Children of immigrants are the fastest growing population of children in the United States and have contributed to the entire growth in the nation’s child population over the past decade, in particular here in DC. More recently, there has been an increase in children themselves immigrating to the United States. Immigrant families are racially and ethnically diverse, and immigrate for a variety of reasons that may include seeking economic opportunity, reuniting with family, fleeing war or violence. Caring for immigrant children and families comes with its own set of challenges, and pediatricians can play a special role in supporting their health and well-being. The newly created DC AAP Immigrant Health Committee is a group of providers with a common interest in caring for these children and their families. Our goal is to provide support for one another, share resources, advocate for immigrant children, and educate ourselves and others about current issues.
Promoting Mental Health In Immigrant Children
May 16, 2017
Chronic exposure to violence, fear of deportation, and reunification difficulties are among the many causes of mental health concerns that immigrant children, and children of immigrant parents, face every day. To support local providers, the Immigrant Health Committee of the DC Chapter of the American Academy of Pediatrics hosted a workshop entitled, “Promoting Mental Health in Immigrant Children”. The goal of the workshop was to bring together child health providers (pediatricians, family physicians, nurse practitioners, nurses, etc.); mental health providers; and school representatives (teachers, social workers, school nurses, school mental health providers, etc.) to share experiences and ideas on caring for immigrant children and children of immigrants. The learning objectives for the session were:
- Distinguish the root causes of mental health illness in local immigrant children and learn how common mental health concerns can manifest themselves.
- Create connections between school personnel and healthcare providers regarding a student’s/patient’s mental health.
- Come away with next steps in developing collaborations and with at least 1 mental health resource in each of our workplace communities.
With a diverse group of over 80 participants, there was a robust and interactive workshop on the strengths and needs of this vulnerable population. The resources from the workshop can be accessed here:
Thank you to the AAP Friends of Children Fund for their generous support of this event, and to the DC Mental Health Access in Pediatrics Program (DC MAP) for logistical support.
Immigrant Child Health Toolkit
The Immigrant Child Health Toolkit was created by the members of the Immigrant Child Health Committee of the DC Chapter of the American Academy of Pediatrics. It is intended for use by medical providers caring for recently arrived immigrant children in their practice. We hope that this toolkit will be a valuable resource both during and around a patient’s medical visit.
The recommendations and resources compiled in this toolkit were created by physicians, lawyers, mental health practitioners and other collaborators – with many years of collective experience caring for immigrant children. While we hope that the content of this toolkit will help you provide better care for the recently-arrived immigrant child, we realize that every patient is unique and has individual needs. This guide is meant to be used as a reference, but is not a replacement for sound clinical judgement and the continued use of collaborate partners you may have in your work environment.
We would like to thank the National AAP Special Interest Group on Immigrant Health for their creation of an initial toolkit, which we used as a template for ours. Special thanks also to the many contributors to the creation of this toolkit.
DC AAP’s Immigrant Child Health Committee co-hosted an advocacy training on patient’s legal rights entitled, What Every Pediatrician Should Know About Immigration Law Pertaining to Your Patients and Families, with American University’s Immigrant Justice Clinic at AU’s Washington College of Law on November 1st.
Over 25 attendees, including DC AAP chapter members and other community-based child health care providers representing multiple health centers and various medical, dental, legal and advocacy groups, joined a robust discussion with AU’s Immigrant Justice Clinic staff that covered a range of topics relevant for child health advocates working with and caring for immigrant children and families. The presentation by the Immigrant Justice Clinic staff included types of immigration legal relief and how physicians can advocate and support their patients and families.
For reference, please find attached the following handouts and reference documents from DC AAP’s advocacy training on patient’s legal rights:
- Powerpoint slides from the presentation
- List of immigration legal referral resources
- A sample draft letter for a physician writing an affidavit of support for a patient’s immigration status
To learn more about DC AAP’s efforts to care for immigrant children and families, contact the co-chairs of DC AAP’s Immigrant Child Health Committee, Daniel Newman, DNewman@childrensnational.org, and Nathalie Quion, NQuion@childrensnational.org.
ICE Raids are Detrimental to Community Health
STATEMENT FROM WASHINGTON DC REGION COMMUNITY-BASED HEALTH AND MENTAL HEALTH CENTERS, HEALTH SECTOR ORGANIZATIONS AND WORKGROUPS
The Obama administration has confirmed that it is conducting immigration raids in the homes of mothers and children from Guatemala, El Salvador, and Honduras who entered the U.S. since May of 2014 and have received orders of deportation. These announcements and actions have caused extreme fear in our immigrant patient populations, and we are already receiving reports on patients who are afraid to come in for services. As health clinics, centers, and organizations devoted to caring for those most underserved in our community, we are deeply troubled by the trauma generated within our communities by these ICE raids, and we join the call for our local leaders to affirm that our localities are safe spaces for immigrants and those fleeing violence.
Our local region has a high proportion of immigrants from Central America, who therefore make up significant segments of our patients and clients. It has been well documented that many of the families recently arriving to our region are fleeing severe and growing violence in Central America. The manner in which ICE officers are conducting raids are re-traumatizing mothers and children who have witnessed and survived arrest, torture, and murder of family members, and attempts on their own lives. Those of us working closely with these families know that a significant number are experiencing severe symptoms of post-traumatic stress disorder, anxiety, and depression. These and other trauma-related conditions can limit major life activities, including the capacity to successfully navigate complicated asylum legal procedures and immigration removal proceedings. There are concerns that many of those with orders of deportation did not receive full due process in court, and deporting them to situations of extreme violence will result in harm or even death.
Raids don’t harm only those with orders of deportation, they create an environment of fear among the entire immigrant community. Many of our immigrant patients and clients have histories of trauma and persecution, and the news reports of predawn raids by ICE in homes, workplaces and in local supermarkets heighten feelings of vulnerability and distrust. Immigrant and refugee families live difficult lives as they adjust to new communities and new cultures. Immigration status is one of the key social determinants affecting health, along with poverty, language, and the lack of familiarity with the US health system. It is fundamental to provide safe spaces for immigrants and refugees as they seek supportive services, and to identify opportunities for improving the trust that they need to have in our institutions so they can fully develop their potential to be healthy and productive. Raids have the opposite effect, deterring immigrants from sending children to school, showing up for clinic appointments or even buying healthy foods, and therefore widening the existing disparities in care.
Our health sector has increasingly embraced a commitment to health equity and health for all. As part of that commitment, we affirm that our health centers and organizations are safe spaces for all, including immigrants and those fleeing violence. We urge our immigrant community to continue seeking services and support from us. We urge our local jurisdictions to work with our immigrant community to assure them of the safety of our schools, public services, and local law enforcement. We urge our federal representatives to work towards comprehensive immigration reform that addresses the root causes of migration, and acknowledges the specific health and mental health needs of those fleeing violence.
Immigrant Health Committee Awarded Healthy People 2020 Grant
The DC AAP’s Immigrant Health Committee has recently been awarded the Friends of Children Healthy People 2020 Grant. As one of five AAP chapters in the nation to win the grant, they will be working to create a “toolkit” for primary care providers to care for recently arrived immigrant children called “Esperanza: Coordinated Care and Excellence for Immigrant Children.”