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Immigrant and Refugee Health

Mental Health

Central American Refugee Health Profile

It can be assumed that the vast majority of children arriving through the CAM program will have experienced some form of significant trauma in their lifetime. These children come from Central American countries with homicide rates ranking among the top five worldwide, high poverty rates, and widespread gang violence. Violence toward women, often perpetuated by gangs and armed criminal groups, has been widely documented. In a 2013 United Nations study, 400 unaccompanied children from El Salvador, Guatemala, Honduras, and Mexico were interviewed. When asked why they had decided to migrate to the United States alone, nearly half (48%) said they left their home country due to escalating violence. Additionally, 81% cited family or opportunities available, 21% reported abuse in the home, and 16% cited situations of deprivation as factors that contributed to their migration70.

Access to inpatient and outpatient mental health services is very limited. A report from the Pan American Health Organization (PAHO) found that only 363 Guatemalan patients were able to access national outpatient mental health facilities, of whom 58% were women, and 14% were children or teens. Of those treated, anxiety disorders were the most common diagnoses71. Due to limited access to outpatient and inpatient psychiatric treatment in El Salvador, Guatemala, and Honduras, it is difficult to determine the prevalence and types of mental health issues among children and adults.

Once in the United States, these refugee children must adapt to a new physical environment and culture. Leaving behind family and loved ones in their home country and adapting to life in the United States, coupled with the stress associated with being alone and potentially reuniting with unfamiliar or unknown relatives, can have severe consequences. These factors increase the risk for depression, anxiety, PTSD, substance abuse, and homelessness72. Therefore, it is important to evaluate these children for mental health issues at initial screening and on an ongoing basis through frequent visits with appropriately trained mental health and primary care providers.

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