As President Donald Trump considers a new executive order on immigration, many refugees in New Haven are now looking to the future with trepidation. A young Syrian girl waiting for her parents and siblings. An Afghani man waiting for his wife and children. Two Iranian sisters waiting for their mother. A Sudanese man waiting for his wife. They are among hundreds of refugees waiting for family members to join them. Maybe they will be waiting a long time.

Often they do not know why they were approved for refugee status ahead of other family members. They do not know why their family members are still in Jordan or Turkey or Indonesia while they got their visas for travel to the United States. But when they are approved, they have to come. When the choice is between dying in your country versus living illegally in an unsafe and overcrowded refugee camp versus accepting a legal invitation to start life in a safe and democratic country, it is not a real choice. Not if you want to survive.

So they come and hope that their families will follow soon. One signature has put that into jeopardy. The courts have granted relief, but that too could change. The future of refugee resettlement into the United States hangs in the balance. Family reunions are delayed, perhaps never to happen. These refugees arrived in a country that welcomed and supported them, then suddenly hear they are not really welcome anymore. Now they are not only alone in a foreign land, but the future is frighteningly uncertain.

Refugees try hard to build a life here, but it is not easy. They look for jobs, they enroll in classes and they throw themselves into learning English, all through the local resettlement agency — Integrated Refugee and Immigrant Services — which helps them settle here.

I see hundreds of refugees every year in our clinic at Yale New Haven Hospital. They all come with stories of persecution, ranging from rape and torture to death threats against their families for helping the United States armed forces in Iraq and Afghanistan. Some have undergone unimaginable horrors. They have witnessed their entire families slaughtered before their eyes, yet have survived a decadeslong journey to eventual freedom.

Whatever their level of trauma, the one thing they all have in common is loss. Loss of family, loss of home, loss of livelihood and most importantly loss of a sense of belonging. They share a common struggle, the burden of learning to live in a new land and starting life over, impoverished and alien. Even refugees with incredible tales of perseverance and survival struggle to adjust. The most resilient refugee sometimes breaks under the strain. Add to this the additional anxiety and distress of long-term separation from family members and the prospect of living in a country that views them as terror threats.

I see refugees who suffer from post-traumatic stress disorder. But I see more refugees with depression and anxiety disorders resulting from the stress of assimilation. PTSD only worsens the impact. The struggles of refugees are not new. However, the country that should support them will now contribute to upsetting their already fragile mental state.

There are thousands of refugee applicants overseas waiting while their lives and their families’ hang in the balance. The new restrictions on refugee entry are extremely troubling, both for its impact on these people and for many other reasons. As I join colleagues and activists in my constitutional right to protest the ban on refugees, I will continue to see patients who are here and are affected by this ban. As a physician, I will strive to provide the best quality of health care to keep them physically and psychologically healthy.

But there is one more thing I will do. As a citizen of the United States, I will say to every refugee I see in my clinic, “You are welcome here.”

Aniyizhai Annamalai is a professor of psychiatry and internal medicine at the Yale School of Medicine. Contact her at .