Children Living With Undocumented Parents May Need Additional Support

Children living in the United States with undocumented parents are at heightened risk of poverty, food insecurity and malnourishment, and adverse childhood experiences compared with their peers. Such adverse experiences include parental arrest and deportation, which can increase the rates of posttraumatic stress disorder, anxiety, and depression in these youth.

“Health care providers who work with the children of undocumented immigrants must be aware of the [many] vulnerabilities [these children face] to provide holistic, comprehensive, compassionate, and effective care,” wrote Shawn S. Sidhu, M.D., of the University of New Mexico and Suzan J. Song, M.D., M.P.H., Ph.D., of George Washington University Medical Center in an article in the October Journal of the American Academy of Child & Adolescent Psychiatry. 

The authors highlighted several clinical considerations to keep in mind when working with this patient population:

• Communication is key to working with children of undocumented parents and their families. “The ease of efficient communication is critical to forming a therapeutic alliance with families, and bilingual mental health providers and/or easy access to high-quality interpreter services can help to facilitate communication with families.”
• Knowledge of a family’s immigration status can help with treatment planning, but such conversations need to be carried out “in a careful and thoughtful way,” as forcing the issue could cause fear for children and their parents, the authors advised. “Providers can explain their rationale in asking this information so that additional referrals for services can be made for the family. Child and adolescent psychiatrists should explain that immigration status is protected information under the Health Insurance Portability and Accountability Act (HIPAA), and that child and adolescent psychiatrists do not have any legal mandate to report this information.”
• The clinical care of the children of undocumented parents will likely involve family therapy. “The trauma experienced by the children of undocumented parents is transgenerational and historical in nature. Thus, a family-centered approach, which could include components of family therapy, allows the entire family unit to heal simultaneously while enhancing the family’s ability communicate with one another and support one another through difficult transitions.”

“Many undocumented parents and their children may refrain from speaking out for fear of retaliation, and therefore their voices may not be heard at a local and national level. This may especially be the case in areas where immigration raids, arrests, detention, and deportation are more prevalent,” Sidhu and Song wrote. “Physicians can play an effective role in advocating for policies that promote the mental health and wellness of children residing with undocumented parents in America.”

For more on actions being taken by psychiatrists to support immigrant families, see the Psychiatric News article “Grassroots Movement of Psychiatrists Arises to Support Asylum-Seeking Families,” by Shawn Sidhu, M.D. For related information, see the Psychiatric Services article “Caring for Families Separated by Changing Immigration Policies and Enforcement: A Cultural Psychiatry Perspective.”

(Image: iStock/Sasiistock)

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