Traumatic stress associated with depression risk among Central American immigrant mothers

Traumatic stress is a key factor associated with depression among immigrant mothers from Central America, reports a study in Family and Community Health: The Journal of Health Promotion & Maintenance – part of a special theme issue devoted to "Family Health in Hispanic Communities" that includes guest editors Paul Branscum, PhD, RD, and Daphne C. Hernandez, PhD, MSEd The journal is published in the Lippincott portfolio by Wolters Kluwer.

"The trauma exposures that undocumented immigrant women and their families experience largely go unacknowledged and untreated, yet traumatic stress coupled with depressive symptoms can impede maternal functioning and the ability to not only take care of oneself but also meet the needs of children and family members," according to the report by Bethany L. Letiecq, PhD, of George Mason University, Fairfax, Va., and colleagues.

Dr. Letiecq adds:

However, we also find that these women are incredibly resilient, given their experiences and continued threats of deportation and family separation by the US government."

CBPR approach looks at mental health of immigrant mothers in an 'ecosystemic framework'

The researchers surveyed 134 undocumented Central American immigrant mothers living in Northern Virginia, focusing on factors affecting the women's mental health. The study used an ecosystemic framework to identify structural, familial, parental, and maternal health predictors of maternal depression.

The study followed a community-based participatory research (CBPR) approach – "equal parts research and action," built on mutually beneficial partnerships between researchers and community partners. Dr. Letiecq comments, "It's essential to understand the context of illegality related to immigration policy, which systematically creates mental and physical health burdens that are unduly experienced by undocumented Latina immigrant mothers, and especially those who are here raising their children alone or without many family and community supports."

On a standard depression scale, 50 percent of the immigrant mothers had scores indicating "clinical concern" for depression. Most of the women had experienced at least one traumatic event, reflecting the high risk of trauma exposures related to migration. Forty percent had symptoms of post-traumatic stress disorder.

A wide range of factors affected maternal depression, including low education, being a single mother, housing problems, food insecurity, and numbers of children. "[A]s mothers felt more isolated, more concerned about their ability to meet their children's needs, and worried about their child's affect [mood and emotions], they experienced more depression symptoms," Dr. Letiecq and coauthors write. While traumatic stressors were related to increased depression symptoms, better self-rated health scores served as a mental health buffer.

Drawing on their findings, the authors also discuss community actions needed to improve the circumstances of immigrant mothers, such as advocating for community-informed mental health care and building awareness of immigrant families' experiences within the local school system. "This work is especially important as anti-immigrant hostilities continue to escalate," the researchers write.

Immigration from Central America has increased dramatically, especially from El Salvador, Honduras, and Guatemala. In 2016, an estimated 1.85 million Central American immigrants were living in the United States without legal authorization. While most children of immigrants are US citizens, it is estimated that at least 40 percent of immigrant children have at least one undocumented parent – a "mixed" legal status that places them at risk of family separation.

"Taken together...the structural and familial challenges can erode maternal mental health among undocumented immigrant mothers," Dr. Letiecq and coauthors conclude. "Comprehensive immigration reform should be at the forefront of any efforts to intervene in the lives of undocumented immigrant mothers as we work to ameliorate suffering and advance health equity and immigrant justice."

At a time when the Hispanic population is the largest and fastest-growing minority group in the United States, it's critically important to address the persistent health disparities within Hispanic communities, according to a foreword by Paul Branscum, PhD, RD, and Daphne C. Hernandez, PhD, MSEd, Guest Editors of the special issue. Focusing on the family as the "primary unit" for which decisions are made in Hispanic culture, the special issue papers "reflect advancements and innovations in the field of family Hispanic health."