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In their native country, they learned throughout their life cultural norms and systems that defined their environment. When these parents immigrate to a new country, their different set of knowledge may not be applicable in many ways to their new environment.
The Disruption of Social Roles
Culturally, language is one of the most important types of knowledge parents pass to their children. Nearly half of adult immigrants in the United States have limited English proficiency. 1
Their children often learn the language faster, often placing these children in the position of interpreters for their parents. These parents can become dependent on their children to negotiate social structures instead of vice versa, potentially undermining the social hierarchy and role of parenting. 2 Both Mr. Contreras and Dr. Nguyen recall that as children of immigrant parents — from Mexico and Vietnam, respectively — they commanded English better than their parents, which often made them take on more “adult roles.” For example, Dr. Nguyen recalls that his mother would solicit his help in grocery shopping because she could neither navigate the aisles effectively nor ask for help. Mr. Contreras commonly found himself acting as an impromptu medical translator for his mother on several occasions. This dependence of immigrant parents on their children for guidance in their host country can be pervasive in other social structures such as legal and academic.
Impact on School
Potentially, an immigrant parent’s lack of knowledge of the language and systems of their host country can make them ineffective advocates for their children at school. Mr. Contreras’s intervention for his patient as a medical student demonstrates this in the arena of school.
Mr. Contreras was rotating at a hospital burn unit in 2023 when R, a young middle school student, and his mother arrived in the emergency department. An incident had occurred at his school. R had been the victim of aggravated battery and assault, sustaining a 3x2 cm burn on his forearm from students placing hot glue onto a piece of cardboard then immediately onto his skin and silencing him by covering his mouth. For months the older students had been bullying R. R’s mother made multiple attempts with both the school’s front desk and counselors to address the issue, but to no avail. R himself, though encouraged to speak up, did not out of fear. As Mr. Contreras realized the situation and the impasse, he used his fluency in Spanish and English to facilitate a joint call with the school district. Within 10 minutes, they were able to connect with a student safety specialist and launch a full investigation. A language barrier and the lack of knowledge of their rights and school system had prevented R’s mother from effectively advocating for her child’s safety.
In Dr. Nguyen’s experience as a teacher, even in classrooms dominated by minority students, the advocacy for students struggling in classes was disproportionate. It favored White parents, but also generally more educated families. This is further supported by a study of 225 schools across six states of kindergarten children showing similar trends, that African American, Latino, and less-educated parents were less involved in their children’s education as reported by teachers.3 It is important to note that in this study teachers were 80% White, 9% Latino, 7% African American, 3% multiracial, and 1% Asian American, suggesting that cultural discrepancy between teachers and parents could be an important factor affecting parent-teacher communication. Dr. Nguyen also recalled trying to discipline several students who were disruptive in his class by telling them he would speak to their parents. Several times, these students would counter defiantly, “Well, good luck, they can’t speak English.” The parents’ dependency on their children to communicate with teachers undermined the abilities of both adults to manage their behaviors and promote learning.
The Mental Health of Immigrant Parents
Migrants often have greater incidence of mental health problems, including depression, PTSD, and anxiety, from a combination of peri-migrational experiences. 4 Immigrant mothers are known to have higher rates of post-natal depression, which cause problems later with child development. 5 Though she warns larger studies are needed, Dr. Fazel’s review of Croatian refugees suggests that displacement from one’s native country is a risk factor for poorer mental health, namely due to difficulty in psychosocial adaptation. 6 The likely mechanism is that lack of access to one’s language and culture, or a language and culture that one can navigate effectively, exacerbates, even engenders mental health sequelae. Because of this, first-generation immigrant children often face harsher and more violent parenting. 7,8 Immigrant parents also may have less access to mental health resources since they often resort to their own cultural practices. Both Mr. Contreras’s and Dr. Nguyen’s following narratives of their mothers’ struggle with mental health illustrate the causes and consequences.
Mr. Contreras, who grew up in a Mexican immigrant household in Los Angeles, saw firsthand how his mother, who faced language barriers and a distrust of Western medicine, turned to traditional healers and herbal remedies for her health needs. Accompanying her to doctor appointments as her translator, he often felt the disconnect between her cultural background and the Western medical system. For her, seeking help from traditional healers was not just about addressing physical ailments but also about finding comfort and familiarity in practices rooted in her cultural beliefs. This preference for cultural or religious methods for mental health support is not uncommon among Mexican immigrant families.
Dr. Nguyen, whose mother was a refugee from Vietnam, recalls her constant depressed mood and suicidal thoughts in the immediate years after she resettled in San Diego. This was caused mostly by the missing of her social supports in Vietnam, her difficulty adjusting to American culture and language, and her difficulty finding work. Often her depression and stress took a darker turn in terms of more violent parenting. Of course, the cause of her poor mental health is hard to parse from the traumas and violence she had faced as a refugee, but in subsequent years, her many brothers and sisters who immigrated through a more orderly process also displayed similar mental health vulnerabilities.
The Mental Health of Children of Immigrant Parents
The relationship between an immigrant parent’s poor mental health and their children is difficult to parse from what we know about native parents and their children. But the primary differences appear to be a great disruption of social roles, the effects of migration itself, and the oftentimes more strict and disciplinarian parenting style as discussed above. Given this, one would expect immigrant children to suffer greater mental health difficulties. However, a recent study of almost 500,000 children in Canada revealed decreased prevalence of conduct disorder, ADHD, and mood and anxiety disorders in immigrant youth, both first- and second-generation, as compared to non-immigrants. 9 This perhaps surprising result highlights how much more we need to understand about the effects of culture on the mental health diagnosis of immigrant youth. It suggests differences in mental health access and use from the cultural factors we mentioned above, to problems with using Western-based mental criteria and symptomatology for diagnosing non-Western children. It can even suggest the underestimation of the protective effects of native culture such as strong ethnic identity and cultural support systems, thereby challenging a purely deficit mental health model of the immigrant experience.
