P3B083: Addressing Parental Mental Health and social Stress in Migrant Families

Background: Since 2012, millions of members of migrant families (MF) have sought protection in the US. Unprecedented numbers apprehended at the US southwest border reflect global humanitarian crises. Histories of trauma occur before, during and after migration. Once released from immigration custody, MF arrive in new communities and face deportation while waiting years for immigration court to decide their fates. Community based interventions can holistically address their complex needs during this time of transition. Terra Firma (TF), founded in 2013, is a wraparound service model built around co-located medical, mental health, social and legal services for unaccompanied migrant children and MF. Parents with high levels of stress or trauma or unmet social needs are at increased risk for engaging in parenting styles that undermine secure child-parent attachment, and may be less emotionally and functionally available to their children. Insecure parent-infant attachments in turn are associated with poor mental health outcomes and interrupted developmental trajectories for children.

Methods: TF aims to mitigate early childhood stress and improve early childhood development through facilitating family resilience and enhancing parental coping through addressing parental distress and social needs in MF with children 6 years or younger by screening: (1) parents for symptoms of trauma, depression and anxiety and refer them to psychotherapy focused on facilitating stabilization and treating trauma and (2) with a standard SDoH screener and refer for individual case management and/or to a social service support group.
Parents complete a baseline screening for: (1) mental health using the PTSD Checklist (PCL-C/PCL-5); the Patient Health Questionnaire (PHQ-9) for Depression, and the General Anxiety Disorder 7 Item Scale (GAD-7); (2) parental stress (Daily Parenting Hassles Survey), and (3) social need (SDoH Screener). To determine improvement in maternal MH and parental coping, screening will be repeated after six months of MH care and scores will be compared to baseline results. Improvement in parental mental health and coping will be assessed by decreasing scores on these measures.

Results: Since the program’s launch in November 2022 TF has enrolled 22 caregivers with 25 children 6y or younger, Preliminary analysis demonstrates that 40% of participants scored positive on at least one mental health measure and 30% scored positive on the parenting difficulty scale. More complete analyses with a larger sample size will be presented at the time of the conference.

Conclusion: Stress not buffered by a loving caregiver i.e. toxic stress, may be detrimental to young children’s present and future health. Preliminary data and clinical experience demonstrate significant parental need. A community based intervention focusing on the early identification of parental distress and social need, such as the one being evaluated in this project, may foster positive parenting and promote child well-being in a population experiencing significant dislocation and trauma.