Parent Nativity and Legal Immigration Status: A National Survey of Barriers to Mental Health Service Use Among Latino Children with Child Welfare Involvement

Background and Purpose:  Much attention has been paid to the mental health needs of children involved with the child welfare system. However, little is known about the mental health care of children of immigrants with child welfare involvement. Recent studies have raised concern that immigrant status and cultural and linguistic issues inhibit access to and use of needed mental health services. The current study examines whether mental health service receipt by Latino children reported for child maltreatment is associated with parent nativity and legal immigration status. It aims to shed light on unmet mental health needs of Latino children, specific points of access to services, and barriers to service receipt in this population.

Methods:   This analysis used data from the second round of the National Survey of Child and Adolescent Well-Being (NSCAW II). The sample was restricted to Latino children aged 3-17 who remained in the home with a biological parent at the time of initial interview, and had complete data for all predictors (n=413). Parental nativity and legal status were defined by variables using information about the parent’s country of origin, citizenship, and legal status. Child mental health need was assessed using the Child Behavior Checklist. Mental health services examined included those received in a specialized, medical, and school setting over a period of 24 months. Bivariate analyses were conducted to estimate whether rates of service use and types of services used differed depending on the nativity and legal immigration status of the parent. Multivariate logistic regression models estimated whether parent nativity and legal immigration status influenced mental health service receipt.

Results: Although no differences in mental health status were noted between groups of Latino children, children of immigrants received mental health services at lower rates than children of U.S.-born parents (p<.05). Specifically, children of undocumented immigrant parents received specialized (p<.05) and school-based (p<.01) services at lower rates than children of U.S. citizens.  Multivariate analyses elucidated that children of foreign-born parents were 7 times less likely to receive services. However, among foreign-born parents, years of residence in the U.S. (a proxy for acculturation) was positively associated with service use. Additional analyses showed that children whose parents were undocumented were 9 times less likely to receive services than those whose parents were U.S. citizens.

Conclusions and Implications: Research has documented that children who receive early intervention for mental health issues have better prognoses than those who do not receive, or are delayed in receiving, treatment. Findings of this study suggest that cultural or linguistic barriers, and, even more so, a parent’s legal immigration status, are primary obstacles to Latino children’s receipt of needed mental health services. Child welfare professionals need to understand the barriers to service utilization and develop strategies to address these barriers to insure that all children—regardless of parental immigration status—are accessing needed resources.