Summary
Dr. Duy Nguyen and Mr. Andrew Contreras are both children of immigrant parents from Vietnam and Mexico, respectively. Dr. Nguyen spent 15 years as an English teacher at San Leandro High School, whose student body was roughly 50% Hispanic and 25% Asian, making immigrant parents a huge swath of his educational partners. Mr. Contreras founded a high school outreach program where he interacted with K-12 children of immigrant youth. In addition, he partners with Fresno’s Economic Opportunity Commission to educate immigrant Hispanic parents and their teens on having difficult conversations with their teenage children on topics such as mental and reproductive health. Dr. Duy Nguyen and Mr. Andrew Contreras will explore the differences in immigrant parent-child relationships, compared with native ones, as they relate to mental health ramifications for the child and parent. They reveal immigrant mental health disruptions regarding culture and language, familial hierarchies, parenting styles, as well as parental mental health sequelae brought about by immigration using research and their own personal experiences.
Dr. Nguyen is a second-year resident at the University of California, San Francisco, Fresno Psychiatry Residency. He was a public high school English teacher for 15 years previously. Mr. Contreras is currently a 4th-year medical student at University of California, San Francisco, and applying to Psychiatry for the 2025 match.
References
1. Rao A et al. Five Key Facts About Immigrants With Limited English Proficiency. KFF. 2024 March 14. https://www.kff.org/racial-equity-and-health-policy/issue-brief-five-key-facts-about-immigrants-with-limited-english-proficiency .
2. Raffaetà R. Migration and Parenting: Reviewing the Debate and Calling for Future Research. International Journal of Migration, Health and Social Care. 2016;12(1):38-50. doi: 10.1108/IJMHSC-12-2014-0052/full/html .
3. Nzinga‐Johnson S et al. Teacher‐Parent Relationships and School Involvement Among Racially and Educationally Diverse Parents of Kindergartners. Elementary School Journal. 2009 Sept. doi: 10.1086/598844 .
4. Close C et al. The Mental Health and Wellbeing of First Generation Migrants: A Systematic-Narrative Review of Reviews. Global Health. 2016 Aug 25;12(1):47. doi: 10.1186/s12992-016-0187-3.
5. Collins CH et al. Refugee, Asylum Seeker, Immigrant Women and Postnatal Depression: Rates and Risk Factors. Arch Womens Ment Health. 2011 Feb;14(1):3-11. doi: 10.1007/s00737-010-0198-7 .
6. Fazel M, Betancourt TS. Preventive Mental Health Interventions for Refugee Children and Adolescents in High-Income Settings. Lancet Child Adolesc Health. 2018 Feb;2(2):121-132. doi: 10.1016/S2352-4642(17)30147-5 .
7. Pottie K et al. Do First Generation Immigrant Adolescents Face Higher Rates of Bullying, Violence and Suicidal Behaviours Than Do Third Generation and Native Born? J Immigr Minor Health. 2015 Oct;17(5):1557-1566. doi: 10.1007/s10903-014-0108-6.
8. Smokowski PR, Bacallao ML. Acculturation and Aggression in Latino Adolescents: A Structural Model Focusing on Cultural Risk Factors and Assets. J Abnorm Child Psychol. 2006 Oct;34(5):659-673. doi: 10.1007/s10802-006-9049-4 .
9. Gadermann AM et al. Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada. JAMA Netw Open. 2022;5(2):e2144934. doi: 10.1001/jamanetworkopen.2021.44934 .
In their native country, they learned throughout their life cultural norms and systems that defined their environment. When these parents immigrate to a new country, their different set of knowledge may not be applicable in many ways to their new environment.
The Disruption of Social Roles
Culturally, language is one of the most important types of knowledge parents pass to their children. Nearly half of adult immigrants in the United States have limited English proficiency. 1
Their children often learn the language faster, often placing these children in the position of interpreters for their parents. These parents can become dependent on their children to negotiate social structures instead of vice versa, potentially undermining the social hierarchy and role of parenting. 2 Both Mr. Contreras and Dr. Nguyen recall that as children of immigrant parents — from Mexico and Vietnam, respectively — they commanded English better than their parents, which often made them take on more “adult roles.” For example, Dr. Nguyen recalls that his mother would solicit his help in grocery shopping because she could neither navigate the aisles effectively nor ask for help. Mr. Contreras commonly found himself acting as an impromptu medical translator for his mother on several occasions. This dependence of immigrant parents on their children for guidance in their host country can be pervasive in other social structures such as legal and academic.
Impact on School
Potentially, an immigrant parent’s lack of knowledge of the language and systems of their host country can make them ineffective advocates for their children at school. Mr. Contreras’s intervention for his patient as a medical student demonstrates this in the arena of school.
Mr. Contreras was rotating at a hospital burn unit in 2023 when R, a young middle school student, and his mother arrived in the emergency department. An incident had occurred at his school. R had been the victim of aggravated battery and assault, sustaining a 3x2 cm burn on his forearm from students placing hot glue onto a piece of cardboard then immediately onto his skin and silencing him by covering his mouth. For months the older students had been bullying R. R’s mother made multiple attempts with both the school’s front desk and counselors to address the issue, but to no avail. R himself, though encouraged to speak up, did not out of fear. As Mr. Contreras realized the situation and the impasse, he used his fluency in Spanish and English to facilitate a joint call with the school district. Within 10 minutes, they were able to connect with a student safety specialist and launch a full investigation. A language barrier and the lack of knowledge of their rights and school system had prevented R’s mother from effectively advocating for her child’s safety.
