No. 112; Updated December 2013
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Each year, many immigrants and refugees move to the United States. Coming to a new country can be an exciting new beginning, but adjusting to a new home, language, and culture can be difficult. These changes can be especially hard on children, who can feel sad, anxious, or angry. They may have difficulty talking about their feelings, misbehave, do poorly in school, or have trouble fitting in and making friends.

Finding a mental health professional who can understand and help with these problems can be difficult. There are many reasons that parents wait to ask for help. These can include:

  • trouble speaking or understanding English
  • trouble understanding the mental health system in the United States
  • thinking the clinician will not understand the culture
  • being afraid of being blamed
  • not having transportation
  • not having health insurance or money to pay
  • worrying that friends or family will find out
  • worrying about legal status
  • worrying about the school, court, or police becoming involved
  • thinking that getting help will keep your child from going to college

If you and your child have moved to the United States and are looking for help from a mental health professional, it is helpful for you to know that there are rules every clinician needs to follow. The clinician must respect your privacy and keep your information private. The clinician needs your permission to talk to anyone about you and your child, including teachers, doctors, and family members. They cannot contact the police or other authorities unless your child is being badly hurt or is in danger of hurting themselves or others.

Immigrant families often want to see a mental health professional who has a similar background. Families may feel it is easier to talk with someone who already understands their culture. Some of the ways that families can find a clinician who shares their cultural background are:

  • talking with members of their cultural community
  • talking with a spiritual or religious leader
  • checking newspapers, magazines, or websites
  • talking with the school counselor or teacher

Talking to a professional from a different culture or background can still be very helpful. If the professional does not speak the same language, interpreters are available. Let your professional know before the visit so that arrangements can be made. It is best not to use your child, a friend, or a family member as an interpreter.

The professional may want to speak to you separately from your child. If your child is already an adult, it is helpful to tell the professional if your family would like to be included in part of the appointment.

Families can help their clinician understand the differences in their culture and backgrounds. If your clinician does not ask, it will be helpful for you to bring up subjects that help the professional understand some of the differences in your culture, such as:

  • cultural values and religious beliefs
  • traditional medicines or treatments used
  • parenting practices and discipline methods
  • the role of family and community in your child’s life
  • what is expected of children at different ages
  • how and when feelings are shown
  • worries or questions you may have about your child

It will also be very helpful for the professional to know what life was like in the home country, and why you left. It will also be important to talk about any stressful experiences that happened before, during, or after the immigration.

One of the challenges that families face is that parents and children may adjust to their new lives differently. Many parents have a harder time adapting to a new culture than their children. The differences between the new culture and the way you were raised in your home country might make you worried that your child will learn different beliefs and values. It is important to tell your clinician about how each member of the family has been adapting to the new culture.

Immigrating to a new country and adapting to a new culture and language can be very difficult. Parents may struggle with finding timely help for their child. There are mental health professionals who share or are aware of the differences in language, culture, and background and can help your child do better in the new country.

For additional information, see Facts for Families:
#0 Definition of a Child and Adolescent Psychiatrist
#4 The Depressed Child
#6 Children Who Can’t Pay Attention/ADHD
#24, #25 Seeking Help for Your Child
#26 Understanding Your Mental Health Insurance
#43 Discipline
#47 The Anxious Child
#52 Comprehensive Psychiatric Evaluation
#71 Multiracial Children
#80 Bullying
#103 Know Your Rights: Consent and Confidentiality
#107 Religion, Spirituality and Your Mental Health Care

See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins)

Facts about Stigma and Mental Illness in Diverse Communities:
www.nami.org/contentmanagement/contentdisplay.cfm?ContentFileID=5148


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The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 8,700 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

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Copyright © 2014 by the American Academy of Child and Adolescent Psychiatry.