Disclosure in Undocumented Families and School Mental Health Clinics

The following describes the case of Miguel and a missed diagnosis in an undocumented minor.Miguel Estrada (all names changed to protect identity) was a 10-year-old boy of Central American origin initially seen at age 8 years in our university outpatient child psychiatry clinic. During the initial evaluation with a native Spanish-speaking provider, his mother, Mrs. Estrada, reported behavioral problems beginning at age 5 with diagnoses of attention-deficit/hyperactivity disorder and intellectual disability; a trauma history was denied. Over the subsequent 2 years, Miguel continued treatment in our outpatient service and later transitioned to our school-based clinic. At the intake visit, Mrs. Estrada explained (with the assistance of his school paraprofessional educator and translator) that they crossed the United States/Mexico border illegally when Miguel was 5 years old. Miguel ’s behavioral problems began when Immigration and Customs Enforcement officials separated him from his parents, his father was deported, and he was exposed to harsh conditions. During his parents’ detention, he was transitioned to five failed foster placements with escalating behavioral problems that eventually led to a 3-month psychiatric residential stay.During the initial visit to the school psychiatric clinic a trauma history was again denied by Miguel and his mother. Ten months into treatment in the school-based psychiatric clinic, Miguel reported hearing a male voice and a motorbike throughou...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - Category: Psychiatry Authors: Tags: Clinical perspectives Source Type: research