Applying an Antiracist Approach to Promoting Health Equity and Psychological Well-Being in Unaccompanied Immigrant Minors

Abstract

Unaccompanied immigrant minors (UIMs) are a fast-growing demographic in the United States, doubling in population since 2014.¹ According to the Office of Refugee Resettlement, a UIM is someone under the age of 18 years who enters the United States without lawful status and an accompanying guardian.² Most UIMs in the United States originate from the Central American northern triangle (ie, El Salvador, Guatemala, Honduras), with violence, extreme poverty, and family re-unification as the top 3 reasons for migration.^1,3 Repeated exposure to stressful and/or traumatic events at home, during migration, and upon arrival increases UIMs' risk for psychological distress and mental disorders.³ UIMs' repeated encounters with race-based trauma (eg, racism, discrimination) further heightens this risk.³ The repercussions of these events are compounded by the fact that UIMs lack the adversity buffering effect that is traditionally associated with the presence of a caregiver.³ Furthermore, UIMs' mental health risk is augmented by their interaction with US systems (eg, legal, immigration, child welfare, educational, healthcare) with policies and practices that are discriminatory, are exclusionary, propagate the view of UIMs as racialized threats to society, and fail to consider their developmental context.^3,4 Considering these risks, it is imperative to the well-being and positive development of UIMs that they have access to quality mental health services (MHS).