The proposed 4 year study requests funds to conduct the first systematic investigation of the mental health and well-being of US-born children of refugees. Since 1980, the US has admitted approximately 2.4 million refugees. These refugees encounter myriad challenges adjusting to life in the US, and have very high rates of mental illness following pre-migration trauma and violence. Recent data indicate that these psychosocial problems of refugees can persist several decades after arrival in the US. These circumstances may present the children of refugees with significant obstacles to becoming psychologically healthy, productive adults. Specifically, they may be at risk for several health and social problems, including psychological disorders, substance use, risky health behaviors, and academic disengagement. Continued scientific inattention to the fate of second generation refugees may have enormous public health costs for both the children and society as a whole. At stake is the capacity of this large group of refugee offspring to become healthy, productive adults, able to take full advantage of opportunities available in the US. We propose to study the mental health and well-being of the US-born children of Cambodian refugees, one of the largest groups of US refugees. The proposed study would take place in Long Beach, CA, home to the largest single community of Cambodian refugees in the US. Data would be collected by conducting face-to-face interviews with approximately 350 US- born adolescent (10th-12th grade) children of Cambodian refugees as well as their parents. Collaboration with the Long Beach Unified School District (LBUSD) will enable a random selection of families using contact information provided by the LBUSD. The proposed application has three broad aims: 1). To characterize US-born children of Cambodian refugees with respect to mental health and well-being. We will also seek to identify subgroups at particularly high risk. Domains of interest include mental health, substance use, behavioral problems, risky health behavior, and academic achievement. The status this group of adolescents will be compared to population norms from nationally representative studies using the same measures. 2). To determine whether the mental health and well-being of US-born children of Cambodian refugees differs as a function of the mental health of their parents. 3). To assess current utilization of mental health and social services, perceived need for specific services, and the barriers to receiving these services. Separate analyses will be directed at quantifying both parental and child service utilization, perceived need, and barriers.

Public Health Relevance

Evidence from various sources suggests that the US-born children of refugees may be at risk for mental health and related psychosocial problems. The proposed research would constitute the first systematic study of the mental health and well-being of US- born children of Cambodian refugees, one of the largest groups of refugees. Results would inform public health policies and practices aimed at providing for the well-being of children of refugees.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Psychosocial Development, Risk and Prevention Study Section (PDRP)
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Tuma, Farris K
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Rand Corporation
Santa Monica
United States
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Marshall, Grant N; Schell, Terry L; Wong, Eunice C et al. (2016) Diabetes and Cardiovascular Disease Risk in Cambodian Refugees. J Immigr Minor Health 18:110-7
Wong, Eunice C; Marshall, Grant N; Schell, Terry L et al. (2015) Characterizing the Mental Health Care of U.S. Cambodian Refugees. Psychiatr Serv 66:980-4
Pedersen, Eric R; Marshall, Grant N; Schell, Terry L et al. (2014) A comparison of Cambodian-American adolescent substance use behavior to national and local norms. Addict Behav 39:1874-8
Wong, Eunice C; Marshall, Grant N; Schell, Terry L et al. (2011) The unusually poor physical health status of Cambodian refugees two decades after resettlement. J Immigr Minor Health 13:876-82