In Dr. Nguyen’s experience as a teacher, even in classrooms dominated by minority students, the advocacy for students struggling in classes was disproportionate. It favored White parents, but also generally more educated families. This is further supported by a study of 225 schools across six states of kindergarten children showing similar trends, that African American, Latino, and less-educated parents were less involved in their children’s education as reported by teachers.3 It is important to note that in this study teachers were 80% White, 9% Latino, 7% African American, 3% multiracial, and 1% Asian American, suggesting that cultural discrepancy between teachers and parents could be an important factor affecting parent-teacher communication. Dr. Nguyen also recalled trying to discipline several students who were disruptive in his class by telling them he would speak to their parents. Several times, these students would counter defiantly, “Well, good luck, they can’t speak English.” The parents’ dependency on their children to communicate with teachers undermined the abilities of both adults to manage their behaviors and promote learning.
The Mental Health of Immigrant Parents
Migrants often have greater incidence of mental health problems, including depression, PTSD, and anxiety, from a combination of peri-migrational experiences. 4 Immigrant mothers are known to have higher rates of post-natal depression, which cause problems later with child development. 5 Though she warns larger studies are needed, Dr. Fazel’s review of Croatian refugees suggests that displacement from one’s native country is a risk factor for poorer mental health, namely due to difficulty in psychosocial adaptation. 6 The likely mechanism is that lack of access to one’s language and culture, or a language and culture that one can navigate effectively, exacerbates, even engenders mental health sequelae. Because of this, first-generation immigrant children often face harsher and more violent parenting. 7,8 Immigrant parents also may have less access to mental health resources since they often resort to their own cultural practices. Both Mr. Contreras’s and Dr. Nguyen’s following narratives of their mothers’ struggle with mental health illustrate the causes and consequences.
Mr. Contreras, who grew up in a Mexican immigrant household in Los Angeles, saw firsthand how his mother, who faced language barriers and a distrust of Western medicine, turned to traditional healers and herbal remedies for her health needs. Accompanying her to doctor appointments as her translator, he often felt the disconnect between her cultural background and the Western medical system. For her, seeking help from traditional healers was not just about addressing physical ailments but also about finding comfort and familiarity in practices rooted in her cultural beliefs. This preference for cultural or religious methods for mental health support is not uncommon among Mexican immigrant families.
Dr. Nguyen, whose mother was a refugee from Vietnam, recalls her constant depressed mood and suicidal thoughts in the immediate years after she resettled in San Diego. This was caused mostly by the missing of her social supports in Vietnam, her difficulty adjusting to American culture and language, and her difficulty finding work. Often her depression and stress took a darker turn in terms of more violent parenting. Of course, the cause of her poor mental health is hard to parse from the traumas and violence she had faced as a refugee, but in subsequent years, her many brothers and sisters who immigrated through a more orderly process also displayed similar mental health vulnerabilities.
The Mental Health of Children of Immigrant Parents
The relationship between an immigrant parent’s poor mental health and their children is difficult to parse from what we know about native parents and their children. But the primary differences appear to be a great disruption of social roles, the effects of migration itself, and the oftentimes more strict and disciplinarian parenting style as discussed above. Given this, one would expect immigrant children to suffer greater mental health difficulties. However, a recent study of almost 500,000 children in Canada revealed decreased prevalence of conduct disorder, ADHD, and mood and anxiety disorders in immigrant youth, both first- and second-generation, as compared to non-immigrants. 9 This perhaps surprising result highlights how much more we need to understand about the effects of culture on the mental health diagnosis of immigrant youth. It suggests differences in mental health access and use from the cultural factors we mentioned above, to problems with using Western-based mental criteria and symptomatology for diagnosing non-Western children. It can even suggest the underestimation of the protective effects of native culture such as strong ethnic identity and cultural support systems, thereby challenging a purely deficit mental health model of the immigrant experience.
Summary
Dr. Duy Nguyen and Mr. Andrew Contreras are both children of immigrant parents from Vietnam and Mexico, respectively. Dr. Nguyen spent 15 years as an English teacher at San Leandro High School, whose student body was roughly 50% Hispanic and 25% Asian, making immigrant parents a huge swath of his educational partners. Mr. Contreras founded a high school outreach program where he interacted with K-12 children of immigrant youth. In addition, he partners with Fresno’s Economic Opportunity Commission to educate immigrant Hispanic parents and their teens on having difficult conversations with their teenage children on topics such as mental and reproductive health. Dr. Duy Nguyen and Mr. Andrew Contreras will explore the differences in immigrant parent-child relationships, compared with native ones, as they relate to mental health ramifications for the child and parent. They reveal immigrant mental health disruptions regarding culture and language, familial hierarchies, parenting styles, as well as parental mental health sequelae brought about by immigration using research and their own personal experiences.
Dr. Nguyen is a second-year resident at the University of California, San Francisco, Fresno Psychiatry Residency. He was a public high school English teacher for 15 years previously. Mr. Contreras is currently a 4th-year medical student at University of California, San Francisco, and applying to Psychiatry for the 2025 match.
