In 2021, the U.S. surgeon general declared a mental health crisis across our nation particularly in adolescents. As a medical student and future pediatrician, I am deeply concerned about this adolescent mental health epidemic. In our state, nearly one quarter of children have one or more behavioral health conditions. Moreover, adolescents who are from immigrant and marginalized communities are especially vulnerable to mental health problems.
This number is staggering and highlights the need for comprehensive and widely available mental health services in Tennessee. To care for all adolescents, we must consider the unique backgrounds and experiences of those from immigrant communities. These children come from multicultural families and comprise an important part of our community.
Children of immigrants are underrepresented in our health care system often due to language and cultural deficiencies in healthcare services. This has impacted mental health services as well; services are not sufficiently tailored to meet the specific needs of these adolescents. Studies have shown that adolescents of immigrant backgrounds can benefit greatly from therapy services that reinforce bilingualism, cultural richness, and family togetherness, all core values that may not be highlighted in conventional mental health services.
Partnership was key to acquiring necessary mental health services
In addition to my clinical training, I serve as co-director of the Vanderbilt Shade Tree Pediatric Primary Care and Adolescent Psychiatry Clinics, student-run free clinics providing care to uninsured children.
Serving in this role has revealed the limited mental health service options for adolescents of immigrant backgrounds particularly for those without insurance. Within our patient panel, nearly 75% of patients have a mental health diagnosis including depression, anxiety, and post-traumatic stress disorder.
Many of these adolescents were initially referred to their school counselor and then to our adolescent psychiatry clinic due to their ineligibility for insurance. We were able to provide them psychiatric services, but as providers, we knew many could benefit greatly from long-term therapy.
Unfortunately, most Tennessee schools do not have a bilingual counselor, nor anyone trained to provide culturally humble mental health services. We ultimately looked beyond our clinic and established a partnership with Family and Children’s Services, a Tennessee nonprofit organization, which has a staff of bilingual, bicultural mental health providers.
This organization represents a small but powerful effort to provide culturally nuanced mental health care to adolescents from immigrant backgrounds.
More:Mental health workers are responding to crisis calls with Nashville police. Here are their stories.
Four ideas for closing the gap on disparities in care
As we look forward to shaping the future of mental health services in our state, we must reflect on how to ensure adolescents of immigrant backgrounds are not left behind.
The Tennessee Department of Mental Health and Substance Abuse Services has recently received federal funding for a School-Based Behavioral Health Liaison Program with the goal of increasing the density of school-based mental health providers in our state.
Through this new program, we have an opportunity as a community to equip mental health providers with the tools to care for adolescents from diverse backgrounds.
There are several ways we can encourage policymakers to fill the gap in care for adolescent children of immigrants:
- Consult experts from organizations that serve bilingual, bicultural adolescents like Family and Children’s Services
- Implement training for school counselors on providing trauma-informed and culturally nuanced therapy
- Advocate for hiring bilingual and bicultural mental health providers in Tennessee schools
- Invest government resources in interpreter services specially trained for mental health visits
In these next months, it is crucial that we advocate for high quality mental health care for all adolescents in our state, including those from immigrant backgrounds.
Starina D’souza is a fourth year medical student in Tennessee.
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