Latina Immigrant Mothers' Perceptions of Mental Health Needs and Services for Children Exposed to Domestic Violence
Children exposed to domestic violence (DV) risk poor psychological adjustment, including post-traumatic stress (Chemtob & Carlson,2004), internalizing and externalizing disorders (Wolfe et al.,2003). This qualitative study used ethnographic interviews with 30 DV survivors to examine mothers’ perceptions of child mental health (MH) needs and help-seeking experiences. This presentation focuses on a subsample of Latina immigrant mothers (n=11). Previous research indicates that Latina immigrants face particular individual and structural barriers to accessing services including heightened fear, financial risks, language barriers, and lack of knowledge about their rights (Amanor-Boadu et al.,2012; Congress & Brownell,2007).
METHODS:
Mothers of school-age children were recruited from five emergency DV shelters using purposive and maximum variation sampling. All but two in this subsample were from Mexico; 63.6% were known to lack legal immigration status. They were 20-52 years old (mean=34.4), with 2-5 children (mean=2.8).
Help-seeking experiences and perceptions of children’s behavioral/emotional needs were elicited using a semi-structured interview guide. Each mother identified one “focus child” (child with greatest challenges). Focus children were 5-17 years old (mean=10.5). Qualitative data were supplemented by: Abusive Behavior Inventory (Shepard & Campbell,1992); Parent Report of Post-traumatic Symptoms (Greenwald & Rubin,1999); Strengths and Difficulties Questionnaire (Goodman,2001). Eight interviews were in Spanish.
Audiotaped interviews were transcribed verbatim for thematic and categorical-content analysis. Transcripts were coded independently by two coders, followed by a consensus process. Case summaries and diagramming aided thematic analysis, with peer debriefing to refine theme development. Fluent Spanish speakers coded Spanish transcripts.
RESULTS:
Most subsample focus children (n=9, 81.8%) had at least one indicator of poor MH. Four overarching themes were apparent regarding help-seeking experiences and perceptions of the child’s MH needs.
First, maternal perceptions of MH needs were complex, often changing over time based on transactions with potential providers and appraisal of help available. Second, thoughts and actions related to help-seeking for children’s MH were intertwined with help-seeking for DV. Third, a complex package of interacting factors represented a major barrier: DV, language, and immigration. Help-seeking was filtered through this package; all three factors made unique contributions to isolating mothers, and DV and immigration both heightened mothers’ fears. Finally, there was low help-attainment in the sample despite numerous frequent contacts with potential helpers and referral sources. This theme was explored further, aided by diagramming each mother’s help-seeking path and changing appraisals of needs and services. This revealed influential turning points: 1) Positive interactions with police alleviated deportation/child separation fears, thus facilitating help-seeking. 2) Many mothers believed that schools would take the lead in addressing child MH needs, often with disappointing results that discouraged further help-seeking.
IMPLICATIONS:
Findings facilitate understanding of complex interacting factors influencing help attainment. Practice and research implications will be discussed. For example, understanding the “package” of barriers faced by this vulnerable population should guide practitioner efforts to reduce them. School professionals may be the only regular non-family contacts for mothers with deportation fears that inhibit help-seeking, increasing their influence as information and referral sources. Greater awareness of their influence could lead to improved culturally-sensitive practices.