



































Interpreter-Mediated Therapy for Refugees:


Graduate Student Journal of Psychology          Copyright 2011 by the Department of Counseling and Clinical Psychology 

2011, Vol. 13               Teachers College, Columbia University 

4 

 

 

The Psychosocial Context and Mental Health Needs of  

Unaccompanied Children in United States Immigration Proceedings 
 

Charles D. R. Baily 
Teachers College, Columbia University 

 

Amber S. Ricks 
Teachers College, Columbia University 

 

Schuyler W. Henderson 
Columbia University 

 

Amanda R. Taub 
Fordham University 

Helen Verdeli 
Teachers College, Columbia University 

 
Little is known about the psychosocial context and mental health needs of children who migrate to 

the United States without a parent.  Under federal law, this group is classified as unaccompanied 

alien children.  They are a particularly vulnerable population, who are at high risk for exposure to 

traumatic experiences in their countries of origin, during their journeys to America, and following 

their arrival and apprehension by U.S. immigration.  This paper focuses on the needs of 

unaccompanied children who have been detained in government custody and are seeking 

immigration relief to prevent them from being deported.  We first outline recent developments in 

legislation and legal service provision designed to protect unaccompanied children.  Next, we 

describe psychosocial stressors associated with the various stages of their migration and explore the 

potential psychological impact of these stressors.  In light of this literature, we discuss different 

reasons lawyers may seek mental health services for their unaccompanied child clients.  Finally, we 

suggest areas for future research to improve understanding of the mental health needs of these 

children.  

 

 

Over the last 15 years, there has been an exponential 

growth in the literature on the mental health of immigrant 

children and families (e.g., Berry, Phinney, Sam, & Vedder, 

2006; Lustig et al., 2004; Pumariega & Rothe, 2010). 

However, one subgroup of immigrants that has received little 

attention is that of children who migrate without a parent or 

other adult family member.  These children have been 

described, among other categorizations, as “children asylum 

seekers,” “juvenile aliens,” “juvenile asylum seekers,” 

“refugee children,” “separated aliens,” “unaccompanied 

immigrant children,” “unaccompanied juvenile aliens,” and 

“unaccompanied minors.”  These terms reflect the varying 

political attitudes and immigration policies of the different 

countries through which the children are traveling or to 

which they are attempting to migrate, and have important 

implications for their legal and social status (Chavez & 

Menjívar, 2010).

 

                                                 
Charles D. R. Baily, M.A., Amber S. Ricks, M.A., Helen 

Verdeli, Ph.D., Department of Counseling and Clinical Psychology, 

Teachers College, Columbia University; Schuyler W. Henderson, 

M.D., M.P.H., Columbia University; Amanda R. Taub, J.D., 

Fordham University. 

Correspondence concerning this article should be addressed to 

Charles D. R. Baily, Teachers College, Columbia University, 

Department of Counseling and Clinical Psychology, Box 102, 525 

West 120th Street, New York, NY 10027. Email: 

cdb2123@tc.columbia.edu. 

Under the terms set out in 6 U.S.C. § 279(g)(2), U.S. 

immigration law defines an unaccompanied alien child as 

any child or adolescent who is without lawful immigration 

status in the United States, is under the age of 18, and does 

not have a parent or legal guardian to provide care and 

physical custody (Haddal, 2007).  This umbrella legal term 

encompasses children with a variety of circumstances, to 

include asylum seekers, recognized refugees, and other 

externally displaced people (Shah, 2005).  Throughout this 

paper, the abbreviated term unaccompanied children will be 

used to refer to children who meet the § 279(g)(2) definition. 

A growing number of unaccompanied children attempt 

to enter the United States each year (Chavez & Menjívar, 

2010).  In 2005, the Department of Homeland Security 

(DHS) apprehended over 114,000 unaccompanied children, 

compared with approximately 98,000 in 2001 (Haddal, 

2007).  Most of the children captured by U.S. immigration 

are Mexican, choose voluntary repatriation, and are deported 

within 72 hours.  A second group, largely comprised of 

children from other Central American countries, is 

transferred to the Division of Unaccompanied Children’s 

Services (DUCS) and enters a more formal custodial process. 

In addition to those deported and those detained, a third 

group of unaccompanied children is not detected, and does 

not come into contact with the authorities at all.  Very little is 

known about this population (Byrne, 2008). 



