Health Fellow Spotlight: Patience Lee, Lutheran Immigration and Refugee Service

Last year, tens of thousands of unaccompanied children were forced to flee their homes and sought asylum protection in the United States. Often, children have faced trauma in their home country, and on their journey to the United States. LIRS’s trauma-informed mental health framework for post-release services to unaccompanied minors and their families is innovative and intentional. We hope that our approach of using a culturally practice-based screening tool will enable us to meet the immediate needs to achieve stabilization in what is in the best interest of the case.

Many of the unaccompanied children we work with arrive to a world of uncertainty, but they are also filled with anticipation and hope for reuniting with family and achieving the American Dream. Unfortunately, many children are unaware of the mental health and emotional challenges they may need to navigate during their adjustment in their adopted country. In working to help these children, it has become increasingly clear that looking for a cultural explanation to an issue is just as important as finding a psychological one.

One of the challenges we encounter, given what a stressful time this can be, is keeping families together. We believe that understanding clients from their cultural vantage point is imperative to best serving them right where they are. Our hope and desire is that a culturally-framed mental health screening tool can help identify unaccompanied children (asylum seekers and refugees) who are experiencing mental health problems and provide them with the support they need to adjust to their new environment.

Once emergent needs have been identified by these minors, we are able to better help. Depending on needs, we are able to provide referrals to further assessment and treatment with a culturally competent licensed mental health professional; provide resources to help normalize coping skills; build resilience and help cope with trauma; help caregivers understand the mental health needs of their children; and connect them with the community services they need.

Unaccompanied minors from Central America and unaccompanied refugee minors from other countries often face significant challenges when they arrive in the United States, including language barriers, cultural differences, trauma from their experiences in their home countries and uncertainty about their future. These challenges can make it difficult for unaccompanied children to adjust to life in the United States. 

A mental health screening from their cultural mindset can help providers like LIRS better understand the unique challenges they are facing and develop culturally sensitive interventions to help them adjust. There is no one-size-fits-all approach to assessing an unaccompanied minor's cultural mindset, so an individual child’s perspective is considered and factored in their treatment and care.

We wish people simply knew and could be more empathic about the fact that unaccompanied refugee minors and unaccompanied minors are facing a mental health crisis. They have experienced persecution, trauma, and the loss of their home country. They have lived through violence, experienced the death of loved ones, and often they are struggling to adjust to a new life. They may be experiencing symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, physical disability, and other mental health problems. These problems can interfere with their ability to function in school, work, and relationships. It is important to remember that unaccompanied refugee minors and unaccompanied minors are resilient individuals who have survived a lot. They deserve our compassion and supportive relationships to help their healing journey.

We believe that the mental health screening tool for unaccompanied children has the potential to make a real difference in the lives of children. We are hopeful that children who are given the opportunity to heal from the trauma they have often experienced will go on to be future leaders and expand our rich history of being a nation of immigrants. By identifying children who are struggling with their mental health, the tool can help to ensure that they receive the support they need to thrive.