References
1. Rao A et al. Five Key Facts About Immigrants With Limited English Proficiency. KFF. 2024 March 14. https://www.kff.org/racial-equity-and-health-policy/issue-brief-five-key-facts-about-immigrants-with-limited-english-proficiency .
2. Raffaetà R. Migration and Parenting: Reviewing the Debate and Calling for Future Research. International Journal of Migration, Health and Social Care. 2016;12(1):38-50. doi: 10.1108/IJMHSC-12-2014-0052/full/html .
3. Nzinga‐Johnson S et al. Teacher‐Parent Relationships and School Involvement Among Racially and Educationally Diverse Parents of Kindergartners. Elementary School Journal. 2009 Sept. doi: 10.1086/598844 .
4. Close C et al. The Mental Health and Wellbeing of First Generation Migrants: A Systematic-Narrative Review of Reviews. Global Health. 2016 Aug 25;12(1):47. doi: 10.1186/s12992-016-0187-3.
5. Collins CH et al. Refugee, Asylum Seeker, Immigrant Women and Postnatal Depression: Rates and Risk Factors. Arch Womens Ment Health. 2011 Feb;14(1):3-11. doi: 10.1007/s00737-010-0198-7 .
6. Fazel M, Betancourt TS. Preventive Mental Health Interventions for Refugee Children and Adolescents in High-Income Settings. Lancet Child Adolesc Health. 2018 Feb;2(2):121-132. doi: 10.1016/S2352-4642(17)30147-5 .
7. Pottie K et al. Do First Generation Immigrant Adolescents Face Higher Rates of Bullying, Violence and Suicidal Behaviours Than Do Third Generation and Native Born? J Immigr Minor Health. 2015 Oct;17(5):1557-1566. doi: 10.1007/s10903-014-0108-6.
8. Smokowski PR, Bacallao ML. Acculturation and Aggression in Latino Adolescents: A Structural Model Focusing on Cultural Risk Factors and Assets. J Abnorm Child Psychol. 2006 Oct;34(5):659-673. doi: 10.1007/s10802-006-9049-4 .
9. Gadermann AM et al. Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada. JAMA Netw Open. 2022;5(2):e2144934. doi: 10.1001/jamanetworkopen.2021.44934 .
In their native country, they learned throughout their life cultural norms and systems that defined their environment. When these parents immigrate to a new country, their different set of knowledge may not be applicable in many ways to their new environment.
The Disruption of Social Roles
Culturally, language is one of the most important types of knowledge parents pass to their children. Nearly half of adult immigrants in the United States have limited English proficiency. 1
Their children often learn the language faster, often placing these children in the position of interpreters for their parents. These parents can become dependent on their children to negotiate social structures instead of vice versa, potentially undermining the social hierarchy and role of parenting. 2 Both Mr. Contreras and Dr. Nguyen recall that as children of immigrant parents — from Mexico and Vietnam, respectively — they commanded English better than their parents, which often made them take on more “adult roles.” For example, Dr. Nguyen recalls that his mother would solicit his help in grocery shopping because she could neither navigate the aisles effectively nor ask for help. Mr. Contreras commonly found himself acting as an impromptu medical translator for his mother on several occasions. This dependence of immigrant parents on their children for guidance in their host country can be pervasive in other social structures such as legal and academic.
Impact on School
Potentially, an immigrant parent’s lack of knowledge of the language and systems of their host country can make them ineffective advocates for their children at school. Mr. Contreras’s intervention for his patient as a medical student demonstrates this in the arena of school.
Mr. Contreras was rotating at a hospital burn unit in 2023 when R, a young middle school student, and his mother arrived in the emergency department. An incident had occurred at his school. R had been the victim of aggravated battery and assault, sustaining a 3x2 cm burn on his forearm from students placing hot glue onto a piece of cardboard then immediately onto his skin and silencing him by covering his mouth. For months the older students had been bullying R. R’s mother made multiple attempts with both the school’s front desk and counselors to address the issue, but to no avail. R himself, though encouraged to speak up, did not out of fear. As Mr. Contreras realized the situation and the impasse, he used his fluency in Spanish and English to facilitate a joint call with the school district. Within 10 minutes, they were able to connect with a student safety specialist and launch a full investigation. A language barrier and the lack of knowledge of their rights and school system had prevented R’s mother from effectively advocating for her child’s safety.
In Dr. Nguyen’s experience as a teacher, even in classrooms dominated by minority students, the advocacy for students struggling in classes was disproportionate. It favored White parents, but also generally more educated families. This is further supported by a study of 225 schools across six states of kindergarten children showing similar trends, that African American, Latino, and less-educated parents were less involved in their children’s education as reported by teachers.3 It is important to note that in this study teachers were 80% White, 9% Latino, 7% African American, 3% multiracial, and 1% Asian American, suggesting that cultural discrepancy between teachers and parents could be an important factor affecting parent-teacher communication. Dr. Nguyen also recalled trying to discipline several students who were disruptive in his class by telling them he would speak to their parents. Several times, these students would counter defiantly, “Well, good luck, they can’t speak English.” The parents’ dependency on their children to communicate with teachers undermined the abilities of both adults to manage their behaviors and promote learning.
The Mental Health of Immigrant Parents
Migrants often have greater incidence of mental health problems, including depression, PTSD, and anxiety, from a combination of peri-migrational experiences. 4 Immigrant mothers are known to have higher rates of post-natal depression, which cause problems later with child development. 5 Though she warns larger studies are needed, Dr. Fazel’s review of Croatian refugees suggests that displacement from one’s native country is a risk factor for poorer mental health, namely due to difficulty in psychosocial adaptation. 6 The likely mechanism is that lack of access to one’s language and culture, or a language and culture that one can navigate effectively, exacerbates, even engenders mental health sequelae. Because of this, first-generation immigrant children often face harsher and more violent parenting. 7,8 Immigrant parents also may have less access to mental health resources since they often resort to their own cultural practices. Both Mr. Contreras’s and Dr. Nguyen’s following narratives of their mothers’ struggle with mental health illustrate the causes and consequences.
