Mental Health Needs of Unaccompanied Minors MARIA ASTUDILLO, LCSW-R DIRECTOR MENTAL HEALTH SERVICES
Transcription
Mental Health Needs of Unaccompanied Minors MARIA ASTUDILLO, LCSW-R DIRECTOR MENTAL HEALTH SERVICES
Mental Health Needs of Unaccompanied Minors MARIA ASTUDILLO, LCSW-R DIRECTOR MENTAL HEALTH SERVICES Definition of UAC • An unaccompanied alien child is a child who has no lawful immigration status in the United States; has not attained 18 years of age; and, there is no parent or legal guardian in the United States, or no parent or legal guardian in the United States is available to provide care and physical custody. See 6 U.S.C. § 279(g)(2) The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org What’s prompting them to flee? • Violence • Poverty • Escaping violence/abuse at home • Seeking better educational opportunities The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org What is Trauma? “Children and adolescents experience trauma under two different sets of circumstances: • Some types of traumatic events involve (1) experiencing a serious injury to yourself or witnessing a serious injury to or the death of someone else, (2) facing imminent threats of serious injury or death to yourself or others, or (3) experiencing a violation of personal physical integrity. These experiences usually call forth overwhelming feelings of terror, horror, or helplessness. Because these events occur at a particular time and place and are usually shortlived, we refer to them as acute traumatic events” (NCTSN) The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org What is Trauma? “In other cases, exposure to trauma can occur repeatedly over long periods of time. These experiences call forth a range of responses, including intense feelings of fear, loss of trust in others, decreased sense of personal safety, guilt, and shame. We call these kinds of trauma chronic traumatic situations.”(NCTSN) The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org UAC Traumatic Experiences • Pre migration trauma • Physical and emotional dangers during the “crossing” • Subjects to sexual violence and sexual trafficking • Multiple losses experienced as a result of immigration process. • Detention camps The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Manifestation of Trauma and Stress • • • • • • • • • Separation anxiety Other Anxiety Disorders PTSD Generalized Anxiety Disorders Depression Anxiety Grief Somatization Disruptive Behaviors Academic difficulties The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Adjustment to new environment • New culture, language, system, family. • Constant fear of deportation, coping with racial profiling and ongoing discrimination. • Unaware of services available • Stigma • Acculturative stress • How does it play out behaviorally? The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Best Practices • Essential to have culturally competent staff • Services must be provided under the umbrella of trauma informed services in school, health care facilities, mental health and foster care. • Collaborative work with providers involved as well as community, particularly churches and or faith based organizations The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Best Practices • Assessment that captures their “story”– a good tool to use is Culturagram ( Congress). • Bilingual / Bicultural clinicians- must be able to conduct clinical work in native language. • Address material/basic needs. • Case management services essential. • Consider solution focused therapy. • Psychosocial supports to families/ sponsors The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Best Practices • Cultural responsive approaches • Cultural Formulation • Obtain information about faith based and community centers that offer support and a sense of safety. • CMH providers should partner with schools as it is a less stigmatizing environment to provide services. • Interpreters should know about mental health The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Address barriers to treatment • Fear of being deported • Lack of finances • Lack of health insurance or knowledge that they can access it. • Language • Working multiple jobs and long hours. • Limited schooling, difficult to place in appropriate grade due to age. • Stigma The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Effective therapy/service models Group Therapy Home Visits Psycho-education Cognitive Behavioral (PTSD, Anxiety, Depression) • Narrative Therapy • Peer and Social Support • Action Planning and Involvement • • • • The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org Therapy Considerations Psychosocial issues are extremely important Legal protection is a big issue Trauma and Stress Resiliency over real social and political stressors and barriers • Family support • Instilling hope and ameliorating anxiety and fear • • • • The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org The Children's Aid Society 105 E. 22nd Street New York, NY 10010 (212) 949-4936 www.childrensaidsociety.org