For Claudia Perez, stress, anxiety and fear are a part of everyday life.

The 24-year-old recipient of the Deferred Action for Childhood Arrivals program is always wondering if she has seen her family for the last time, a common feeling where she lives in Santa Ana, a Southern California city where immigrants make up 46 percent of the population.

“Every day I fear for my family,” said Perez, who came to the United States from Mexico with her parents when she was 5.

“Whenever they go to work, I’ll come home thinking, ‘Oh wait, did my mom get picked up by ICE (U.S. Immigrations and Customs Enforcement), or did she have any contact with the police?’”

Perez and her family are not alone.

According to a survey conducted this year by The Children’s Partnership, an advocacy group in Los Angeles, 90 percent of health care providers across the state report an increase in anxiety and fear in children from immigrant families since the 2016 presidential election. About 70 percent of these patients show an increase in depression symptoms.

Fear of deportation has also impacted access to health care, with 42 percent of providers reporting that children from immigrant families are skipping more medical appointments. And 40 percent of immigrant parents told providers they are considering opting out of public health care, food stamps or other benefits, presumably over fear that the information they provide to the government could be used to deport them.

But one way to counteract these negative health outcomes has been activism.

When California voted last year to become the first “sanctuary state” in the country, prohibiting state and local agencies from coordinating with federal immigration authorities such as ICE, “that was a big win,” said Perez, who serves as executive director of the immigrant youth organization Resilience Orange County.

Now, in the face of escalating anti-immigrant rhetoric and policies since the 2016 election, immigrant rights groups across the state have been developing innovative strategies, such as cell-phone warning systems and know-your-rights workshops to protect their own communities from federal immigration authorities—a move organizers say can not only prevent deportations and detentions, but also combat the fear encompassing immigrant communities today.

“Even though there’s this campaign of fear and hatred, we’re seeing our communities fighting back and not letting ourselves be intimidated,” said Carlos Perea, policy director for Resilience Orange County. “We’re saying, ‘What can we do? What steps can we take to make sure that we push back?’”

Perea is also a recipient of the Deferred Action for Childhood Arrivals. Known as DACA, the Obama-era policy to gives legal status to young undocumented immigrants who came to the United States as children. Last year President Donald Trump announced plans to phase out the program.

Texting ‘ALERTA’ for ICE Updates

Perhaps the most common deportation-resistance tool used across the state is a rapid response network, which sends text messages or social media alerts about ICE activity.

Last year the Central Coast Alliance United for a Sustainable Economy launched such a system in Santa Barbara and Ventura Counties. By texting “ALERTA” to the phone number 24587, or visiting 805immigrant.org, residents can receive updates about local ICE operations, and can also provide tips or correspond with organizers. The system has about 2,500 users and sends about four to six messages per month, according to Frank Rodriguez, policy and communications associate for the Alliance.

One of the primary purposes of the rapid response network is “squashing rumors,” Rodriguez said. For instance, a rumor that 14 people had been picked up at a Winchell’s Donut House in a predominantly Latino neighborhood in Santa Barbara sparked panic last year, he said—but the raid never happened.

“We use this not only as a way to clarify rumors, but also to empower people,” Rodriguez said. “We’re trying to make sure that we’re not just perpetuating fear, but letting people know that they have the agency to take steps to help themselves and to be prepared.”

Other groups, such as the Los Angeles-based Coalition for Humane Immigrant Rights, directly confront ICE through organized actions.

Cinthia Flores, legal and policy counsel for the organization, said the group has focused its efforts on I-9 audits, which are used to verify that employees have legal authorization to work and have been issued to several Los Angeles employers this year. By organizing the community at work sites where I-9 audits are scheduled, ICE has backed down, she said.

“We are all well aware that I-9s are within the scope of authority for ICE, but what we’ve seen is that sometimes there are collateral pickups,” Flores said. “We want to be vigilant and think about all the ways that folks are at risk when ICE is present in communities.”

And in the Bay Area, the Services Immigrant Rights and Education Network trains immigrants how to interact with ICE at home, work or in public. The San Jose-based group runs know-your-rights, deportation-defense and safety-planning clinics. The workshops offer legal support for those in detention or facing deportation, help families prepare guardianship if a parent is taken away, and teach residents how to stand up to ICE.

“A lot of times ICE doesn’t have a judicial warrant for the individual they’re picking up,” said Maricela Gutierrez, executive director of the Network. “If folks would just know their basic rights, it could prevent them from being detained, in many instances.”

For instance, one family attended a clinic and later had ICE knock on the front door, she said. Instead of letting them in, the family slid a know-your-rights card under the door to the agents outside. The card reads, in part, “If ICE shows up at your home, DO NOT open the door, ask for a judicial warrant signed by a judge,” which is one of the rights that anyone has, regardless of immigration status.

After seeing the card, the ICE agents left, Gutierrez said.

A Setback and a Plot Twist

But with these victories are also new challenges.

Proposed changes to federal immigration policy revealed last month would penalize immigrants seeking legal permanent residence for using public benefits such as CalWorks, CalFresh and Medi-Cal.

Doreena Wong, director of the health access project for Asian Americans Advancing Justice-Los Angeles, said that even though the proposal hasn’t been finalized, it’s already having a negative impact on immigrant communities’ access to health care.

“They’ll be eligible for public benefits but they won’t apply for them because they’re worried they’ll be used against them,” she said. “We’re already seeing people who have heard about this and are thinking about dis-enrolling.”

And in Orange County, the city of Los Alamitos voted last month to exempt itself from the “sanctuary state” law, and to join U.S. Attorney General Jeff Session’s lawsuit against the policy, becoming the first city in California to do so. The county’s Board of Supervisors followed suit, and several other cities are considering similar measures.

The Orange County decisions were “devastating,” said Resilience Orange County’s Perez, but have also sparked courage across the immigrant community. Now, the group has developed a twist on the traditional rapid response network, by using its alert system to send notifications about anti-sanctuary ordinances across the county in order to mobilize resistance.

“We want to make sure that the community has the power,” said Perea, with the same organization. “Even though they’re undocumented, we have power that we can exercise … in shifting the public’s perceptions of how people see immigrants.”