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Pediatric Mental Health Stressors Related to Migration

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Nurses in Western society have been caring for migrant families through the ages. Migrant children have a particularly challenging journey when traveling to a foreign land. They are often linked to a lower socioeconomic class and are at risk for acute disease and mental health stressors following a long journey. These physical and mental stressors are often present with the initial health assessment intake and are directly related to the difficult journey, malnutrition, dehydration, lack of clothing and shelter, and familial stress and/or separation from loved ones. Misinterpretation and misunderstandings occur as the journey ends at the border with language and cultural barriers. Overcrowded conditions, unfamiliar foods and sleeping arrangements, and isolation contribute to the anxiety and depression often seen in migrant children. Nurses are uniquely equipped to provide culturally sensitive care and communication to alleviate some of the stress when entering a new country.

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Pediatric Mental Health Stressors Related to Migration

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- Printer friendly version of this teaching strategy
- Ana Lucia case study
Learning Objectives
Students will:
- Recognize the effects of the migrant journey on the mental health of migrant children
- Identify how nurses can play a role in acclimating migrant children to the Western medical model of health care
- Identify available and appropriate culturally and linguistically sensitive services for improved health care among migrant children and their families
Learner Pre-Work

Review Maslow’s Hierarchy of Needs.

Read the World Health Organization’s webpage on Migration and Health: Key Issues http://www.euro.who.int/en/health-topics/health-determinants/migration-and-health/migrant-health-in-the-european-region/migration-and-health-key-issues

Read:
Chang, C. (2019). Social determinants of health and health disparities among immigrants and their children. Current Problems in Pediatric and Adolescent Health Care, 49(3), 23-30. Retrieved from https://www.sciencedirect.com/journal/current-problems-in-pediatric-and-adolescent-health-care/vol/49/issue/1
Suggested Learning Activities
1. Review the Ana Lucia case study about a three-year-old female from Guatemala experiencing malnourishment, dehydration, and fatigue.
- Lead a classroom discussion about Ana Lucia’s basic needs from Maslow’s Hierarchy of Needs.
  - What are Ana Lucia’s psychological and physical needs?
  - What are Ana Lucia’s safety needs? Identify potential frightening equipment or experiences Ana Lucia might encounter in the hospital.
  - What interprofessional collaboration and referrals should be established for this family?
- Lead a classroom discussion on nursing behaviors that will support Ana Lucia.
  - Identify barriers in communication as they relate to a three-year-old non-native English speaker who has different cultural traditions and beliefs.
  - How can a professional interpreter or a translating phone app facilitate communication with Ana Lucia and her mother?
  - How can nurses address the loss of Ana Lucia’s “doll”?
  - How do nurses alleviate fear with children unfamiliar with technology and traditional hospital routines?
    - Nonverbal suggestions: smiles, eye contact at the child’s level, slow, careful movements
    - Suggested comfort items: blankets, colorful, simple toys and stuffed animals, culturally sensitive foods
    - Assessment suggestions: demonstrate on puppet or doll
2. Identify community resources that provide a bridge for language communication barriers for migrant children. Complete the table below as you gather information about resources available in your area:

Name/Address of Resource

Services Provided

Language(s) Offered
Suggested Reading

Linton, J., & Green, A. (2019). Providing care for children in immigrant families. Pediatrics, 144(3). Retrieved from https://pediatrics.aappublications.org/content/144/3/e20192077

Center for Applied Linguistics Immigrant & Refugee Integration: http://www.cal.org/areas-of-impact/immigrant-refugee-integration

Centers for Disease Control and Prevention Immigrant and Refugee Health: https://www.cdc.gov/immigrantrefugeehealth/

World Health Organization Refugee and Migrant Health: https://www.who.int/migrants/en/
Author Information

Jennifer Ware, MSN, RN
University of Texas at El Paso
El Paso, Texas