Mary Lehman Held

Immigrant and refugee children and youth are at heightened risk for posttraumatic stress disorder (PTSD), anxiety, and depression, yet the comparative efficacy of psychological and psychosocial interventions remains unclear. This systematic review and network meta-analysis evaluated interventions for reducing these outcomes among immigrant and refugee children and youth. Eligible studies included randomized and non-randomized trials of psychological or psychosocial interventions with comparison conditions and pre–post measures of PTSD, anxiety, or depression. Thirty studies met inclusion criteria. Random-effects network meta-analyses were conducted using standardized mean differences (SMDs). Twelve intervention categories were identified across clinical, school, community, and humanitarian settings. For PTSD symptoms, narrative exposure therapy (SMD = 1.69, 95% CI [0.75, 2.64]), eye movement desensitization and reprocessing (EMDR; SMD = 1.67 [0.83, 2.50]), cognitive-behavioral therapy (CBT; SMD = 1.20 [0.56, 1.83]), and integrative therapies (SMD = 0.92 [0.24, 1.60]) were significantly more effective than inactive controls. For anxiety symptoms, EMDR (SMD = 0.82 [0.24, 1.41]), CBT (SMD = 0.67 [0.19, 1.14]), and crisis management (SMD = 0.63 [0.14, 1.12]) showed significant effects relative to inactive controls. For depression, no intervention demonstrated a statistically significant advantage over inactive control, although several interventions showed positive estimates with substantial uncertainty and heterogeneity. Findings support trauma-oriented interventions for reducing PTSD and anxiety symptoms, while evidence for depression remains limited and inconsistent.

Caregiver strain or stress resulting from caring for a child with emotional/behavioral problems—can negatively impact the psychological health of caregivers and may underly decisions to seek mental health services for their youth. The Caregiver Strain Questionnaire‐Short Form 11 (CGSQ‐SF11) was developed to assess caregiver strain, but a Spanish language form has yet to be evaluated, limiting its utility with Latinx families. This study evaluated the CGSQ‐SF11 as a tool for assessing caregiver strain among Latinx caregivers. The sample included 511 Latinx caregivers of youths aged 6–18 who self‐selected into English ( n = 275) or Spanish ( n = 236) questionnaires. In general, caregivers reported moderate levels of caregiver strain, and caregivers who completed the Spanish survey reported significantly lower youth mental health problem severity and caregiver strain relative to those in the English survey. Confirmatory factor analyses suggest that a three‐factor structure fit the data better (i.e., objective, subjective internalized, and subjective externalized strain) than a global factor. However, a bifactor model suggested that the variance in the total score was best represented by a unidimensional structure. The CGSQ‐SF11 achieved metric invariance, which suggests that the latent variable and strength of factor loadings for the global scale were similar across language forms. Finally, we provide evidence of convergent validity through associations between the CGSQ‐SF11 global scale and measures of youth internalizing and externalizing problems. Our findings support the use of CGSQ‐SF11 English and Spanish language forms with Latinx caregivers.

Tornadoes in the southeastern United States create disproportionate damage and fatalities, especially for Latinx communities. Latinx immigrants often have limited prior experience with tornadoes, while also facing linguistic, cultural, and structural barriers that can reduce access and responses to warnings. To better understand Latinx experiences and potential strategies to improve warning access, this qualitative study examined lived experiences, warning reception, and preparedness among Latinx adults and identified strategies to improve communication. The study included in-depth interviews with Latinx adults across the Southeast ( n = 37), followed by a case study in one city entailing separate focus groups with Latinx community leaders and National Weather Service (NWS) staff. Finally, a joint meeting with Latinx leaders and NWS staff was held to identify potential feasible solutions. Thematic analysis revealed barriers related to language, terminology, housing, and trust in official sources. In response, participants reported a reliance on informal networks and social media for information. Potential solutions included strengthening Spanish communication strategies, use of visual materials to convey information, partnering with trusted community organizations and schools, and building sustained relationships between NWS and Latinx communities. The case study process highlighted collaboration with community leaders as a practical model for culturally responsive communication and strategizing toward a solution. Findings underscore the need for linguistically and culturally tailored warning strategies to promote equitable tornado safety and preparedness. Significance Statement: Tornadoes are a significant threat in the southeastern United States, where Latinx communities are growing rapidly. Many Latinx immigrants lack previous exposure to tornadoes and may not receive or fully understand warnings due to language barriers, lack of tornado-related knowledge, and lower trust in official systems. This study shows how these factors can reduce timely protective action and increase vulnerability. Through interviews with Latinx residents, Latinx community leaders, and National Weather Service staff, we identify practical ways to improve communication, including strengthening Spanish-language delivery, use of visual and nonwritten materials, and partnerships with Latinx-serving community organizations. Culturally and linguistically responsive warning systems are key approaches to reaching vulnerable communities toward more equitable disaster preparedness and safety.

