By Kaitlyn Le, Cal Poly Journalism Student
Nearly from the moment the presidential administration changed in 2025, Zandra Alfaro-Olea said she began to see drop-offs in requests for some of the services she provides at Transitions-Mental Health Association (TMHA) in San Luis Obispo.
Families who had shown up reliably to the group’s Spanish language parenting course began missing sessions. Some stopped coming altogether.
Before the election, about 100 people would seek help from the group each month. After, the number immediately dropped by half.
“And now we’re at around 20 people,” per month, Alfaro-Olea said. And the drop was despite the group’s efforts to adapt to concerns by, for example, moving parenting classes from in-person to Zoom.
Across the region, healthcare providers report seeing the same trend, with increased fear making people reluctant to seek routine checkups, follow-up care and mental health support. That fear exists within a broader national context. As of early April, U.S. Immigration and Customs Enforcement (ICE) held more than 60,000 people in detention, one of the highest detention levels in recent years.
“It doesn’t matter if you’re a U.S. citizen or not,” said TMHA Community Engagement Director Michael Kaplan. “People are scared to meet friends in public, about how they present themselves, and about whether a space truly feels safe.”
County of San Luis Obispo Public Health Deputy Public Information Officer Olivia Montiano said she has also noted the trend among Latinx and mixed-status families.
As rumors spread about ICE warrants and possible raids, often people can’t tell whether nearby activity involves targeted enforcement or something broader, creating uncertainty across communities, said Montiano.
Beginning in late summer and into the fall of 2025, Montiano said her department and community partners began to notice clinic appointments dropping off when enforcement activities were reported nearby.
Schools reported attendance declines of about 20% on certain days. Community health events, fairs and festivals were canceled out of concern that public promotion could draw unwanted attention.
“People are going out as little as possible to protect themselves and their families,” Montiano said. “That’s not good for health and well-being in general.”
Rinaldo Caminada is a nutritionist at the SLO NOOR Foundation in San Luis Obispo, a free clinic serving uninsured patients regardless of immigration status. He said he sees a growing number of patients skipping follow-up care for chronic conditions because they are afraid to leave home.
To mitigate the risk of leaving home, he travels with the clinic’s mobile van to Paso Robles and Atascadero to reach migrant farmworkers. Others take phone appointments on their one day off from working in the fields or restaurants, so that medical care does not cost them a day’s wage.
Caminada recalled advising a woman in Santa Maria to walk outside with her children for exercise. Out of fear, she told him she couldn’t. They talked through alternatives she could do without leaving the house.
Money is an important factor. Gov. Gavin Newsom’s 2026 budget cut new enrollment for full-scope Medi-Cal eligibility for undocumented adults and proposes charging premiums for others in the program.
The Noor clinic runs entirely on donations and grants, with doctors, nurses and physician assistants volunteering their time pro bono. Cal Poly students also volunteer as medical scribes.
Caminada said the atmosphere is unlike a typical doctor’s office, with no insurance forms and no long waits.
Such support is needed because medical costs can be so high. Caminada noted that a consultation with a cardiologist in private practice might cost hundreds of dollars.
“But if you’re cleaning hotel rooms, how can you spend $200 to talk to a doctor about your heart?” Caminada said.
“Healthcare is about providing dignity and health, regardless of what your immigration status is,” he said.
To reduce barriers, some Central Coast organizations have expanded telehealth services. Programs such as WIC provide support remotely, while phone interpretation services help bridge language gaps. Partnerships with community clinics and nonprofits including Planned Parenthood, CAPSLO and SLO Noor Foundation continue to operate mobile and pop-up clinics to reach uninsured and rural residents.
As someone whose own family includes some without legal status, Alfaro-Olea of the Transitions-Mental Health Association said she understands that the fear some are facing has health impacts of its own.
Children, she noted, are in a stage of emotional development that requires understanding about how to process the fear of possible separation.
In the Spanish-language parenting course she leads, sessions cover topics ranging from understanding diagnoses such as ADHD and schizophrenia to setting boundaries and practicing self-care. She sees these tools becoming increasingly urgent as health services and access to care grow more limited for undocumented and mixed-status families.
“The fear of people receiving services and [of] going out is delaying treatment for just basic needs, and that’s especially [so] in children,” she said. “It’s only going to be causing, you know, a little more instability, more fear, more anxiety.”
