is one of the initial steps for individuals who report significant psychiatric symptoms that are impairing their functioning at work in the U.S.. Important regulations and laws in the United States that are essential knowledge to performing thorough mental disability evaluations include the ADA and Americans with Disabilities Act Amendments Act of 2008 (ADAAA), Social Security Disability, Workers' Compensation, and private disability insurance. These laws differ in applicability and in their definitions of disability. Social Security Disability is applicable to workers who have long-term impairments regardless of whether the disability arose on or off the job, while Worker's Compensation is specific to persons with work-related illness and injuries that occur on the job (Reno, Williams, & Sengupta, ). The Social Security definition of a disabled person is a person who is not "able to engage in any substantial gainful activity because of a medically-determinable physical or mental impairment(s): that is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months" (Social Security Red Book, ). However, the Workers' Compensation definition of what illnesses/injuries are compensated, the level of benefits and who provides the insurance are state-specific. Due to these differences in definition of disability, it is essential for the mental health professional performing a mental disability evaluation to clarify with the referral source or referring agency which legislation and laws they feel are directly relevant to the specific situation before starting the evaluation. While the ADA and ADA Amendments Act of 2008 have had the greatest impact on the improvement of conditions for mentally disabled individuals in employment over the last 25 years, they have also been the most challenging by far for mental health experts to understand and apply (Cook, ). Interestingly, the ADA has had a much quicker effect on improving access to services for the medically disabled as compared with the mentally disabled in the U.S. (Ullman, Johnsen, Moss, & Burris, ). This article reviews the history and status of current ADA- and ADAAA-related law and employment as well as Canadian disability law and global progress towards universal disability legislation as evidenced by the 2006 Convention on the Rights of Persons with Disabilities.