Mental health of children held at a United States immigration detention center.

Rationale; Children held in immigration detention may be at risk for mental health disorders due to the impacts of pre-migration factors, including exposure to violence, their displacement from their home countries, their journey between countries, and the conditions of their detention. Limited research has demonstrated high rates of clinical depression, post-traumatic stress disorder (PTSD), and anxiety disorders among detained immigrant children. Objective; In this cross-sectional study, we assessed the mental health of children held at a US immigration detention center over two months in mid-2018. Method; We interviewed 425 mothers about their eldest child age 4-17 using the Parent-Report Strengths and Difficulties Questionnaire (SDQ). A subset of 150 children age ≥9 completed the UCLA Post-Traumatic Stress Disorder Reaction Index (PTSD-RI). Results; Among the 425 children studied, many demonstrated elevated scores for emotional problems (32%), peer problems (14%) and total difficulties (10%) on the SDQ. Younger children (age 4-8 years) demonstrated more difficulties associated with conduct, hyperactivity, and total difficulties (all p < 0.001) compared to older children. Children who had been forcibly separated from their mothers demonstrated significantly more emotional problems (49%, p = 0.003) and total difficulties (15%, p = 0.015) than those who had never been separated. Of the 150 children who completed the PTSD-RI, 17% had a probable diagnosis of PTSD. In all, nearly half (44%) of all children demonstrated at least one emotional or behavioral concern. Conclusions; These data demonstrate that children being held in immigration detention experience high levels of mental health distress. Results suggest they would benefit from more comprehensive mental health screening and release into the community, as well as culturally-responsive and trauma-informed mental health care.