BAILY, HENDERSON, RICKS, TAUB, & VERDELI 

 

5 

 

This paper will focus primarily on the second group of 

children referred to above, unaccompanied children who 

have been detained in U.S. immigration custody and are 

awaiting immigration proceedings.  In 2010, 8,302 such 

children were detained in DUCS custody (M. Dunn, personal 

communication, April 1, 2011).  Though demographic 

information fluctuates slightly from year to year, 

approximately 85% of the children detained are from 

Guatemala, Honduras, or El Salvador, three-quarters are 

males, and their median age is 16 (Dunn, 2011; Haddal, 

2007).  

Advocacy organizations (e.g., Amnesty International, 

2003; Byrne, 2008; Human Rights First, 2004; Human Rights 

Watch, 1998; Women’s Refugee Commission, 2009) and 

government agencies (e.g., United States Department of 

Health and Human Services: Office of the Inspector General 

[DHHS], 2008) alike have expressed their concern about the 

well-being of unaccompanied children awaiting immigration 

proceedings.  These unaccompanied children are likely to be 

exposed to psychosocial stressors at each stage of the 

migration process (Sourander, 1998).  They may be fleeing 

violence in their countries of origin, suffer abuses on the long 

journey to the United States, have traumatic detention 

experiences, and go through the adversarial legal process 

without the support of close family and friends (Women’s 

Refugee Commission, 2009).  Such experiences put them at 

elevated risk for posttraumatic stress disorder (PTSD) and 

other forms of psychopathology, including depression, 

anxiety, and conduct problems (Piwowarczyk, 2006). 

This paper explores the link between the legal and 

mental health needs of unaccompanied children, and situates 

the work of lawyers representing them in immigration 

proceedings in the wider psychosocial context of their 

migration process.  As a backdrop to this discussion, we first 

outline recent developments in legislation and the provision 

of legal services to support unaccompanied children. 

 

Legal Provisions for Unaccompanied Children 
 

There is an inherent tension in the functions assigned to 

the U.S. immigration service vis-à-vis unaccompanied 

children.  On the one hand, like any immigration service, the 

DHS has an adversarial role in prosecuting children’s 

presence in the country and arguing for deportation.  On the 

other hand, it has a duty of care towards children in its 

custody (Women’s Refugee Commission, 2002, 2009).  At 

the international level, guidelines from the United Nations 

High Commissioner for Refugees (UNHCR) assert that any 

children apprehended by immigration authorities should not 

be detained, and stress the importance of providing children 

with access to schools and other developmentally important 

activities such as recreation and play (UNHCR, 1999).  At 

the domestic level, the U.S. federal class action settlement of 

1985 known as the Flores Settlement established minimum 

standards for placement, treatment, and release to sponsors of 

unaccompanied children in federal custody (DHHS, 2008).  

Over the last 10 years, considerable efforts have been 

made to improve the treatment of unaccompanied children in 

immigration custody, expand the forms of immigration relief 

available to them, and increase their access to legal services. 

In order to separate its conflicting roles as prosecutor and 

caretaker, the government created the DUCS in 2003 to 

administer to this population’s needs (Women’s Refugee 

Commission, 2009).  The Flores Settlement mandates that 

unaccompanied children be placed “in the least restrictive 

setting appropriate” and released to such settings “without 

unnecessary delay” (Women’s Refugee Commission, 2009, 

p. 69; p. 70).  The DUCS has greatly improved adherence to 

these guidelines, and the majority of children detained are 

now released within a few days (DHHS, 2008).  When 

possible, they are sent to relatives residing in the U.S.  If they 

have no suitable relatives available, they are placed in 

DUCS-funded foster care or other child-appropriate 

residential facilities (Haddal, 2007).  The DUCS has created 

guidelines for the provision of psychological and 

psychosocial services within its facilities while children are 

going through the often long and stressful legal process to 

determine their eligibility to stay in the United States 

(Women’s Refugee Commission, 2009). However, it is 

unclear how consistently these services are provided. A 2008 

survey of 22 DUCS-funded facilities found that the majority 

of children’s files were missing assessments or lacked 

required documentation of mental health services or 

engagement in psychosocial activities (DHHS). 

