Mental Health Needs of
Unaccompanied Minors
MARIA ASTUDILLO, LCSW-R
DIRECTOR MENTAL HEALTH SERVICES
Definition of UAC
• An unaccompanied alien child is a child who
has no lawful immigration status in the United
States; has not attained 18 years of age; and,
there is no parent or legal guardian in the
United States, or no parent or legal guardian
in the United States is available to provide
care and physical custody. See 6 U.S.C. §
279(g)(2)
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
What’s prompting them to flee?
• Violence
• Poverty
• Escaping violence/abuse at home
• Seeking better educational opportunities
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
What is Trauma?
“Children and adolescents experience trauma under two
different sets of circumstances:
• Some types of traumatic events involve (1) experiencing a
serious injury to yourself or witnessing a serious injury to or
the death of someone else, (2) facing imminent threats of
serious injury or death to yourself or others, or (3)
experiencing a violation of personal physical integrity.
These experiences usually call forth overwhelming feelings
of terror, horror, or helplessness. Because these events
occur at a particular time and place and are usually shortlived, we refer to them as acute traumatic events” (NCTSN)
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
What is Trauma?
“In other cases, exposure to trauma can occur
repeatedly over long periods of time. These
experiences call forth a range of responses,
including intense feelings of fear, loss of trust in
others, decreased sense of personal safety, guilt,
and shame. We call these kinds of
trauma chronic traumatic situations.”(NCTSN)
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
UAC Traumatic Experiences
• Pre migration trauma
• Physical and emotional dangers during the
“crossing”
• Subjects to sexual violence and sexual
trafficking
• Multiple losses experienced as a result of
immigration process.
• Detention camps
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Manifestation of Trauma and Stress
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Separation anxiety
Other Anxiety Disorders PTSD
Generalized Anxiety Disorders
Depression
Anxiety
Grief
Somatization
Disruptive Behaviors
Academic difficulties
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Adjustment to new environment
• New culture, language, system, family.
• Constant fear of deportation, coping with
racial profiling and ongoing discrimination.
• Unaware of services available
• Stigma
• Acculturative stress
• How does it play out behaviorally?
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Best Practices
• Essential to have culturally competent staff
• Services must be provided under the umbrella
of trauma informed services in school, health
care facilities, mental health and foster care.
• Collaborative work with providers involved as
well as community, particularly churches and
or faith based organizations
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Best Practices
• Assessment that captures their “story”– a
good tool to use is Culturagram ( Congress).
• Bilingual / Bicultural clinicians- must be able to
conduct clinical work in native language.
• Address material/basic needs.
• Case management services essential.
• Consider solution focused therapy.
• Psychosocial supports to families/ sponsors
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Best Practices
• Cultural responsive approaches
• Cultural Formulation
• Obtain information about faith based and
community centers that offer support and a
sense of safety.
• CMH providers should partner with schools as
it is a less stigmatizing environment to provide
services.
• Interpreters should know about mental health
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Address barriers to treatment
• Fear of being deported
• Lack of finances
• Lack of health insurance or knowledge that they
can access it.
• Language
• Working multiple jobs and long hours.
• Limited schooling, difficult to place in appropriate
grade due to age.
• Stigma
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Effective therapy/service models
Group Therapy
Home Visits
Psycho-education
Cognitive Behavioral (PTSD, Anxiety,
Depression)
• Narrative Therapy
• Peer and Social Support
• Action Planning and Involvement
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The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
Therapy Considerations
Psychosocial issues are extremely important
Legal protection is a big issue
Trauma and Stress
Resiliency over real social and political
stressors and barriers
• Family support
• Instilling hope and ameliorating anxiety and
fear
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The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org
The Children's Aid Society  105 E. 22nd Street  New
York, NY  10010  (212) 949-4936 
www.childrensaidsociety.org