In 2018, Immigration and Customs Enforcement conducted a large-scale workplace raid in East Tennessee. Nearly 100 workers were initially arrested, with 54 being detained out of state. Grief and fear associated with the raid rippled across families and the community. In response, community organizations, faith leaders, and other advocates provided both immediate and long-term emotional support and financial relief to address basic needs. The current qualitative study was designed to explore experiences of community responders and providers who supported families, through individual interviews. Participants ( n = 11) were asked a set of semi-open-ended questions regarding their roles, as well as the short- and long-term impacts of the raid. Transcribed interviews were coded by two research team members, applying inductive thematic analysis approaches. Three overarching themes emerged: (1) Immediate Response; (2) Impact of the Raid; and (3) Barriers and Lessons Learned. Results suggest that both community members and providers responded immediately following the raid, providing donations and support. The raid detrimentally impacted families who had a member detained, the community, and providers themselves. Multiple barriers and lessons learned emerged to inform preparation in this and other communities. Findings offer crucial insights for understanding not only the needs but also effective strategies for responding to raids.

Newly arriving individuals who have relocated from another country, especially those escaping situations of stress and violence, trauma, and uncertainty, can experience challenges with integration in a new country. To respond to these needs among new arrivals, we utilized community-based participatory research (CBPR) to develop a novel and culturally responsive intervention. In this research note, we describe our partnership with a community agency, the agency’s vital role in the development of this intervention, the salience of community voice, and the agency’s unique needs. To conclude, we highlight best practices for implementing community-centered interventions and discuss implications for future research with new arrivals.

Decisions to migrate are based on individual and family assessments of risk and opportunity, shaped by economic conditions, risks and experiences of violence, resources, and networks, which interact with personal factors and opportunity. During the journey, migrating people may encounter threats to their safety and wellbeing from both human and natural hazards. This study drew on survey data from 305 Mexican and Central American participants who migrated into the US between 2013 and 2022 alone or with families and children. Respondents provided demographic data and answered questions about stressors that prompted their migration, dangerous experiences encountered on their journey, sources of support, and what they wished they had known. Factors that influenced migration included economic stressors such as loss of job and poverty, witnessing or experiencing interpersonal violence or state violence such as kidnapping or threats to self or family, and environmental factors such as natural disasters. Approximately a third of participants traveled with their children, parents or siblings. Younger migrants and migrating people traveling with children reported significantly higher likelihood of encountering dangers during migration. Implications for supporting migrating children and families who have encountered violence and trauma are discussed, as well as limitations of the research.

Migrating people fleeing violence and persecution face narrowing options to seek safety through the U.S. immigration courts. Social work’s historical and ongoing commitment to immigrant health and immigrant justice supports an enlarged presence within asylum and other immigration processes. In the role of experts, social work clinicians can evaluate displaced people to collect evidence of harm, draft reports and affidavits for the lawyer, and may even testify to educate the court on the physical and mental sequelae of violence and trauma. They play an essential part in communicating the complexity of migrating people’s stories to adjudicators. Social work clinicians seeking to join this work will attune to cultural humility, relationship building, and an opportunity to support displaced peoples’ human right to safety, in line with the skills and values of the profession. This paper serves as a brief introduction to how clinical social workers can use their mental health expertise to contribute to immigrant legal proceedings, as well as a call to action to invite both new and established social workers to use their clinical skills to meet our profession’s ethical obligations to the human rights of migrating people.

Existing research highlights the impact of migration-stage stress on the mental health of Latinx migrants. However, there remains limited understanding of the experiences of recently arrived Mexican and Central American migrants who have fled hardships and encountered substantial challenges throughout their migration journey. To address this gap, this study was designed to examine the associations between cumulative stress experienced at distinct stages of migration (pre-migration, peri-migration, and post-migration) to the United States (U.S.) and depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms. Additionally, the study aimed to examine the moderating role of social support as a protective factor for these mental health outcomes. Using a cross-sectional design, survey data were collected from Mexican and Central American migrants who arrived within the past decade (n = 305). Multiple regression analyses were employed to assess the relationship between stage-specific migration stressors and reported symptoms of depression, anxiety, and PTSD. Higher pre-migration and post-migration stress were significantly associated with increased symptoms of depression, anxiety, and PTSD, while peri-migration stress was specifically associated with heightened anxiety and PTSD symptoms. Notably, social support demonstrated a protective effect on all mental health symptoms, although no significant moderating effects were observed. Findings highlight the critical importance of addressing migration-stage stress throughout all stages of migration. This study presents practice and policy implications to promote the wellbeing and integration of Mexican and Central American migrants in the U.S.