Improvements have been made in the immigration relief 

available to unaccompanied children.  Special Immigrant 

Juvenile Status (SIJS) is a form of immigration relief through 

which eligible unaccompanied children may obtain lawful 

immigration status (Byrne, 2008).  It provides a relatively 

fast route to permanent residence, with a high rate of 

successful adjustments of status (Shah, 2005).  Other forms 

of immigration relief that may be available to unaccompanied 

children include asylum and petitions based on the Victims of 

Trafficking and Violence Protection Act (VTVPA) (Byrne, 

2008). 

Access to legal services for children petitioning to 

remain in the United States is also improving.  Unlike 

criminal defendants, immigration petitioners do not have a 

right to appointed counsel (Kerwin, 2005).  Organizations 

such as Legal Aid, Catholic Charities, and pro bono programs 

in law firms provide free legal representation to 

unaccompanied children in many parts of the country, but 

have never been capable of serving the entire population.  In 

a government survey of unaccompanied children in custody 

in 1999, only 43% were represented by attorneys (United 

States Department of Justice: Office of the Inspector General, 

2001).  To supplement existing legal resources and 

coordinate the provision of counsel to unaccompanied 

children, Angelina Jolie and Microsoft co-founded Kids in 

Need of Defense (KIND) in 2008.  The organization now has 

offices in major cities across the United States.  Improving 

representation is an important component of access to justice.  

Multiple studies have shown that immigrants with legal 



MENTAL HEALTH OF UNACCOMPANIED CHILDREN 

 

6 

 

representation are more likely to be successful in their 

petitions for immigration relief (e.g., Ramji-Nogales, 

Schoenholtz, & Schrag, 2007; Transactional Records Access 

Clearinghouse, 2006).  Unaccompanied children, in 

particular, are unlikely to be able to represent themselves 

effectively without the aid of counsel (Byrne, 2008). 

Legal advocacy is situated within the wider psychosocial 

context of unaccompanied children’s ongoing migration 

process.  Lawyers may spend many months working with 

their unaccompanied child clients, the children's U.S. 

sponsors, and their families abroad to prepare their 

immigration cases and lead them through the multiple court 

hearings and other administrative steps involved in securing 

immigration relief.  Their advocacy efforts can also include 

helping these children connect to other professional services 

to address their academic, social, and psychological needs.  

Anecdotal reports from lawyers working with 

unaccompanied children suggest that many of their clients 

are struggling with psychological difficulties.  To better serve 

these children, their mental health needs should be 

contextualized in terms of the different psychosocial stressors 

to which they may be exposed during their migration process. 

 

Psychosocial Stressors Associated with Migration of 

Unaccompanied Children 
 

An extensive literature on the psychosocial stressors 

associated with migration has characterized this process as a 

series of phases: (1) premigration, (2) transit, (3) temporary 

resettlement, and (4) permanent settlement (Berry, Phinney, 

Sam, & Vedder, 2006; Lustig et al., 2004; Pumariega & 

Rothe, 2010).  Although only a small proportion of this work 

has been conducted with a focus on unaccompanied children, 

the available research suggests that their experience can be 

conceptualized in terms of these four phases. 

 

Premigration 
During the premigration phase, unaccompanied children 

are often caught up in social and political conflict as a result 

of civil war or other forms of institutional violence, such as 

the gang problems afflicting much of Central America 

(Dalrymple, 2006).  They are likely to have experienced 

threats or persecution, either directly or against loved ones 

(Sourander, 1998), and to have witnessed and/or engaged in 

violence (Lustig et al., 2004).  Whereas younger children 

tend to migrate to the United States to reunify with family 

members, older children often migrate for economic purposes 

(López Castro, 2007).  Apprehended children have also 

described migrating to the United States to flee gangs, evade 

forcible recruitment by military or paramilitary organizations, 

escape coercion into child labor or prostitution, and avoid the 

aftermath of natural disasters (Chavez & Menjívar, 2010). 

 

Transit 
In the transit phase, unaccompanied children can spend 

months traveling alone to the United States in dangerous 

conditions.  They may be attacked by bandits or gangs or 

abused by local police who are ostensibly there to protect 

them (Casillas, 2006; Seugling, 2004).  Due to the tightening 

of immigration controls, children are increasingly being 

entrusted to coyotes (people smugglers), exposing them to 

potential abuse and sexual exploitation (Bhaba & Schmidt, 

2008; Fazel & Stein, 2002).  Many of the most impoverished 

Central American children travel north towards the United 

States on the roofs of trains or under the boxcars.  There are 

often accidents in which people lose limbs or even die 

(Chavez & Menjívar, 2010). 