Mr. Contreras, who grew up in a Mexican immigrant household in Los Angeles, saw firsthand how his mother, who faced language barriers and a distrust of Western medicine, turned to traditional healers and herbal remedies for her health needs. Accompanying her to doctor appointments as her translator, he often felt the disconnect between her cultural background and the Western medical system. For her, seeking help from traditional healers was not just about addressing physical ailments but also about finding comfort and familiarity in practices rooted in her cultural beliefs. This preference for cultural or religious methods for mental health support is not uncommon among Mexican immigrant families.
Dr. Nguyen, whose mother was a refugee from Vietnam, recalls her constant depressed mood and suicidal thoughts in the immediate years after she resettled in San Diego. This was caused mostly by the missing of her social supports in Vietnam, her difficulty adjusting to American culture and language, and her difficulty finding work. Often her depression and stress took a darker turn in terms of more violent parenting. Of course, the cause of her poor mental health is hard to parse from the traumas and violence she had faced as a refugee, but in subsequent years, her many brothers and sisters who immigrated through a more orderly process also displayed similar mental health vulnerabilities.
The Mental Health of Children of Immigrant Parents
The relationship between an immigrant parent’s poor mental health and their children is difficult to parse from what we know about native parents and their children. But the primary differences appear to be a great disruption of social roles, the effects of migration itself, and the oftentimes more strict and disciplinarian parenting style as discussed above. Given this, one would expect immigrant children to suffer greater mental health difficulties. However, a recent study of almost 500,000 children in Canada revealed decreased prevalence of conduct disorder, ADHD, and mood and anxiety disorders in immigrant youth, both first- and second-generation, as compared to non-immigrants. 9 This perhaps surprising result highlights how much more we need to understand about the effects of culture on the mental health diagnosis of immigrant youth. It suggests differences in mental health access and use from the cultural factors we mentioned above, to problems with using Western-based mental criteria and symptomatology for diagnosing non-Western children. It can even suggest the underestimation of the protective effects of native culture such as strong ethnic identity and cultural support systems, thereby challenging a purely deficit mental health model of the immigrant experience.
Summary
Dr. Duy Nguyen and Mr. Andrew Contreras are both children of immigrant parents from Vietnam and Mexico, respectively. Dr. Nguyen spent 15 years as an English teacher at San Leandro High School, whose student body was roughly 50% Hispanic and 25% Asian, making immigrant parents a huge swath of his educational partners. Mr. Contreras founded a high school outreach program where he interacted with K-12 children of immigrant youth. In addition, he partners with Fresno’s Economic Opportunity Commission to educate immigrant Hispanic parents and their teens on having difficult conversations with their teenage children on topics such as mental and reproductive health. Dr. Duy Nguyen and Mr. Andrew Contreras will explore the differences in immigrant parent-child relationships, compared with native ones, as they relate to mental health ramifications for the child and parent. They reveal immigrant mental health disruptions regarding culture and language, familial hierarchies, parenting styles, as well as parental mental health sequelae brought about by immigration using research and their own personal experiences.
Dr. Nguyen is a second-year resident at the University of California, San Francisco, Fresno Psychiatry Residency. He was a public high school English teacher for 15 years previously. Mr. Contreras is currently a 4th-year medical student at University of California, San Francisco, and applying to Psychiatry for the 2025 match.
References
1. Rao A et al. Five Key Facts About Immigrants With Limited English Proficiency. KFF. 2024 March 14. https://www.kff.org/racial-equity-and-health-policy/issue-brief-five-key-facts-about-immigrants-with-limited-english-proficiency .
2. Raffaetà R. Migration and Parenting: Reviewing the Debate and Calling for Future Research. International Journal of Migration, Health and Social Care. 2016;12(1):38-50. doi: 10.1108/IJMHSC-12-2014-0052/full/html .
3. Nzinga‐Johnson S et al. Teacher‐Parent Relationships and School Involvement Among Racially and Educationally Diverse Parents of Kindergartners. Elementary School Journal. 2009 Sept. doi: 10.1086/598844 .
4. Close C et al. The Mental Health and Wellbeing of First Generation Migrants: A Systematic-Narrative Review of Reviews. Global Health. 2016 Aug 25;12(1):47. doi: 10.1186/s12992-016-0187-3.
5. Collins CH et al. Refugee, Asylum Seeker, Immigrant Women and Postnatal Depression: Rates and Risk Factors. Arch Womens Ment Health. 2011 Feb;14(1):3-11. doi: 10.1007/s00737-010-0198-7 .
6. Fazel M, Betancourt TS. Preventive Mental Health Interventions for Refugee Children and Adolescents in High-Income Settings. Lancet Child Adolesc Health. 2018 Feb;2(2):121-132. doi: 10.1016/S2352-4642(17)30147-5 .
7. Pottie K et al. Do First Generation Immigrant Adolescents Face Higher Rates of Bullying, Violence and Suicidal Behaviours Than Do Third Generation and Native Born? J Immigr Minor Health. 2015 Oct;17(5):1557-1566. doi: 10.1007/s10903-014-0108-6.
