Mental health of children held at a United States immigration detention center

Sarah A MacLean; Priscilla O Agyeman; Joshua Walther; Elizabeth K Singer; Kim A Baranowski; Craig L Katz

doi:10.1016/j.socscimed.2019.04.013

Mental health of children held at a United States immigration detention center

Soc Sci Med. 2019 Jun:230:303-308. doi: 10.1016/j.socscimed.2019.04.013. Epub 2019 Apr 29.

Authors

Sarah A MacLean¹, Priscilla O Agyeman², Joshua Walther³, Elizabeth K Singer⁴, Kim A Baranowski⁵, Craig L Katz⁶

Affiliations

¹ Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA. Electronic address: sarah.maclean@icahn.mssm.edu.
² Graduate Program of Public Health, Icahn School of Medicine at Mount Sinai, 17 E. 102nd Street, New York, NY, 10029, USA.
³ Department of Medical Education, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
⁴ Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
⁵ Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
⁶ Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA; Department of Health System Design & Global Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.

PMID: 31047760
DOI: 10.1016/j.socscimed.2019.04.013

Abstract

Rationale; Children held in immigration detention may be at risk for mental health disorders due to the impacts of pre-migration factors, including exposure to violence, their displacement from their home countries, their journey between countries, and the conditions of their detention. Limited research has demonstrated high rates of clinical depression, post-traumatic stress disorder (PTSD), and anxiety disorders among detained immigrant children. Objective; In this cross-sectional study, we assessed the mental health of children held at a US immigration detention center over two months in mid-2018. Method; We interviewed 425 mothers about their eldest child age 4-17 using the Parent-Report Strengths and Difficulties Questionnaire (SDQ). A subset of 150 children age ≥9 completed the UCLA Post-Traumatic Stress Disorder Reaction Index (PTSD-RI). Results; Among the 425 children studied, many demonstrated elevated scores for emotional problems (32%), peer problems (14%) and total difficulties (10%) on the SDQ. Younger children (age 4-8 years) demonstrated more difficulties associated with conduct, hyperactivity, and total difficulties (all p < 0.001) compared to older children. Children who had been forcibly separated from their mothers demonstrated significantly more emotional problems (49%, p = 0.003) and total difficulties (15%, p = 0.015) than those who had never been separated. Of the 150 children who completed the PTSD-RI, 17% had a probable diagnosis of PTSD. In all, nearly half (44%) of all children demonstrated at least one emotional or behavioral concern. Conclusions; These data demonstrate that children being held in immigration detention experience high levels of mental health distress. Results suggest they would benefit from more comprehensive mental health screening and release into the community, as well as culturally-responsive and trauma-informed mental health care.

Keywords: Child psychiatry; Immigration; PTSD; Trauma; United States.

MeSH terms

Adolescent
Child
Cross-Sectional Studies
Emigration and Immigration*
Female
Humans
Male
Mass Screening
Mental Disorders / diagnosis*
Mothers / psychology
Refugees / psychology*
Stress Disorders, Post-Traumatic / diagnosis*
Stress Disorders, Post-Traumatic / psychology
United States