Moving Forward in Mental Health Care for Refugee, Asylum-Seeking, and Undocumented Children
Given the current political and climate crisis, the number of forcedly displaced individuals continues to rise, posing new challenges to host societies aiming to support and respond to the needs of those fleeing war or persecution. In this article, we turn our attention to current and historical sociopolitical contexts influencing the mental health of forcedly displaced children (ie, refugee, asylum-seeking, and undocumented) during their resettlement in high-income countries, proposing timely ways to respond to evolving needs and recommendations to redress ubiquitous structural inequities that act as barriers to education...
Source: Child and Adolescent Psychiatric Clinics of North America - November 3, 2023 Category: Psychiatry Authors: Keven Lee, Rachel Kronick, Diana Miconi, C écile Rousseau Source Type: research

Cultural Considerations and Response to Trauma for Displaced Children at the Border
The United States has long been the leading destination for Latin Americans seeking refuge. However, in the last 7  years, many children from Mexico and northern Central America, composed of El Salvador, Honduras, and Guatemala, have joined this migratory flow. The experience of forced migration is intense, chronic, and complex for children in their home countries, during their journey, and on arrival in the Un ited States. Their stories can inform clinical practices, such as Psychological First Aid and Trauma-Focused Cognitive Behavioral Therapy, to promote resilience in children in vulnerable conditions. (Source: Child ...
Source: Child and Adolescent Psychiatric Clinics of North America - November 1, 2023 Category: Psychiatry Authors: Georgina Sanchez-Garcia, Beverly J. Bryant, Sarah L. Martin Source Type: research

Upholding the Human Rights and Well-Being of Refugee Children Through Effective Clinical Care
Refugee children are often exposed to adversities and traumatic experiences that can harm the mental health and well-being of refugee children. These include human trafficking and exploitation and dangers in detention centers and refugee camps. All these adverse events can be traumatic and contribute to poor mental health, including posttraumatic stress, anxiety, depression, and substance use disorders. Therefore, the assessment of refugee children and adolescents should include screening and identification for these experiences, provision of evidence-based trauma treatment, and social supports to promote their well-being ...
Source: Child and Adolescent Psychiatric Clinics of North America - October 28, 2023 Category: Psychiatry Authors: Lisa R. Fortuna, Michelle V. Porche Source Type: research

Advocacy and Policy
Mental health challenges experienced by migrant children are shaped by multiple factors within the health care system and society at large. It is essential for health care providers to recognize the profound impact of these influences on child well-being. By actively engaging in advocacy and policy initiatives, health care providers can address structural barriers, social inequalities, and stigma that perpetuate mental health disparities. Through their advocacy efforts, providers can contribute to creating an inclusive society that upholds children ’s rights and ensures equitable access to mental health support and servi...
Source: Child and Adolescent Psychiatric Clinics of North America - October 28, 2023 Category: Psychiatry Authors: Abishek Bala, Jessica Pierce, Karen Pierce, Suzan Song Source Type: research

Management of Psychiatric Emergencies Among Migrant Youth in Institutional and Community Settings
Migrant youth commonly access mental health care for the first time during emergencies, rather than through ambulatory means. Suicidal behaviors may occur more often among migrants than nonmigrant youth, and they may suffer from post-traumatic stress, depression, anxiety, and display disruptive behaviors more frequently than their nonmigrant counterparts. Brief emergency interventions include safety planning, psychoeducation, parent training on communication and establishing routines, and behavioral therapies like activity scheduling and sleep hygiene. (Source: Child and Adolescent Psychiatric Clinics of North America)
Source: Child and Adolescent Psychiatric Clinics of North America - October 28, 2023 Category: Psychiatry Authors: Linda Chokroverty Source Type: research

Acculturating Systems of Care to Ensure Healthy Futures for Latine Migrant Youth
Migration across the Americas is an ever-changing process with current trends including increased migration into the United States of Latine youth. Experiences before, during, and after migration can increase the risk of psychiatric illness, including discriminatory and exclusionary experiences when accessing care. Acculturation typically focuses on the process that the immigrant group experiences when coming into contact with a host culture. Members of the host culture and systems of care can take intentional steps to acculturate themselves in an integrative manner in an effort to reduce host –immigrant friction and bet...
Source: Child and Adolescent Psychiatric Clinics of North America - October 28, 2023 Category: Psychiatry Authors: Leeallie Pearl Carter Source Type: research

Posttraumatic Stress Disorder in Our Migrant Youth
There is an ongoing diagnostic and treatment challenge for migrant youth with posttraumatic stress disorder (PTSD) that many clinicians face. Current studies have helped clinicians to develop a better understanding of the migrant youth ’s journey including potentially traumatic and adverse events they encounter. This includes determining if premigration, migration, and postmigration stressors have had an impact on the individual. This has also helped clinicians, educators, and legal advocates to use a collaborative approach to a ddress the migrant youth’s needs for managing the severity of PTSD symptoms. (Source: Child...
Source: Child and Adolescent Psychiatric Clinics of North America - October 28, 2023 Category: Psychiatry Authors: Vanessa C. D ’Souza Source Type: research

