Behavioral Health, Mental Health, Substance Abuse
Comparing the Mental Health of Adolescent Citizens and Immigrants Using a Nationally Representative Survey
(School of Public Health (UMD) Health Services Administration Master's Student)
Objective: To explore the mental health of adolescent immigrant health and compare it to their citizen counterparts using a nationally representative survey. Approach: Using the Strengths and Difficulties Questionnaire (SDQ) supplement from the National Health Interview Survey (2014-2015), we compared the psychological distress of adolescent US citizens vs. non-citizens, controlling for age, gender, race/ethnicity, poverty, and parent education using regression analyses. The SDQ is a validated scale that aggregates 5 survey items to measure mental health severity, one question to determine psychological problems, and one question about emotional difficulties Findings: The unadjusted means of adolescents surveyed (n=12,637) indicate that citizens experience worse mental health outcomes and have a higher prevalence of emotional difficulties (1.689 vs. 1.312 P <0.000*; 1.308 vs 1.138 P<0.000*). The multivariable regression showed Non-citizen adolescents having substantially reduced odds of emotional difficulties and had a lower SDQ score compared to citizens (OR= 0.55 p<.021), but were not significantly different for having a likely psychological problem. Conclusion: Results suggest that the “healthy immigrant paradox” holds true for mental health outcomes in adolescents. The current political climate toward non-citizens may impact this outcome moving forward. Future monitoring is warranted along with analysis of immigrant subgroups, and the relationship between time in the US and mental health. Public Health Significance: Immigrants are a vulnerable population at increased risk for poor physical, psychological, and social health outcomes. The literature is inconclusive in determining whether immigrants experience worse mental health outcomes, or if the “healthy immigrant paradox” persists. Little is known regarding psychological distress among immigrant adolescents.