Mental health and adaptation among newcomer immigrant youth in United States educational settings

Supporting Transition Resilience Among Newcomer Groups (STRONG): Examining effectiveness and acceptability in urban public schools

The Supporting Transition Resilience Of Newcomer Groups (STRONG; Hoover et al., 2019) program was developed to support mental health among newcomer refugee and immigrant students by (1) promoting positive adjustment during resettlement through a trauma-informed, strengths-based approach, contextualized to meet the needs of refugee and immigrant youth; and (2) improving access to services through school-based programming. The purpose of this study was to examine the acceptability and effectiveness of STRONG on the mental health and resilience of refugee and immigrant students using a group randomized waitlist control design. A sample of 64 newcomer students (Mage = 13.9, SD = 3.11; 41% female) was recruited to participate in the STRONG program, representing 19 different countries of origin and diverse ethnicities (44% Latiné; 34% Asian; 13% Middle Eastern/North African; 8% African/Black). Additionally, teachers or administrators from each participating STRONG school completed interviews, while group facilitators (e.g., clinicians and bilingual teachers) were invited to participate in focus groups. This study provides preliminary evidence that STRONG supports newcomer mental health, with students in the immediate treatment group showing reductions in anxiety/depression and externalizing symptoms compared to the waitlist. Qualitative findings provide additional support for the acceptability and benefits of this intervention. However, coping efficacy unexpectedly decreased, and several interactions with school type (e.g., high school vs. elementary) emerged. Additional research is warranted to further evaluate this promising intervention for newcomer youth.

Case Management for Social Needs of Youth and Families in School-Based Health Centers

BACKGROUND

School-based health centers (SBHCs) are ideal settings to address social needs of youth and families. Case managers can play a vital role in social care interventions.

METHODS

We piloted a program to incorporate a Case Manager into the care team of 1 SBHC serving 2 local schools with over 900 students and their surrounding communities. This project's purpose was to evaluate program feasibility, utilization, and acceptability. Our mixed-methods evaluation included analyses of data from electronic health records, client satisfaction surveys, and staff interviews.

RESULTS

During the 6-month pilot, the Case Manager served 133 clients (about one third of all SBHC clients served) through 593 contacts. Most contacts included referrals to support services (90%) and 37% addressed newcomer immigrant adjustment. All 37 respondents to the satisfaction survey during the 3-month administration period (44% response rate) reported that the Case Manager made them feel comfortable asking for help; 95% reported getting the help they needed. The 7 SBHC staff interviewed shared many program benefits, including increased time for clinical services.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Inequities in children's health and educational achievement are influenced by structural factors. Results from our pilot program demonstrate that SBHCs may be well-positioned to deliver social care interventions and that case managers enhance the ability to deliver quality care.

CONCLUSIONS

School-based programs to address unmet social needs are critical to supporting learning and wellness for all youth. Robust studies are needed to further test the impacts of case management in SBHCs.

Trauma Informed Best Practices and Resiliency

Children who experience fleeing from their home countries, whether with family members or unaccompanied, almost certainly experience trauma. The response of caring systems should remain grounded in the known principles of trauma-informed care, an understanding of best practices based on evidence-based and informed interventions and the developmental process. In addition, care providers should be working to maximize the safety of the environment in which they are interacting with children and youth and considering the style, approach, and content of interaction to balance the purpose of any interaction with the safety and security needs of each child or youth.

Acculturating Systems of Care to Ensure Healthy Futures for Latine Migrant Youth

Migration across the Americas is an ever-changing process with current trends including increased migration into the United States of Latine youth. Experiences before, during, and after migration can increase the risk of psychiatric illness, including discriminatory and exclusionary experiences when accessing care. Acculturation typically focuses on the process that the immigrant group experiences when coming into contact with a host culture. Members of the host culture and systems of care can take intentional steps to acculturate themselves in an integrative manner in an effort to reduce host-immigrant friction and better coordinate care across systems.