Trauma Informed Best Practices and Resiliency
Children who experience fleeing from their home countries, whether with family members or unaccompanied, almost certainly experience trauma. The response of caring systems should remain grounded in the known principles of trauma-informed care, an understanding of best practices based on evidence-based and informed interventions and the developmental process. In addition, care providers should be working to maximize the safety of the environment in which they are interacting with children and youth and considering the style, approach, and content of interaction to balance the purpose of any interaction with the safety and s...
Source: Child and Adolescent Psychiatric Clinics of North America - October 25, 2023 Category: Psychiatry Authors: Jeanette M. Scheid Source Type: research

Addressing Health Inequity and Mental Health of Migrant Children at the Border
Dr Anaya: I trained with underserved populations at LA County + USC for both adult and child/adolescent psychiatry. The population I worked most closely with were immigrant families, LGBTQ youth, and their intersection. When I finished training, I started working with Refugee Health Alliance in Tijuana once to twice per month, providing free care for patients, supporting medical providers, and participating in advocacy. Both of my parents are immigrants, and luckily, Spanish was my first language, so I felt like I had some insight and skills that might be a good foundation for supporting humanitarian work at the border. (S...
Source: Child and Adolescent Psychiatric Clinics of North America - October 25, 2023 Category: Psychiatry Authors: V. Karina Anaya, Joshua D. Feder Tags: Interview Source Type: research

AACAP ’s Strategic Plans to Enhance the Diversity of the Child Psychiatry and Child Mental Health Workforce Across all Mission Areas
This article will discuss AACAP ’s strategic plan for diversifying the workforce, this will be done with 3 main points: promoting diversity, equity, and inclusion (DEI) across all mission area, creating a pipeline of child and adolescent psychiatrists, and monitoring DEI activities and progress on an organizational level. (Source: Child and Adolescent Psychiatric Clinics of North America)
Source: Child and Adolescent Psychiatric Clinics of North America - October 20, 2023 Category: Psychiatry Authors: Tashalee R. Brown, Tami D. Benton, Warren Yiu Kee Ng Source Type: research

Worcester Refugee Assistance Project
Refugee populations are diverse and can present with a variety of unique and complex circumstances. The purpose of this article is to examine an organization that provides care to refugee youth, the ways in which this is accomplished, and a few of the challenges that have been faced. Specifically, the work of this organization will be examined using a Systems of Care philosophy to demonstrate how using these concepts can assist in providing sensitive, high-quality care. (Source: Child and Adolescent Psychiatric Clinics of North America)
Source: Child and Adolescent Psychiatric Clinics of North America - October 20, 2023 Category: Psychiatry Authors: Emily Hochstetler, Omar Taweh, Anushay J. Mistry, Peter Metz Source Type: research

Fostering Mental Health Workforce Diversity with Courage and Creativity
From 2020 to 2023, the nation experienced a series of culture shocks. In the United States, the murder of George Floyd was witnessed around the world; over 100,000 children lost a parent or caregiver during the COVID-19 pandemic; Black youth suicide rates increased at alarming rates, and LGBTQ youth faced increasing legal restrictions. Diversity initiatives offer a promising path to develop a more inclusive culture, but they must adhere to new legal guidelines to succeed. In order to anchor change, organizations must make a sustained commitment to integrated diversity and workforce development programs in child and adult m...
Source: Child and Adolescent Psychiatric Clinics of North America - October 17, 2023 Category: Psychiatry Authors: Howard Y. Liu, Altha J. Stewart Tags: Preface Source Type: research

Unaccompanied Children in the Office of Refugee Resettlement Care
Unaccompanied children entering the United States are cared for in a variety of care provider settings across the country while they are in the custody of the Office of Refugee Resettlement (ORR). While in an ORR care provider program, children receive physical and mental health-care services, classroom education, social skills/recreation services, vocational training as appropriate, family unification services, access to legal support, and case management. The Mental and Behavioral Health Services Team was created in 2019 to provide oversight of the mental health of unaccompanied children in ORR care. (Source: Child and A...
Source: Child and Adolescent Psychiatric Clinics of North America - October 11, 2023 Category: Psychiatry Authors: Mawuena Agbonyitor Source Type: research

Trauma Exposure in Migrant Children
Trauma exposure significantly impacts sleep in children. Nightmares are common. Evidence-based therapies are superior to medications but may not always be available in acute settings. No FDA-approved medications exist for the treatment of trauma-related sleep disturbances in youth. The evidence-base for the use of medications is largely based on case reports, retrospective chart reviews, clinical opinion, and adult studies. This evidence is reviewed for a number of medications, including prazosin, trazodone, alpha-2 agonists, quetiapine, and others. (Source: Child and Adolescent Psychiatric Clinics of North America)
Source: Child and Adolescent Psychiatric Clinics of North America - September 26, 2023 Category: Psychiatry Authors: Beverly J. Bryant Source Type: research

Complex Psychiatric Histories and Transgender and Gender Diverse Youth
Transgender and gender diverse (TGD) individuals face higher rates of stressors driving disproportionate health risks. Although psychiatric conditions are important to consider in the context of greater health-promoting efforts for TGD youth, any mental health concerns may or may not be related to gender identity or associated dysphoria. Nevertheless, it is essential to consider the impact of complex mental health factors on decisional capacity and gender care discussions. Psychiatric care of TGD youth includes stratifying risk factors through a minority stress lens, balancing acute needs with patient and caregiver priorit...
Source: Child and Adolescent Psychiatric Clinics of North America - September 21, 2023 Category: Psychiatry Authors: Amy Curtis, Shanna Swaringen, Aron Janssen Source Type: research