The highly diverse and rapidly growing Houston metropolitan area is home to 1.6 million immigrants. In 2017, for the first time, the region was home to more Latino than non-Hispanic White residents, alongside substantial Asian and African populations. Mexico remains the top origin country for immigrants in Houston, but other foreign-born populations, including from Venezuela, Cuba and Nigeria, have grown much more quickly in recent years.
The provision of trauma-informed and culturally responsive mental health care services for vulnerable immigrant children is a social justice and human rights issue that must be tackled. Specifically in Houston, vulnerable immigrant children are facing a serious humanitarian crisis. When immigrant children leave shelters and enter the community, they are lost to follow-up and many of their physical and mental health care needs remain unmet. We are in desperate need of an organizing group to gather community resources, create awareness, and educate local service providers across the Houston area so they may join us in providing mental health services to vulnerable immigrant children.
Wicked Problem Description:
There is incredible diversity within immigrants in Houston. This diverse population includes many, but unaccompanied minors (UMs) are likely the most vulnerable immigrants in the United States (Antony & Thomas, 2017). UMs are defined as children younger than 18 years of age without lawful immigration status and have no parent or legal guardian available to offer care (Byrne & Miller, 2012). In recent years, large numbers of UMs began arriving to the United States from Guatemala, El Salvador and Honduras seeking safety from alarmingly increased rates of gang, community and domestic violence. Yet, there are very few resources and research studies that address the health needs of UMs, particularly their psychological and emotional supports (Carlson et al., 2012). Texas Children’s Mobile Clinic Program in conjunction with Texas Children’s Trauma and Grief Center, Yes to Youth in Montgomery County, affiliated universities and local nonprofits propose a solution named BRIDGE UM! to address the wicked problem of inadequate access, provision and use of mental health services for vulnerable immigrant children including UMs in the Houston community.
The project will pair medical and mental health staff to develop training modules for community providers to identify vulnerable immigrant children in need and deliver trauma-informed, and culturally responsive, mental health services. Our strategy includes three main areas of focus:
- Creating a local network: We propose to create a comprehensive network of Houston area health care providers, community leaders, mental health care professionals, and community agencies to address health disparities by increasing access, provision and use of mental health care services.
- Creating the first clinical model: The project will create the first clinical model to screen children at physician offices and provide community mental health services for vulnerable immigrant children in the Houston area with intention to replicate the model in other cities throughout the United States.
- Addressing our challenges: Our aim is to reach immigrants, including UMs, who have left an ORR sponsored shelter. Currently, reaching vulnerable immigrant children is a challenge as many leave the shelter and are lost to follow up. Our partnership will be essential in locating these youth and sharing resources.
Establish a knowledge base and coalition throughout the Houston community to provide clinical services that support the mental health needs of vulnerable immigrant children by addressing the lack of access, provision and use of mental health care.
Short-term: Complete an in-depth needs assessment in the Houston area of vulnerable immigrant children’s mental health access, provision and use of services, and build a collaborative coalition of key health care partners
Long-term: Deliver resources and trainings to providers dedicated to serving vulnerable immigrant children in Houston by creating a unified standard of trauma-informed, and culturally responsive, screening and mental health care. Create a toolkit of best practices to replicate the model in other locations throughout the United States.
Year 1 Needs Assessment: Complete an in-depth needs assessment in the Houston area of vulnerable immigrant children’s mental health access, provision and use of services.
Year 1 & 2 Development: Develop a collaborative coalition of key health care partners and create a toolkit of best practices to support the mental health needs of vulnerable immigrant children.
Year 3 Implementation: Deliver resources and trainings to providers dedicated to serving vulnerable immigrant children in Houston by creating a unified standard of trauma-informed and culturally responsive mental health care.
The diverse, interdisciplinary clinical team will be assisted by community partners (built through the coalition), university partnerships, and key mentors who are experts in the fields of trauma, mental health and vulnerable immigrant children.
We will begin the project with a comprehensive health needs assessment using focus groups and interviews with vulnerable immigrant children, clinical providers and community leaders to understand mental health needs and resources. After the project implementation, we will conduct an outcomes evaluation to measure our impact via analyzing the numbers served (vulnerable immigrant children and partners in network) and the level of preparedness in delivering trauma-informed and culturally responsive services.