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Increasing Numbers of Children of Asylum Seekers Face Mental Health Crisis: Are We Collecting Data?

 

Considering the high levels of violence throughout the Northern Triangle (countries of El Salvador, Guatemala, and Honduras) in addition to poverty, food insecurity, political turmoil, and domestic violence, unaccompanied children and families alike leave their countries in search of safety and improved lives. 

As many of them have ties to relatives and communities in the United States… Central American refugees will continue to try to make their way to the United States…the flows can be expected to persist, if not increase. 

The children who end up in our local communities and schools are suffering with extremely high numbers of adverse experiences. As a trauma psychotherapist who works primarily with adult refugees, I use the ACE International Questionnaire (ACE-IQ).  However, I am increasingly seeing their traumatized children. I don’t use any ACE questionnaire, but I am curious what efforts are in place for collecting data on this growing young demographic? 

Please feel free to email me or post your response here.

rebecca.tavangar@gmail.com

 

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Julie McDevitt posted:

Hi Rebecca,

I'm so glad you asked this question.  I would also like to connect with people who are working with this population.  I work at a FQHC (community health clinic) in San Francisco and over the past two years have seen a huge increase in this population, and even more so, women who are fleeing with their children (although some of this might be due to having better way of identifying them).  We also have a project in which we take referrals from lawyers to do mental health evaluations for asylum cases.  It's unusual for me to meet a recent arrival (this includes Mexico too) who doesn't have significant post-trauma symptoms.  We are not using any specific tool to screen, and the ACES questionnaires I've seen do not really fit our general clinic population or at least are not the most salient traumatic experiences.  I'd be interested how people are tracking this.  One difficulty we've come up with the pediatric population is that, by the time they get to us, they are with family members or guardians, and seem like any other youth beginning care at the clinic.  I would like to come up with a simple flyer which could identify or contact people (school district, etc) as well as the integrated behavioral health services we have at the clinic.  Does anybody have something like this?

Hello Julie,

The American Academy of Pediatrics (AAP) has a toolkit which addresses mental health concerns for immigrant children and includes links to pediatric assessments for children who may need mental health services: the Trauma Symptom Checklist for Young Children (TSCYC) and the Trauma Symptom checklist forChildren (TSCC). Assessment of mental health among children in immigrant and refugee families involves several key elements:

  • Screening for trauma
  • The influence of acculturation
  • Consideration of changing social support structure
  • Resilience

(https://www.aap.org/en-us/Docu...emotional_health.pdf)

The important questions that this toolkit addresses are:

  • What considerations should be included in a mental health assessment of immigrant children?

  • What risk and protective factors should be included in the mental health assessment?

  • What mental health screening instruments are available for use with children of immigrants?

  • How can I help children link to mental health treatment?

Also Physicians for Human Rights (PHR) released several fact sheets with links to important resources here: http://physiciansforhumanright...ylum/factsheets.html

 

 

I am very interested in the Alero Project- sounds like a great initiative! 

Let's keep in touch!

Rebecca

 
 
Rebecca Tavangar, M.A., P.C.
Psychotherapist | Trauma Specialist 
Alianzas de Phoenixville
(610) 755.2254
 
rebecca.tavangar@gmail.com
Robert Olcott posted:

Rebecca Tavangar, How is an (WHO) ACE International Questionaire scored? I did not find the scoring guide when I was on the WHO (World Health Organization) website yesterday. I was curious what the current 'median score' might be-if it is based on the WHO 2013 assessment of the world's healthiest children survey? Thank You.

Hi Robert, the WHO has suggested two methods of analysis here: http://www.who.int/violence_in...ce_for_analysing.pdf

Hi Rebecca,

I'm so glad you asked this question.  I would also like to connect with people who are working with this population.  I work at a FQHC (community health clinic) in San Francisco and over the past two years have seen a huge increase in this population, and even more so, women who are fleeing with their children (although some of this might be due to having better way of identifying them).  We also have a project in which we take referrals from lawyers to do mental health evaluations for asylum cases.  It's unusual for me to meet a recent arrival (this includes Mexico too) who doesn't have significant post-trauma symptoms.  We are not using any specific tool to screen, and the ACES questionnaires I've seen do not really fit our general clinic population or at least are not the most salient traumatic experiences.  I'd be interested how people are tracking this.  One difficulty we've come up with the pediatric population is that, by the time they get to us, they are with family members or guardians, and seem like any other youth beginning care at the clinic.  I would like to come up with a simple flyer which could identify or contact people (school district, etc) as well as the integrated behavioral health services we have at the clinic.  Does anybody have something like this?

Rebecca Tavangar, How is an (WHO) ACE International Questionaire scored? I did not find the scoring guide when I was on the WHO (World Health Organization) website yesterday. I was curious what the current 'median score' might be-if it is based on the WHO 2013 assessment of the world's healthiest children survey? Thank You.

Last edited by Robert Olcott
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