Immigrant Health is Interpersonal

By Amanda Venta, Ph.D.
University of Houston
Posted Sept. 9, 2024

Waves of Latinx immigration to the United States have changed in recent decades, and our scientific literature is only beginning to catch up. Regional violence and unrest in the Northern Triangle of Central America (i.e., El Salvador, Honduras, and Guatemala) have pushed families to seek asylum in the U.S. Simultaneously, we have seen growth in children traveling without a guardian (i.e., unaccompanied immigrant minors) from the same region.

Health care professionals now find large numbers of Latinx immigrant youth and families in their waiting rooms, yet relatively little published research on their mental health experiences and clinical needs exist. Latinxs, in general, are underrepresented in published research. First generation-asylum-seekers from Central America, while characterizing recent waves of immigrants and rapidly increasing their demographic share in the U.S., have been practically invisible to the scientific literature until recently.

It was during these shifts that I began working with the Office of Refugee Resettlement (ORR) to provide psychological services for unaccompanied immigrant minors. I received referrals for youth who were displaying psychological symptoms while living in ORR-approved facilities.

Dr. Venta and colleagues look out from the international bridge connecting McAllen, Texas and Reynosa, Mexico, where many migrants try to cross into the U.S., and many have lost their lives doing so. Credit: Mark Teiwes

High-Stakes Health Consequences

Across hundreds of cases, the prototypic experience is that of a 16- or 17-year-old boy from the Northern Triangle. We typically see a child who is left in his home country early in life by his father, who migrated to the U.S. to establish a foothold. Shortly thereafter, the child’s mother also migrates North in search of better opportunities or to flee growing regional danger. The child grows up with several different caregivers, coping in various ways with separation from his parents and surviving adversities associated with poverty, violence, and the absence of his primary caregivers.

In late adolescence, the child decides to make the journey to the U.S. himself—sometimes with his parents’ blessing and sometimes without. Though escape from gang and cartel threats, poverty, and educational aspirations were often relevant, the emotionally salient motivation is almost always an interpersonal one—a view, idealized as it may be—that being reunited with mom or dad would solve the many problems this child has survived during the previous 10 to 12 years. As a clinical scientist with training in child and family psychology and attachment theory, I can no longer see immigration as a partisan, political issue; I see it as an interpersonal issue—a family issue with high-stakes health consequences.

Over the last 10 years, the bulk of my research, including a three-year longitudinal study of recently immigrated Latinx youth and an ongoing, four-year longitudinal study of Latinx asylum-seeking adults, have reinforced this message: the health and well-being of immigrants depends upon their interpersonal ties.

Trauma exposure is nearly universal in the child, adolescent, and adult Latinx asylum-seekers we have interviewed, and clinically significant symptoms of posttraumatic stress disorder (PTSD) are the norm, with 60% of our samples showing clinical elevations. This health disparity is jarring and deserving of clinical attention, but it is not the whole picture. Indeed, our work documents that interpersonal risks like family separation due to migration are prevalent and tied to interpersonal functioning and mental health in youth and young adulthood.

More broadly, the interpersonal experience of failed belonging among young adult Latinx immigrants is a significant predictor of suicide-related thoughts and behaviors. Discrimination, in youth and adults, demonstrates significant relations to mental health problems. Our work repeatedly shows that these interpersonal risks are potently connected to immigrant health, even in the context of surviving trauma, migration, and settlement in a new country.

Sticking Together, Making It Through, and Thriving

Dr. Venta talks to a young girl at a migrant camp in Reynosa, Mexico. Credit: Mark Teiwes.

At the same time, the immigrant context is full of evidence of resilience, and interpersonal factors play a significant role on this side of the coin as well. Our work with Latinx youth and young adults demonstrates that family relationships built on trust and communication are associated with reduced mental health problems and increased prosocial behavior and resilience. Even in families who experience separation, secure relationships can persist and continue to exert positive effects on mental health.

Familismo, a Latinx cultural value emphasizing the primacy of the family, acts as a protective factor in our research on suicide-related thoughts and behaviors and underlies the provision of social support in immigrant families. Above and beyond the family context, young migrants’ perceived connections to school and peer relationships relate significantly to their mental health.

Our work now includes clinical encounters with hundreds of immigrant minors and face-to-face and online data collection with thousands of Latinx children, adolescents, and adults. In many of these cases, the atrocities they have survived take center stage. Their experiences are unfathomable to many of us, and their suffering— leaving their children, losing their parents, and experiencing many forms of trauma—is palpable. And yet, they speak strongly of another story—one of resilience, of sticking together, of making it through, and of thriving under circumstances they never expected.

Our research has coalesced on the notion that this resilience hinges on the interpersonal strengths and ties that Latinx immigrants carry with them along the journey. While some of these are tangible—like available caregivers with stable documentation status—most of them are felt—mental representations of caregivers as loving and reliable despite separation and perceptions of belonging at home, school, and in the U.S. that can withstand political realities about documentation status and immigration court.

We can all learn from these examples.

We thrive together.

Amanda Venta, Ph.D., is a Latina bilingual associate professor at the University of Houston. Her research focuses on the development of psychopathology in youth, with expertise in how family relationships relate to risk and resilience. Over the last decade, she has worked clinically and centered her research on the experiences of immigrant youth and families from Central America with multiple awards from NIMHD (1R01MD016897-01A1 and R15MD014302-01). She serves on the editorial boards of Attachment and Human Development, Research on Child and Adolescent Psychopathology, the Journal of Clinical Child and Adolescent Psychology, and she is the associate editor of Behaviour Research and Therapy. Together, she has published 135+ scientific papers, chapters, and books.

Disclaimer: NIMHD encourages the use of common terminology in collecting and reporting data, and this includes the standardization of racial and ethnic terms as identified in the revised OMB Statistical Policy Directive No. 15 for federal statistics and administrative reporting.