8. Smokowski PR, Bacallao ML. Acculturation and Aggression in Latino Adolescents: A Structural Model Focusing on Cultural Risk Factors and Assets. J Abnorm Child Psychol. 2006 Oct;34(5):659-673. doi: 10.1007/s10802-006-9049-4 .
9. Gadermann AM et al. Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada. JAMA Netw Open. 2022;5(2):e2144934. doi: 10.1001/jamanetworkopen.2021.44934 .
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<root generator="drupal.xsl" gversion="1.7"> <header> <fileName>168350</fileName> <TBEID>0C05078F.SIG</TBEID> <TBUniqueIdentifier>MD_0C05078F</TBUniqueIdentifier> <newsOrJournal>News</newsOrJournal> <publisherName>Frontline Medical Communications</publisherName> <storyname>Child Psych Consult: Immigrant</storyname> <articleType>2</articleType> <TBLocation>QC Done-All Pubs</TBLocation> <QCDate>20240613T102922</QCDate> <firstPublished>20240613T110105</firstPublished> <LastPublished>20240613T110106</LastPublished> <pubStatus qcode="stat:"/> <embargoDate/> <killDate/> <CMSDate>20240613T110105</CMSDate> <articleSource/> <facebookInfo/> <meetingNumber/> <byline>Nguyen and Contreras</byline> <bylineText> DUY NGUYEN, MD, AND ANDREW CONTRERAS </bylineText> <bylineFull> DUY NGUYEN, MD, AND ANDREW CONTRERAS </bylineFull> <bylineTitleText/> <USOrGlobal/> <wireDocType/> <newsDocType>Column</newsDocType> <journalDocType/> <linkLabel/> <pageRange/> <citation/> <quizID/> <indexIssueDate/> <itemClass qcode="ninat:text"/> <provider qcode="provider:imng"> <name>IMNG Medical Media</name> <rightsInfo> <copyrightHolder> <name>Frontline Medical News</name> </copyrightHolder> <copyrightNotice>Copyright (c) 2015 Frontline Medical News, a Frontline Medical Communications Inc. company. All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>Fundamentally, an immigrant parent’s traditional role as teacher of culture and social systems to their children is undermined by immigration.</metaDescription> <articlePDF/> <teaserImage>289439</teaserImage> <teaser> <span class="normaltextrun">Immigrant parents can become dependent on their children to negotiate social structures instead of vice versa, potentially undermining the social hierarchy and role of parenting.</span> </teaser> <title>The Effects of Immigration on the Parent-Child Relationship </title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear>2024</pubPubdateYear> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>PN</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> <journalTitle/> <journalFullTitle/> <copyrightStatement/> </publicationData> <publicationData> <publicationCode>FP</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> <journalTitle/> <journalFullTitle/> <copyrightStatement>Copyright 2017 Frontline Medical News</copyrightStatement> </publicationData> </publications_g> <publications> <term canonical="true">25</term> <term>15</term> </publications> <sections> <term>39313</term> <term canonical="true">27729</term> <term>41022</term> </sections> <topics> <term canonical="true">248</term> </topics> <links> <link> <itemClass qcode="ninat:picture"/> <altRep contenttype="image/jpeg">images/2401126b.jpg</altRep> <description role="drol:caption">Dr. Duy Nguyen</description> <description role="drol:credit"/> </link> </links> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>The Effects of Immigration on the Parent-Child Relationship </title> <deck/> </itemMeta> <itemContent> <p> <span class="normaltextrun"><span class="tag metaDescription">Fundamentally, an immigrant parent’s traditional role as teacher of culture and social systems to their children is undermined by immigration.</span> In their native country, they learned throughout their life cultural norms and systems that defined their environment. When these parents immigrate to a new country, their different set of knowledge may not be applicable in many ways to their new environment.</span> <span class="eop"> </span> </p> <h2> <span class="normaltextrun">The Disruption of Social Roles</span> <span class="eop"> </span> </h2> <p> <span class="normaltextrun">Culturally, language is one of the most important types of knowledge parents pass to their children. Nearly half of adult immigrants in the United States have limited English proficiency.</span> <sup>1</sup> <span class="normaltextrun"> </span> </p> <p> <span class="normaltextrun">Their children often learn the language faster, often placing these children in the position of interpreters for their parents. These parents can become dependent on their children to negotiate social structures instead of vice versa, potentially undermining the social hierarchy and role of parenting.</span> <sup>2</sup> <span class="normaltextrun"> Both Mr. Contreras and Dr. Nguyen recall that as children of immigrant parents — from Mexico and Vietnam, respectively — they commanded English better than their parents, which often made them take on more “adult roles.” For example, Dr. Nguyen recalls that his mother would solicit his help in grocery shopping because she could neither navigate the aisles effectively nor ask for help. Mr. Contreras commonly found himself acting as an impromptu medical translator for his mother on several occasions. This dependence of immigrant parents on their children for guidance in their host country can be pervasive in other social structures such as legal and academic.