Running to Stand Still: Trauma, Stress and Substance Use Among Unaccompanied Migrant Youth in Texas

Introduction. Experiences of state-sponsored violence and structural inequalities in Central America, high numbers of homicide and extortion, and a desire to reunify with family, were critical factors in the more than 65,000 unaccompanied migrant youth (UMY) traveling to the U.S. without a parent in 2014. UMY from Mexico and Central America often face stressful and traumatic experiences in their country of origin, during the migration journey, and in the post-migration context. These stressors may increase youths’ vulnerability to internalizing and externalizing symptoms. The current study implemented a concurrent, parallel mixed methods research design, whereby we collected quantitative (survey) and qualitative (focus groups) data simultaneously to explore: (a) the frequency of posttraumatic stress disorder, depression, suicidal ideation, and substance use, (b) their exposure to trauma at pre-migration, migration, and post-migration, and (c) how youth may cope with these adversities.

Methods. UMY (N = 30) were recruited from two middle and three high schools in the summer, 2016. There were an equal proportion of female (n=15) and male (n=15) participants. Participants’ were from Honduras (n=10), Guatemala (n=8), México (n=6), and El Salvador (n=6). In the survey, youth were assessed on traumatic exposure (Life Events Scale), posttraumatic stress disorder (Child PTSD symptom scale), clinical depression (Patient Health Questionnaire Youth form), and substance use (Youth Behavior Risk Survey). Additionally, 10 focus groups were conducted with youth to probe about trauma experiences and stressful life events at pre-migration, migration and post-migration. The focus groups were analyzed in Spanish using thematic analysis.

Results. On average, youth experienced 8.27 (SD 4.55) traumatic exposures. Over one-half of the sample met the criteria for posttraumatic stress disorder (56.7%), 30% for major depressive disorder, and 30% reported suicidal ideation in the past year. While most youth reported no or infrequent substance use, they indicated having easy access to nearly all substances. Qualitative data revealed that youth faced persistent trauma exposure, including family separation, family and community violence, a lack of institutional protection, and pervasive poverty. One student said, “The gangs, they give…a death sentence, if you don’t join them then they will kill you.” There were gender differences in trauma narratives, with females emphasizing sexual violence and males describing gang related violence; “the gangs will follow people…there were several occasions that they followed me because they wanted to rape me.” Some youth described coping with these experiences in a variety of ways, including religion, sports, and talking about their problems. Yet, although schools are often supportive environments for youth, only 27% of youth reported they could depend on an adult at school.

Conclusion. The identification and recruitment of UMY have made it challenging to ascertain their needs. The current study found that UMY flee their counties of origin to escape extreme violence and reunite with family. In the U.S., they report unresolved trauma and grief. If left untreated, these can be risk factors for mental illness and disability in adulthood. Reinforcing healthy coping is an area where school and community providers can intervene to improve these youths’ well-being.