Migrant Children Face Trauma Without MH Support
Abstract
Recent reports have highlighted how difficult it is for migrant youth, especially unaccompanied children, to access health care, despite this population’s overwhelming need for quality mental health support. APA’s new Immigration Toolkit is a comprehensive resource to support psychiatrists as they provide this needed care.
In recent years, the global refugee crisis has become a pressing issue, with the number of refugees more than doubling in the past decade. Thousands of migrant children were forcibly separated from their parents in 2018 under the Trump administration’s zero tolerance policy. In addition, recent reports have revealed that children who are U.S. citizens were also removed from their parents and placed in foster homes. A significant number of these children are still separated from their parents. The traumatic impact of this practice on these children is well documented.
In a report published in April, the American Academy of Pediatrics and the Migration Policy Institute outlined the numerous barriers that unaccompanied children face in accessing care, such as the complexity of the U.S. health care system, missed opportunities by schools and community organizations to connect them with care, and deficiencies in the discharge health paperwork that the Office of Refugee Resettlement provides children and their sponsors. The authors drew on field visits they conducted in Los Angeles, New Orleans, and Houston; interviews with more than 100 health professionals working with this population; and interviews with children themselves. The report noted that it should be expected that unaccompanied children have experienced trauma in some degree, whether in their home country, at the border, or in the United States.
Additionally, an April New York Times report emphasized that immigrant families, including those who have been granted legal asylum in the country, face numerous barriers to securing government aid, such as food stamps and cash subsidies.
Meanwhile, media outlets widely reported in March that the Biden administration was considering reviving the practice of detaining migrant families who cross the border illegally.
The increasing number of traumatized refugees demands attention from the field of psychiatry, as refugees often experience a range of mental health challenges due to the trauma and stress of their displacement. This is especially true for children and families who are particularly vulnerable during such crises.
Psychiatrists are encountering migrant children and their families from various parts of the world in their daily practices, and standard treatment methods may not always be effective in addressing their unique needs. As a result, there is a growing recognition of the importance of culturally sensitive psychiatric care for this population.
To address this need, the APA Council on Children, Adolescents, and Their Families developed the Immigration Toolkit. The toolkit is designed to assist mental health professionals in providing care to migrants and refugee children, adolescents, and their families. The toolkit is divided into several sections, each addressing different aspects of this complex issue, including the following:
The ethical and legal considerations involved in caring for this population, with a particular emphasis on the rights of children and families.
The mental health challenges faced by refugees, including trauma-related disorders, depression, anxiety, and adjustment disorders. The toolkit provides guidance on the assessment, diagnosis, and treatment of these conditions and emphasizes the importance of cultural sensitivity and understanding.
The various policies and guidelines that mental health professionals should be aware of when working with migrants and refugee children and families. This includes the role of mental health professionals in advocating for the needs of this population and navigating the complex legal and administrative systems.
Finally, because working with children and families with a history of trauma can place a significant emotional strain on mental health professionals, the toolkit provides tips on self-care and wellness, highlighting the importance of taking care of oneself while providing care to others.
The Immigration Toolkit was developed by a group of council members who recognized the need for better understanding and support for migrants and refugee children and their families. The members include Balkozar Adam, M.D., Anish Dube, M.D., M.P.H., Rana Elmaghraby, M.D., Lisa Fortuna, M.D., M.P.H., Mary Ann Schaepper, M.D., M.Ed., Gabrielle Shapiro, M.D., Shawn Sidhu, M.D., Suzan Song, M.D., Rahul Vasireddy, M.D., and German Velez, M.D. The toolkit represents a significant contribution to the field of mental health and provides a valuable resource for mental health professionals who work with this population. ■
Resources
“A Path to Meeting the Medical and Mental Health Needs of Unaccompanied Children in U.S. Communities”
Balkozar Adam, M.D., is a child and adolescent psychiatrist with Burrell Behavioral Heath and professor emeritus at the University of Missouri.
Gabrielle Shapiro, M.D., is a clinical professor of psychiatry at the Icahn School of Medicine at Mount Sinai and APA secretary.
German Velez, M.D., is a child and adolescent psychiatry fellow at Weill Cornell Medicine and the Columbia College of Physicians and Surgeons Department of Psychiatry and APA’s resident-fellow member trustee.