[[{"fid":"289439","view_mode":"medstat_image_flush_left","fields":{"format":"medstat_image_flush_left","field_file_image_alt_text[und][0][value]":"Dr. Duy Nguyen, University of California, San Francisco, Fresno","field_file_image_credit[und][0][value]":"","field_file_image_caption[und][0][value]":"Dr. Duy Nguyen"},"type":"media","attributes":{"class":"media-element file-medstat_image_flush_left"}}]] <br/><br/></span> </p> <h2> <span class="normaltextrun">Impact on School</span> <span class="eop"> </span> </h2> <p> <span class="normaltextrun">Potentially, an immigrant parent’s lack of knowledge of the language and systems of their host country can make them ineffective advocates for their children at school. Mr. Contreras’s intervention for his patient as a medical student demonstrates this in the arena of school. </span> </p> <p><span class="normaltextrun">Mr. Contreras was rotating at a hospital burn unit in 2023 when R, a young middle school student, and his mother arrived in the emergency department. An incident had occurred at his school. R had been the victim of aggravated battery and assault, sustaining a 3x2 cm burn on his forearm from students placing hot glue onto a piece of cardboard then immediately onto his skin and silencing him by covering his mouth. For months the older students had been bullying R. R’s mother made multiple attempts with both the school’s front desk and counselors to address the issue, but to no avail. R himself, though encouraged to speak up, did not out of fear. As Mr. Contreras realized the situation and the impasse, he used his fluency in Spanish and English to facilitate a joint call with the school district. Within 10 minutes, they were able to connect with a student safety specialist and launch a full investigation. A language barrier and the lack of knowledge of their rights and school system had prevented R’s mother from effectively advocating for her child’s safety. <br/><br/>In Dr. Nguyen’s experience as a teacher, even in classrooms dominated by minority students, the advocacy for students struggling in classes was disproportionate. It favored White parents, but also generally more educated families. This is further supported by a study of 225 schools across six states of kindergarten children showing similar trends, that African American, Latino, and less-educated parents were less involved in their children’s education as reported by </span>teachers.<sup>3</sup><span class="normaltextrun"> It is important to note that in this study teachers were 80% White, 9% Latino, 7% African American, 3% multiracial, and 1% Asian American, suggesting that cultural discrepancy between teachers and parents could be an important factor affecting parent-teacher communication. Dr. Nguyen also recalled trying to discipline several students who were disruptive in his class by telling them he would speak to their parents. Several times, these students would counter defiantly, “Well, good luck, they can’t speak English.” The parents’ dependency on their children to communicate with teachers undermined the abilities of both adults to manage their behaviors and promote learning. <br/><br/></span></p> <h2> <span class="normaltextrun">The Mental Health of Immigrant Parents</span> <span class="eop"> </span> </h2> <p> <span class="normaltextrun">Migrants often have greater incidence of mental health problems, including depression, PTSD, and anxiety, from a combination of peri-migrational experiences.</span> <sup>4</sup> <span class="normaltextrun"> Immigrant mothers are known to have higher rates of post-natal depression, which cause problems later with child development.</span> <sup>5</sup> <span class="normaltextrun"> Though she warns larger studies are needed, Dr. Fazel’s review of Croatian refugees suggests that displacement from one’s native country is a risk factor for poorer mental health, namely due to difficulty in psychosocial adaptation.</span> <sup>6</sup> <span class="normaltextrun"> The likely mechanism is that lack of access to one’s language and culture, or a language and culture that one can navigate effectively, exacerbates, even engenders mental health sequelae. Because of this, first-generation immigrant children often face harsher and more violent parenting.</span> <sup>7,8</sup> <span class="normaltextrun"> Immigrant parents also may have less access to mental health resources since they often resort to their own cultural practices. Both Mr. Contreras’s and Dr. Nguyen’s following narratives of their mothers’ struggle with mental health illustrate the causes and consequences. </span> </p> <p> <span class="normaltextrun">Mr. Contreras, who grew up in a Mexican immigrant household in Los Angeles, saw firsthand how his mother, who faced language barriers and a distrust of Western medicine, turned to traditional healers and herbal remedies for her health needs. Accompanying her to doctor appointments as her translator, he often felt the disconnect between her cultural background and the Western medical system. For her, seeking help from traditional healers was not just about addressing physical ailments but also about finding comfort and familiarity in practices rooted in her cultural beliefs. This preference for cultural or religious methods for mental health support is not uncommon among Mexican immigrant families. <br/><br/>Dr. Nguyen, whose mother was a refugee from Vietnam, recalls her constant depressed mood and suicidal thoughts in the immediate years after she resettled in San Diego. This was caused mostly by the missing of her social supports in Vietnam, her difficulty adjusting to American culture and language, and her difficulty finding work. Often her depression and stress took a darker turn in terms of more violent parenting. Of course, the cause of her poor mental health is hard to parse from the traumas and violence she had faced as a refugee, but in subsequent years, her many brothers and sisters who immigrated through a more orderly process also displayed similar mental health vulnerabilities. <br/><br/> </span> <span class="eop"> </span> </p> <h2> <span class="normaltextrun">The Mental Health of Children of Immigrant Parents</span> <span class="eop"> </span> </h2> <p> <span class="normaltextrun">The relationship between an immigrant parent’s poor mental health and their children is difficult to parse from what we know about native parents and their children. But the primary differences appear to be a great disruption of social roles, the effects of migration itself, and the oftentimes more strict and disciplinarian parenting style as discussed above. Given this, one would expect immigrant children to suffer greater mental health difficulties. However, a recent study of almost 500,000 children in Canada revealed decreased prevalence of conduct disorder, ADHD, and mood and anxiety disorders in immigrant youth, both first- and second-generation, as compared to non-immigrants.