Undocumented Adolescents: Building Hope

By Mahoney, Diana | Clinical Psychiatry News, May 2008 | Go to article overview

Undocumented Adolescents: Building Hope


Mahoney, Diana, Clinical Psychiatry News


The guidance offices of many of this country's large urban middle schools and high schools--particularly those in economically depressed areas--are teeming with what psychiatrist Dr. Dean DeCrisce of New York University Medical Center refers to as a "lost population"--undocumented immigrant adolescents who appear hopeless and helpless in terms of improving their situation.

At the annual meeting of the American Society for Adolescent Psychiatry (ASAP) earlier this year, Dr. DeCrisce, formerly a private practitioner in California, described "one of many such adolescents" who was referred to him as part of a program for troubled kids in a Los Angeles public high school. The 17-year-old student was referred by the school because he "appeared depressed and unmotivated."

The boy's family had migrated from Mexico when he was 5 months old. He lived with extended intact family in one of two bedrooms of a small apartment in East Los Angeles. His family spoke only Spanish at home, his mother was a homemaker, and his father was a day laborer. He came to the clinic with no medical or other records except for the school referral, which documented that he had been at the current school for about a year and was doing poorly in school.

"The student said that he had been treated previously with Zoloft, although he didn't know why, and he said he never took it, anyway," Dr. DeCrisce said, adding that efforts to meet with one or both parents were consistently thwarted.

"At the time, I really didn't know what was going on with this kid. There were so many things that didn't make sense. Here, he had lived in East L.A. all of his life, yet he had never been to the beach. He was 17 years old, yet he didn't drive or have any plans to get a driver's license. He didn't work, and he had no plans for college or the future. "At first I thought, 'Wow, this kid is really depressed, but he didn't really seem depressed, which is what led me to think about his immigration status," Dr. DeCrisce said.

During the course of therapy, Dr. DeCrisce learned that although the student had lived in the United States since he was a baby and had been educated in this country from first grade, "he was illegal, and because of that, he couldn't get a job, couldn't get a license, and had a constant sense of fear about leaving his neighborhood or going too far away from his parents," he said. "It was then that I realized the root of the hopelessness that this kid--and many of the other adolescents that I saw in the clinic--exuded."

About 1.8 million youth live in the United States today without proper documentation and about 3.1 million live in households headed by at least one undocumented immigrant, according to an analysis of the U.S. Census Bureau's March 2005 Current Population Survey produced by the Pew Hispanic Center, a nonpartisan research organization supported by the Pew Charitable Trusts (http://pewhispanic.org/files/reports/61.pdf).

As a consequence of migration, the acculturation process, and their illegal status, these youth face multiple psychosocial stressors that pose a set of unique psychiatric risks, Dr. Lisa Fortuna said in a panel discussion at the ASAP meeting. Many of these children and their families are plagued by premigration social and environmental stressors, such as poverty, exposure to violence, sexual or physical victimization, and substance use. They also have postmigration stressors, including loss of family friends, country, and lifestyle; changes in social supports; language difficulties; poverty; discrimination; segregation; isolation; and fear.

Data from the Longitudinal Immigrant Student Adaptation study, an interdisciplinary and comparative study designed by the Harvard Immigration Project at the Harvard Graduate School of Education, Cambridge, Mass., suggest that undocumented immigrant students often arrive in this country after multiple family separations and trauma and, once settled, continue to experience fear and anxiety about being caught, becoming separated from their families, and being deported (New Dir. …

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