 

Temporary Resettlement 
In the temporary resettlement phase, unaccompanied 

children who have been apprehended and detained may have 

stressful detention experiences.  Subsequently, upon their 

release, they face a period of legal uncertainty in unfamiliar 

surroundings and without their usual sources of support 

(Perez Foster, 2001; Sourander, 1998).  

Since the creation of DUCS, there have been 

improvements in the detainment conditions of 

unaccompanied children (Byrne, 2008).  However, there is 

also evidence that some of the policies designed to protect 

children are inconsistently followed.  For example, DUCS 

facility staff have reported that procedures for identifying 

victims of rape, abuse, and trafficking as well as for assessing 

mental health issues are insufficient (Women’s Refugee 

Commission, 2009).  A minority of unaccompanied children 

are not transferred to DUCS custody and remain in prison-

like conditions in secure Immigration and Customs 

Enforcement (ICE) facilities (Women’s Refugee 

Commission, 2009).  Reports by advocacy organizations 

about conditions in such facilities have revealed practices 

such as not informing unaccompanied children of their rights, 

detaining them among adult or juvenile criminal offenders, 

forcing them to wear prison-like uniforms, hand-cuffing or 

shackling them, and denying them access to legal counsel or 

contact with family members (Bhaba & Schmidt, 2008; 

Byrne, 2008; Women’s Refugee Commission, 2009).  

Under the terms of the Flores Settlement, many 

unaccompanied children are released quickly from detention 

to family members residing in the United States (Byrne, 

2008).  However, these relatives may not know the children 

well nor be anticipating their arrival, and they may not be 

financially or emotionally equipped to accommodate them. 

 For those children released to DUCS-funded foster care or 

residential facilities, accommodation varies from houses in 

residential neighborhoods to secured buildings with barred 

windows and locked doors (DHHS, 2008; Women’s Refugee 

Committee, 2009).   

Whether unaccompanied children are housed with family 

members or in DUCS-sponsored facilities, evidence from the 

wider immigration literature suggests that the temporary 

resettlement phase may present a variety of psychosocial 

stressors (Ehntholt & Yule, 2006).  Fear of deportation, 

delays in processing applications for immigration relief, and 

worries about relatives left at home are common during this 



BAILY, HENDERSON, RICKS, TAUB, & VERDELI 

 

7 

 

period of uncertainty (Silove, McIntosh, & Becker, 1993; 

Sinnerbrink, Silove, Field, Steel, & Manicavasagar, 1997). 

 

Permanent Settlement 
For unaccompanied children who are successful in their 

immigration petitions, permanent settlement in the United 

States brings its own set of potential stressors, such as 

acculturation issues and prejudice within the local culture 

(Perez Foster, 2001).  Most unaccompanied children do not 

speak English when they arrive, and as a result they may 

struggle academically and socially (Portes, 1999). 

 Furthermore, they may not seek mental health support or 

treatment due to cultural stigma or other barriers to accessing 

care such as limited financial resources or a lack of local 

psychosocial services appropriate to their needs (Sinnerbrink 

et al., 1997). 

 

Psychological Impact of Migration of Unaccompanied 

Children 
 

To date, no empirical study has assessed the 

psychological impact of migration on unaccompanied 

children in the United States (Chavez & Menjívar, 2010).  

Most of the available information on the mental health of 

these children comes from qualitative reports by advocacy 

groups and focuses specifically on the adverse impact of 

prolonged detention in immigration facilities (e.g., Women’s 

Refugee Commission, 2002, 2009).  These reports have 

documented high rates of PTSD, anxiety, depression, 

aggression, psychosomatic complaints, and suicidal ideation 

among unaccompanied children in detention (Bhaba & 

Schmidt, 2008; Chavez & Menjívar, 2010; Women’s 

Refugee Commission, 2009).  These qualitative findings 

from the United States mirror the types of psychopathology 

found in empirical studies of unaccompanied children 

detained in Finland (Sourander, 1998) and the Netherlands 

(Reijneveld, de Boer, Bean, & Korfker, 2005).  However, 

with the exception of this work on the impact of detention, 

there is a paucity of information regarding the effects of 

psychosocial stressors associated with unaccompanied 

children’s migration. 

