Children's Mental Health Services in Domestic Violence Shelters and the Influence of Immigration Status

PURPOSE: In 2011, as many as 12,062 children daily were staying in U.S. domestic violence (DV) emergency shelters. Research on psychological adjustment of DV-exposed children indicates that 40 to 60% show clinical levels of internalizing or externalizing psychological disorders. Despite the large number of children in shelters and prevalence of mental health needs among them, there is minimal information on shelter mental health services for children with even less for children of undocumented immigrant women. This literature gap is alarming as the risk profile of children of undocumented immigrants may be heightened due to perceived and actual barriers to accessing mental health services. This poster presents one of the first studies to examine children’s services in DV shelters, including those for children of undocumented immigrants.

METHODS: This 2011 online survey collected both descriptive quantitative information and context-rich qualitative information on shelter services for children in Texas DV shelters. Open-ended qualitative questions on how, if at all, shelter residents’ immigration status affects service delivery were included. All Texas emergency DV shelters, recruited via the Texas Council on Family Violence, were surveyed with a response rate of 74%(N=55). Each shelter identified the practitioner most knowledgeable on children’s services to respond. Quantitative analyses entailed calculating frequencies; qualitative analysis entailed having each case coded independently by two trained coders using content analytic methods and a consensus process to resolve differences. The sample included shelters serving every county, were half rural-based and half urban/suburban, ranged from 10-125 beds (mean=39,SD=27.3) and had housed 7-750 children in the previous year (mean=227,SD=218.6), for an average length of stay of 30 days (range=5-90,SD=18.6).

RESULTS: The most common children’s services were basic needs assistance (n=51,92.7%) and case management (n=45,81.9%). Three-quarters of the shelters provided individual counseling for children (n=41,74.5%), 31(56.4%) provided family counseling and 26(47.3%) provided group counseling. Although these services begin to address children’s mental health needs, only 7(12.7%) shelters provided screening and assessment of psychological functioning. The question, “Does the immigration status of a parent or children affect the shelter’s service delivery in any way?” yielded a puzzling finding: only 3(5.5%) responded “yes.” Responding to a qualitative follow-up question, these three participants described challenges related to accessing services, including health care, employment, housing, and service barriers within shelters because of insufficient bilingual staff. Elsewhere in the survey, however, other respondents described service barriers related to family immigration status. Findings may suggest social desirability and shelter advocates’ strong ethic of care, a methodological limitation of question phrasing, or lack of understanding of undocumented families’ specialized needs.

IMPLICATIONS: Results contribute to the literature by being one of the first studies to describe children’s shelter-based services. Since many shelters are providing counseling without formalized assessment, shelters may benefit from education on standardized mental health screening tools. In light of recent legislative debate regarding reauthorization of the Violence against Women Act and its protection of undocumented immigrant DV victims, our findings regarding barriers to care for their children are compelling. Discussion includes recommendations for future research as well as relevant methodological issues.