Immigrant children need mental health care, too
Today’s talk about the mental health crisis among children and adolescents — for whom suicide is a leading cause of death — consistently disregards a crucial population: the children of immigrants. As we grapple with the increasing prevalence of mental health issues among youth, we must factor in the unique challenges faced by this often marginalized, growing group. Immigrants and their U.S.-born children now number approximately 90 million, an increase of approximately 20% since 2010. Immigrant children now represent one in four children in the U.S. Their well-being is our collective responsibility, and we must address the disparities hindering their access to support and resources for the good of all. If we continue ignoring the mental health of children of immigrants (also including refugees and migrants), the downstream effects of intergenerational trauma will become too expensive for society to bear.
Inherited trauma
My parents were boat refugeeimmigrants from Vietnam. At 19, my father stole a communist boat and sailed to a Hong Kong refugee camp, where he lived for two years. At 16, my mother nearly drowned in a capsized boat off the coast of South Vietnam. Both arrived separately in California, home to the largest Vietnamese diaspora in the world.
I inherited the racism and discrimination that my parents felt in the U.S. as intergenerational trauma, via an upbringing that included unstable housing, racial discrimination, fetishization
and poverty.
The year 2025 will mark 50 years since the start of the Vietnam War, and it is disheartening to watch history repeat itself as the U.S. receives influxes of migrants from Afghanistan, Ukraine, Israel-Palestine, Haiti, Venezuela and more — many from countries in which the U.S. has had direct involvement.
Youth with unrecognized mental health problems are vulnerable to developing comorbidities like diabetes, obesity and cardiovascular diseases in adulthood. These chronic conditions cost health systems and insurance companies billions of downstream dollars when not detected early, per the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association’s joint state of national emergency regarding the mental health of children and adolescents.
Geopolitical policies like the Biden Administration’s proposed bipartisan immigration package and extension of temporary protected status help. This extension temporarily allow immigrants from specific countries to live and work in the U.S., protecting them from deportation.
However, the policy is reevaluated every 18 months. This instability and uncertainty of immigration status impacts the mental health not just of the adults, but of their children and their grandchildren.
Many new immigrants also undergo harrowing experiences as they arrive in the U.S. We have seen many instances of immigrant families crossing the southern U.S. border with Mexico, being bused from Texas to other major U.S. cities, and being forced to sleep on sidewalks, in police stations, under highway underpasses.
What to do
How will these traumatic experiences impact mental health longterm? Why is the mental health of children of immigrants often ignored even though we know the challenges and risks associated with doing so?
At best, they are ignored out of convenience.At worst, the reasons are overtly racist, even violent. Language access is a challenging barrier, requiring an active investment. Officials and others offer reasons shrouded in intersecting language injustice, racism, and xenophobia — including methodological challenges such as small sample sizes — to justify lack of investment these issues.
But we have overcome language barriers, racial bias, and other forms of discrimination to successfully deliver mental health services and interventions for youth from historically minoritizedcommunities, including from a “mixed-status family,” in which members include people with different citizenship or immigration statuses.
We must adopt a similarly multi-faceted, multi-sectoral, systematic approach to immigrant children’s mental health.
We need to offer multilingual services to alleviate barriers so that immigrants may participate in research. Additionally, we must destigmatize mental health within immigrant communities through culturally sensitive awareness campaigns/initiatives. Educational institutions can offer cultural competency training for educators, and resources that specifically address the mental health needs of immigrant children; inclusive, supportive schools can become crucial allies in supporting immigrant child mental health.
Policymakers should also prioritize immigrant perspectives in mental health initiatives, including allocating resources for culturally competent mental health services, and policies that address the unique challenges faced by immigrant children and families.
For every child
Through open dialogue, research, education, and policies that acknowledge children of immigrants’ unique challenges, we can finally address the 25% of children in our nation who have been forgotten in the mental health conversation.
The mental health of every child, regardless of background, is not just our responsibility. Our societal well-being depends upon it.