The wider literature on immigration and trauma suggests 

that unaccompanied children in the United States are at high 

risk for the development of psychopathology.  The majority 

are from Central America, a region whose recent history of 

civil wars and institutionalized violence make children 

especially likely to have been exposed to potentially 

traumatic events.  Thus, they are vulnerable to developing 

PTSD symptoms and other mental health problems (Locke, 

Southwick, McCloskey, & Fernández-Esquer, 1996).  

Repeated traumatic exposure during the various phases of the 

migration process can exert a compounding effect on the 

impact of premigration trauma (Robjant, Hassan, & Kasona, 

2009; Sinnerbrink et al., 1997), and may lead to complex 

trauma reactions (National Child Traumatic Stress Network, 

2003).  Children’s responses to complex trauma can include 

attachment problems, emotional and behavioral regulation 

difficulties, dissociative episodes, poor self-image, and 

physical and cognitive deficits (Courtois, 2004; Herman, 

1992; National Child Traumatic Stress Network, 2003). 

 Lack of parental support, which can provide an important 

regulating influence following traumatic exposure, may place 

unaccompanied children at particular risk for developing 

psychopathology (Lustig et al., 2004). 

In addition to mental health problems, unaccompanied 

children may be at risk for other psychosocial problems. 

 Separation from parents has been shown to predict poor 

academic achievement in recently arrived immigrant children 

(Suárez-Orozco, Bang, & Onaga, 2010), and unaccompanied 

children’s academic and social development may have been 

disrupted by lack of access to schools in their countries of 

origin or during the migration process (Fazel & Stein, 2002). 

However, there is a lack of research focusing specifically on 

psychosocial difficulties among unaccompanied children. 

Despite the multiple stressors associated with migration, 

many unaccompanied children show resilient outcomes. 

 Both individual variables (e.g., a child’s sense of self-

efficacy) and contextual factors (e.g., transit or detention 

experiences) may contribute to whether or not children 

develop psychopathology (Luthar & Zelazo, 2003).  Different 

children may experience psychosocial stressors in a variety 

of ways.  For example, the presence of family members is not 

necessarily protective against the stress of immigration 

custody: a study of children in immigration detention in 

Australia (Mares & Jureidini, 2004) found that the experience 

of parental distress, traumatization, and mental illness during 

detention increased children’s vulnerability to 

psychopathology.  In some circumstances, the fact that a 

child has successfully navigated multiple stressors to make it 

to the United States can be evidence of psychological 

resourcefulness.  Based on low rates of mental health 

problems observed among adult Mexican 

immigrants, Escobar and colleagues developed the migration 

of the fittest hypothesis (Escobar, 1998).  This construct holds 

that, due to the harsh realities of the immigration process, 

only the strongest and most resilient attempt and succeed in 

coming to the United States.  This idea may also apply to 

unaccompanied children, who are likely to endure a host of 

psychosocial stressors alone.  Alternatively, in some cases a 

child’s highly developed survival skills may mask other 

social and emotional deficits (Piwowarczyk, 2006). 

Taken as a whole, the literature on the psychosocial 

stressors associated with migration suggests that 

unaccompanied children in immigration proceedings are at 

high risk for psychopathology.  However, there are likely 

considerable differences between children based on 

individual characteristics (e.g., children’s age and gender) 

and their varied migration stories (e.g., why they left their 

country of origin, how they traveled to the U.S border, and 

how long they were detained in immigration custody).  The 

impact of these different factors warrants further study, and a 

better understanding of the mental health needs of 

unaccompanied children will assist lawyers who work with 

this population in making appropriate referrals. 



MENTAL HEALTH OF UNACCOMPANIED CHILDREN 

 

8 

 

Mental Health Referral Practices of Lawyers Working 

with Unaccompanied Children 
 

Lawyers may request psychological services for their 

clients for a variety of reasons: to provide assessment and 

expert testimony to bolster a client’s case; to give advice or 

clarification about a client’s presentation and history; to 

deliver treatment to a client who is exhibiting distress or 

symptoms of a mental illness (Galowitz, 1999; Price & 

McCreary, 1976).  Given their elevated risk for psychological 

distress, unaccompanied child clients may be particularly in 

need of such services. 