</span> <sup>9</sup> <span class="normaltextrun"> This perhaps surprising result highlights how much more we need to understand about the effects of culture on the mental health diagnosis of immigrant youth. It suggests differences in mental health access and use from the cultural factors we mentioned above, to problems with using Western-based mental criteria and symptomatology for diagnosing non-Western children. It can even suggest the underestimation of the protective effects of native culture such as strong ethnic identity and cultural support systems, thereby challenging a purely deficit mental health model of the immigrant experience. </span> </p> <p> <span class="eop"> </span> </p> <h2> <span class="normaltextrun">Summary</span> </h2> <p> <span class="normaltextrun">Dr. Duy Nguyen and Mr. Andrew Contreras are both children of immigrant parents from Vietnam and Mexico, respectively. Dr. Nguyen spent 15 years as an English teacher at San Leandro High School, whose student body was roughly 50% Hispanic and 25% Asian, making immigrant parents a huge swath of his educational partners. Mr. Contreras founded a high school outreach program where he interacted with K-12 children of immigrant youth. In addition, he partners with Fresno’s Economic Opportunity Commission to educate immigrant Hispanic parents and their teens on having difficult conversations with their teenage children on topics such as mental and reproductive health. Dr. Duy Nguyen and Mr. Andrew Contreras will explore the differences in immigrant parent-child relationships, compared with native ones, as they relate to mental health ramifications for the child and parent. They reveal immigrant mental health disruptions regarding culture and language, familial hierarchies, parenting styles, as well as parental mental health sequelae brought about by immigration using research and their own personal experiences.</span> <span class="end"> </span> <span class="normaltextrun"> </span> </p> <p> <span class="eop"> </span> </p> <p> <em> <span class="eop">Dr. Nguyen is a second-year resident at the </span> <span class="normaltextrun">University of California, San Francisco,</span> <span class="eop"> Fresno Psychiatry Residency. He was a public high school English teacher for 15 years previously. Mr. </span> <span class="normaltextrun">Contreras is currently a 4th-year medical student at University of California, San Francisco, and applying to Psychiatry for the 2025 match.</span> </em> </p> <h2> <span class="normaltextrun">References</span> <span class="eop"> </span> </h2> <p> <span class="normaltextrun">1. Rao A et al. Five Key Facts About Immigrants With Limited English Proficiency. KFF. 2024 March 14. </span> <span class="Hyperlink"> <a href="https://www.kff.org/racial-equity-and-health-policy/issue-brief/five-key-facts-about-immigrants-with-limited-english-proficiency">https://www.kff.org/racial-equity-and-health-policy/issue-brief-five-key-facts-about-immigrants-with-limited-english-proficiency</a> </span> <span class="normaltextrun">.<br/><br/>2. Raffaetà R. Migration and Parenting: Reviewing the Debate and Calling for Future Research. International Journal of Migration, Health and Social Care. 2016;12(1):38-50. </span> <span class="Hyperlink"> <a href="https://www.emerald.com/insight/content/doi/10.1108/IJMHSC-12-2014-0052/full/html">doi: 10.1108/IJMHSC-12-2014-0052/full/html</a> </span> <span class="normaltextrun">.<br/><br/>3. Nzinga‐Johnson S et al. Teacher‐Parent Relationships and School Involvement Among Racially and Educationally Diverse Parents of Kindergartners. Elementary School Journal. 2009 Sept. </span> <span class="Hyperlink"> <a href="https://www.journals.uchicago.edu/doi/abs/10.1086/598844?journalCode=esj">doi: 10.1086/598844</a> </span> <span class="normaltextrun">.<br/><br/>4. Close C et al. The Mental Health and Wellbeing of First Generation Migrants: A Systematic-Narrative Review of Reviews. Global Health. 2016 Aug 25;12(1):47. </span> <span class="Hyperlink"><a href="https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-016-0187-3">doi: 10.1186/s12992-016-0187-3</a>.</span> <span class="normaltextrun"><br/><br/>5. Collins CH et al. Refugee, Asylum Seeker, Immigrant Women and Postnatal Depression: Rates and Risk Factors. Arch Womens Ment Health. 2011 Feb;14(1):3-11. </span> <span class="Hyperlink"> <a href="https://link.springer.com/article/10.1007/s00737-010-0198-7">doi: 10.1007/s00737-010-0198-7</a> </span> <span class="normaltextrun">.<br/><br/>6. Fazel M, Betancourt TS. Preventive Mental Health Interventions for Refugee Children and Adolescents in High-Income Settings. Lancet Child Adolesc Health. 2018 Feb;2(2):121-132. </span> <span class="Hyperlink"> <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(17)30147-5/fulltext">doi: 10.1016/S2352-4642(17)30147-5</a> </span> <span class="normaltextrun">.<br/><br/>7. Pottie K et al. Do First Generation Immigrant Adolescents Face Higher Rates of Bullying, Violence and Suicidal Behaviours Than Do Third Generation and Native Born? J Immigr Minor Health. 2015 Oct;17(5):1557-1566. </span> <span class="Hyperlink"><a href="https://link.springer.com/article/10.1007/s10903-014-0108-6">doi: 10.1007/s10903-014-0108-6</a>.</span> <span class="normaltextrun"><br/><br/>8. Smokowski PR, Bacallao ML. Acculturation and Aggression in Latino Adolescents: A Structural Model Focusing on Cultural Risk Factors and Assets. J Abnorm Child Psychol. 2006 Oct;34(5):659-673. </span> <span class="Hyperlink"> <a href="https://link.springer.com/article/10.1007/s10802-006-9049-4">doi: 10.1007/s10802-006-9049-4</a> </span> <span class="normaltextrun">.<br/><br/>9. Gadermann AM et al. Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada. JAMA Netw Open. 2022;5(2):e2144934. </span> <span class="Hyperlink"> <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789061">doi: 10.1001/jamanetworkopen.2021.44934</a> </span> <span class="normaltextrun">.</span> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> </itemContent> </newsItem> </itemSet></root>
