6 and attentive parent, the DFCS worker, representing the role of the state, shamed this young woman and made her feel like she was a poor parent and provider for her child. Jackie recounted a story about a 15-year-old boy who tried to adjust to farmworker life and the painful isolation that often comes with solo migration. This boy was brought across the Mexican border in order to work on a farm in Florida, and a contractor brought him to South Georgia from Florida. He was all alone without family or friends. Several months after arriving in Georgia, the boy began to have panic attacks. One night, he had a panic attack so severe, he thought it was a heart attack, and he called 911 (emergency number) at the barracks where he lived, and an ambulance transported him to the hospital. Jackie was called by the Department of Family and Children’s Services (DFCS) when the hospital realized that he did not have any relatives or guardians. She was asked to take him in, as DFCS had no foster families who would take him and nowhere else to bring him. She decided to take him, and found out that he was not free to go home to Mexico until he paid all of the money back to the contractor who had paid the coyote that crossed him (smuggled him across the border). The boy was concerned that he or his family would be hurt if he did not pay back the money he owed before returning to Mexico. Jackie used her connections to demand that one of the farm contractors pay the bus fare to return the boy to his home and promise not to hurt him or his family. This young man traveled alone, without family or friends, to Georgia, leaving behind his support network. Once farmworkers arrive in Southern Georgia, rather than starting with a clean slate and earning money to send back to their families in Mexico or support their families in the United States, many start with the burdens described in this case. While the living quarters are close, Jackie notes a lack of human connection among the male farmworkers, whose primary socialization revolves around alcohol once the workday is over. Alcoholism is a part of daily life of farm- workers, and alcohol is available even when food is not readily available, as alcohol vendors come around the bar- racks in trucks. As most farmworkers do not have access to their own transportation, they are unable to reliably go out to purchase food or do laundry; however, alcohol is readily available to farmworkers and children of any age. Documentation status has a signiﬁcant impact on the mental health of farmworkers. Access to mental healthcare is a challenge for all Americans, but it is particularly chal- lenging for those who lack insurance, a language in common with most practitioners, and transportation and availability to access services. Unique mental health challenges arise from the circumstances of migrant farmworkers and the con- ditions under which they work and live. Typically, they live with other men in barracks, separated from their wives, children, and extended family. This lack of social support can create situations of extreme anxiety and depression for farm- workers, compounded by their isolation and poverty, and exacerbated by the challenges of identity that spans two cul- tures. Fear of violence and retribution causes unique stress on migrant farmworkers that may not be experienced by other Nursing Research and Practice immigrants. Farmworkers’ lives are often tightly controlled by contractors, the middle men between the growers and the farmworkers, who determine when they are paid, how much, when they arrive and leave the workplace, the type of housing and transportation they have access to, along with other basic services. Contractors are associated with some of the most severe abuses in agriculture, as they control every aspect of daily life of the farmworker [22]. Once farmworkers arrive in Southern Georgia, rather than starting with a clean slate and earning money to send back to their families in Mexico or support their families in the United States, many begin with the burden of repayment of the debt of passage to the United States. Traditional Latino gender norms intersect with the isola- tion of farmwork to make for a very lonely life for many of the male farmworkers in Southern Georgia. Jackie describes explaining to the Family Farmworker Health Project students that male farmworkers might present to the students with what seems like a minor injury, and they are looking for caring and emotional support that they do not often get in their daily lives, as many are separated from their mothers, wives, and children. In addition, traditional gender norms adversely impact women, who are often expected to prepare food for men in the adjacent barracks, while also working in the ﬁelds or packing sheds for 10 to 12 hours per day. Jackie commented that if a woman ends up in a domestic violence shelter, the goal of the shelter is to assist women in becoming self-suﬃcient, which requires employment. If the woman is undocumented, she cannot become employed, which creates a grave problem for undocumented women who are abused. Jackie also speculated that sometimes men would prefer that their female partners remain undocumented as a way of maintaining power over the household. While the majority of farmworkers in southern Georgia are undocumented, women are even more likely to be undo- cumented than men, as they may have joined their spouses in Georgia who are on H2A visas illegally [23]. Women who migrate with their partners bear unique vulnerability to mental illness and violence due to the gendered power dif- ference within the family [24]. In addition, the fear of deport- ation often creates anxiety and depression. Jackie reported a very high level of domestic violence within farmworker families. If the couple has diﬀering legal status, this may pre- vent women who are abused from seeking help due to many barriers, including a language barrier, lack of autonomy, and fear of deportation. While there is a way of receiving tempo- rary documentation if a woman is being abused (a U visa), substantial paper work and legal representation are required [25]. 4. Conclusion As with all case studies, our ability to generalize the ﬁndings of this case study to other cases is limited. While the results of this case study identify critical themes of migrant farmworker health among a small, rural population of farmworkers in southern Georgia, the salience of invisibility, isolation, and limited access to healthcare has been noted in several previous studies. Garcia and Gondolf identiﬁed situational