Mental health professionals can be called upon to 

support unaccompanied children’s immigration cases by 

conducting a psychological assessment and providing expert 

testimony.  The three primary forms of humanitarian relief 

for which unaccompanied children may be eligible each 

require evidence of psychosocial stress.  In the case of SIJS 

petitions, evidence must be provided that children are eligible 

for long-term foster care due to neglect, abuse, or 

abandonment, and that it is not in their best interests to return 

to their home country (Shah, 2005).  To make an asylum 

claim, a well-founded fear of persecution on the basis of race, 

religion, national origin, political opinion, or social group 

must be established.  Petitions based on VTVPA require 

evidence of transportation of unaccompanied children for 

subsequent exploitation, usually in the form of forced labor 

or prostitution (Byrne, 2008).  Expert mental health 

testimony can bolster each of these types of claims by 

documenting exposure to relevant psychosocial stressors and 

their impact on the unaccompanied child. 

Lawyers may call upon mental health professionals to 

help unaccompanied children recount traumatic events from 

their history that provide grounds for one of the above forms 

of relief.  Anecdotal evidence from lawyers suggests that 

without such assistance, unaccompanied children with trauma 

histories often avoid telling the truth about what has 

happened to them, which can undermine legitimate claims for 

immigration relief.  This is consistent with findings from the 

psychological literature that children with PTSD may avoid 

talking about traumatic experiences (Schaal & Elbert, 2006). 

Aside from case-specific considerations, lawyers may 

also seek mental health services for unaccompanied children 

out of a more general concern for their well-being.  However, 

mental health treatment may also, indirectly, assist in 

children’s immigration relief claims.  For example, 

improvements in symptoms of disorders such as PTSD and 

depression can increase children’s ability to recount or verify 

difficult migration experiences.  Additionally, immigration 

judges commonly inquire about children’s school attendance 

and other behaviors over the course of the immigration 

process.  A child who has received mental health services 

may be better able to respond to such questions. 

Although lawyers frequently call on mental health 

professionals to assist unaccompanied children in 

immigration proceedings, there has been little systematic 

study of how, when, and why they decide to make referrals.  

Research in this area is urgently required to ensure that the 

mental health needs of unaccompanied children are being 

appropriately met.  For example, efforts should be made to 

help children provide testimony with the least discomfort 

possible.  Child advocacy centers routinely use 

multidisciplinary teams (including lawyers and mental health 

professionals) to interview victims of abuse and their families 

about sensitive material. Not only does this protect children 

by reducing the number of times they have to recount abuses, 

it has also been shown to lead to more reliable and consistent 

information, and higher rates of successful cases (Smith, 

Witte, & Fricker-Elhai, 2006).  Whether such an approach 

would be feasible and applicable to the case of 

unaccompanied children bears exploration.   

 

Directions for Future Research 
 

Unaccompanied children are a challenging population to 

study.  Typically, they are only officially identified when 

apprehended and placed in immigration proceedings. 

 Conducting research with children is always ethically 

complicated, but when there are sensitive legal 

considerations and parents are not available to provide 

informed consent, the task is rendered even more difficult. 

 Furthermore, while legal categories like unaccompanied 

alien child are created to protect the rights of children, they 

also create a propensity to assume high degrees of similarity 

among individuals within a given category (López Castro, 

2007).  However, beyond their uncertain immigration status, 

there is no other single factor that consistently unites 

unaccompanied children as a homogenous group (Henderson, 

Baily, & Weine, 2010).  

Nevertheless, as a whole, the existing evidence suggests 

that unaccompanied children in immigration proceedings are 

a highly vulnerable population and at risk for exposure to 

multiple psychosocial stressors and their psychological 

sequelae.  At this time, several domains of study warrant 

further attention: the familial context of these children; their 

psychosocial and psychiatric needs; their experience of the 

U.S. immigration process; and their lawyers’ perceptions of 

their mental health needs. 

With regard to the familial context of unaccompanied 

children, there are many questions one might ask: Where are 

their families and what compelled the children to separate 

from them?  Do they intend to reunite with parents or other 

family members and, if so, when and where?  How do they 

understand this separation - is it something normal, unusual, 

temporary, or permanent?  These children’s thoughts about 

their family situation are likely be varied and complex, and 

possibly quite different from other culture-bound 

expectations for children of their age.  One of the concerns 

some unaccompanied children raise with their lawyers is 

whether they will be able to get into the workplace promptly 

in order to start sending money to family members back 

home.  Even if they have a promising case for acquiring 

permanent legal status, the pressure to start earning causes 

some children to choose voluntary repatriation and attempt to 



BAILY, HENDERSON, RICKS, TAUB, & VERDELI 

 

9 

 

reenter the country again illegally, rather than pursue the 

time-consuming immigration process. 

Information on the psychosocial and psychiatric needs of 

unaccompanied children is also limited.  Both studies (e.g., 

Bhaba & Schmidt, 2008; Chavez & Menjívar, 2010) and 

anecdotal accounts from their lawyers suggest that some of 

these children are very distressed and have identifiable 

clinical disorders, but many questions remain:  How do the 

children themselves tell their own stories?  And what place is 

there in their narratives for psychological, psychiatric, and 

psychosocial explanations (e.g., “I’m not crazy”, “This is 

normal”, or “I feel very sad”)?  How do they conceptualize 

loss, trauma, and resilience?  What coping resources are 

available to them, and how do they access this support?  How 

do factors such as age, gender, reason for migration, and 

country of origin moderate the experience of migration 

stress?  Finally, how can psychological and psychiatric 

expertise, which is subject to criticism of its own cultural 

specificity (Summerfield, 2008), help understand and assist 

this varied population? 

Further research is also required to understand how the 

immigration process impacts unaccompanied children’s 

mental health and psychosocial functioning.  Anecdotally, 

lawyers report that some of their clients express relief at 

being apprehended by U.S. immigration, freed from abusive 

coyotes, and given regular meals and a warm place to sleep. 

 Some children are intimidated by coyotes into lying to 

immigration officials about their age and, as a result, get sent 

to adult detention facilities entirely inappropriate to their 

needs.  Out of fear for themselves and family members, some 

opt to take voluntary departure to Mexico so that they can 

attempt to reenter the country immediately and start paying 

off the coyotes to whom they are in financial bondage.  More 

generally, how do children feel about being apprehended and 

“criminalized”?  How are laws explained to them?  How do 

they understand the legal options that may be available to 

them, and what informs their decisions about how to 

proceed? 

More systematic research on how lawyers understand the 

psychosocial context and mental health needs of their 

unaccompanied child clients is also needed.  What are 

lawyers’ experiences of working with these children?  How 

do they identify mental health problems in their clients, and 

how does it impact their work with them?  How might having 

a clinical diagnosis affect immigration proceedings?  Often 

unaccompanied children live in immigrant communities in 

which many people are undocumented and understandably 

wary of contact with official institutions and public services.  

Given this context, lawyers may offer a rare point of access 

and source of information about these children.  They also 

provide one conduit into the mental health system for those 

children in need.  However, currently this process is poorly 

understood.  When, how, and why do lawyers access 

assessment or treatment services for their unaccompanied 

child clients?  Do they have any process for screening for 

mental health problems, either formally or informally?  

These, and other questions like them, offer not only an 

avenue for better understanding the mental health needs of 

unaccompanied children, but also the possibility of 

improving their access to feasible and effective mental health 

services. 

 

Conclusion 
 

The research reviewed in this paper suggests that 

unaccompanied children in immigration proceedings are 

likely to have experienced multiple psychosocial stressors 

during the process of their migration to the United States, and 

are at high risk for psychological problems.  The literature 

also indicates that over the last 10 years considerable 

progress has been made in improving their situation.  At the 

legislative level, the forms of immigration relief available to 

unaccompanied children have expanded; at the advocacy 

level, legal and non-governmental organizations have 

successfully lobbied for improved conditions for children 

apprehended and detained by immigration services; at the 

services level, access to expert legal representation has been 

improved.  There seems to be growing consensus that it is in 

society’s best interests to normalize unaccompanied 

children’s immigration status and, for those permitted to stay, 

support them in their aspirations.  In order to facilitate this 

process, it is crucial that their psychosocial circumstances 

and mental health needs be understood and addressed. 

 

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