Key Points

• Youth make up over half of the world's migrants and refugees; they face traumatic experiences before, during, and after migration.

• Migration-related trauma can have profound and lasting effects on well-being via neurobiological and psychological mechanisms and contribute to the development of mental health conditions such as post-traumatic stress disorder (PTSD).

• The psychobiological consequences of migration-related trauma should inform policies to promote well-being for migrant and refugee children.

• The policy recommendations target providing mental health services, mitigating chronic daily stressors, and preventing migration-related trauma.

• Local, state, and federal legislators should use the recommendations presented here to take action to improve as well as prevent further harm to the lives of migrant children.

Over half of the world's migrants and refugees are under the age of eighteen (United Nations High Commissioner for Refugees [UNHCR], 2019), and over 2.5 million migrant and refugee children are living in the United States (U.S.; Levesque, 2021). Adversity is inherent to migrant and refugee children's experiences before, during, and after migration (Mercado et al., 2022). Literature on early adversity sheds light on potential neurobiological, psychological, and behavioral consequences of migration-related experiences for children across development (Blackmore et al., 2020; Cohodes, Kribakaran et al., 2021; MacLean et al., 2020). Here, we apply a neurodevelopmental lens to migration-related adversity and trauma (i.e., actual or threatened death, serious injury, or sexual violence) for children and propose implications for policy change.

Throughout, this review refers to children migrating from their countries of origin as “migrant and refugee children,” in describing the experiences of children who are seeking asylum after fleeing their home countries due to violence, war, and persecution. We also use these terms for children who are emigrating in search of better opportunities or safer living conditions but not formally seeking asylum or refugee status. Although migration-related adversity affects children worldwide, when possible, we focus on the experiences of migrant and refugee children from Mexico, Central America, and Haiti coming to the U.S.

Trauma Exposure Associated with Migration

Migrant and refugee children experience trauma throughout their migration journeys. Trauma exposure is common prior to migration (Keller et al., 2017), with exposure to actual or threatened violence frequently cited as the reason for family migration (Ornelas & Perreira, 2011). During migration, which is itself inherently stressful, youth frequently face significant trauma, with studies suggesting that the majority of caregivers fear for their and their family's safety during migration (Fazel et al., 2012; Ornelas & Perreira, 2011). Families experience forced separation, trafficking, kidnaping, injury by border control officers, sexual violence, racism, and witnessing violent and sexual crimes against children (O’Connor et al., 2015).

Once in the U.S., families are frequently placed in detention facilities and face continued violence. Investigative and firsthand reports have documented horrific conditions in detention centers, including insufficient or poor nutrition, hygiene, and medical and psychological resources, as well as constant light exposure, cold temperatures, forced separation, sexual assault, verbal abuse and intimidation from Immigration and Customs Enforcement (ICE) employees, physical threats, actual and threatened deportation and family separation, and shackling during deportation (Neusner, 2022; O’Connor et al., 2015).

Following migration, migrant and refugee children encounter persistent threats of family separation and deportation (Chaudry et al., 2010). Furthermore, the violence of systemic racism and anti-immigrant policies result in food insecurity, housing instability, and barriers to accessing healthcare (Viruell-Fuentes et al., 2012) and can threaten migrants’ mental and physical health (Eskenazi et al., 2019). Together, the trauma inherent to the experience of migration confers significant risk for children's mental health and long-term well-being, as delineated in the next section.

Psychological Effects of Migration-Related Trauma

Migration-related trauma can have lasting impacts on mental health across development (Blackmore et al., 2020; Fazel et al., 2012; Hampton et al., 2021) and likely exacerbates the effects of previous trauma exposure on children's mental health (Fazel et al., 2012; Sidamon-Eristoff et al., 2022). Specifically, exposure to traumatic events in childhood can contribute to immediate and long-term mental health conditions, including PTSD (McLaughlin, Green et al., 2010), which migrant and refugee children experience at a high rate (Blackmore et al., 2020; MacLean et al., 2019, 2020; O’Connor et al., 2015). Further, experiencing detention and horrific conditions in detention centers may directly affect migrant and refugee children's development of symptoms following migration-related trauma (Keller et al., 2003; Sidamon-Eristoff et al., 2022). Children held in detention centers in the U.S. experience even higher levels of mental health conditions relative to migrant and refugee youth who do not spend time in detention centers (MacLean et al., 2019, 2020).

Attachment to their parents enables children to self-regulate and function in the context of stress. Consequently, parental presence or absence during migration-related stress can mitigate—or exacerbate—effects on children's mental health. Caregivers can buffer the consequences of migration-related trauma exposure (Bean et al., 2007; MacLean et al., 2019, 2020); however, migration often involves threatened or actual caregiver-child separation in detention centers (Waddoups et al., 2019), constituting a major source of caregiving adversity (Cohodes, Kribakaran et al., 2021). In addition to threatening the immediate physical safety of children, forcible separation from caregivers deprives children of the buffering effect of their caregiver's presence (Gunnar & Donzella, 2002). Relative to children who were not separated, children who were forcibly separated from a caregiver during migration experience more psychological difficulties (Bean et al., 2007; MacLean et al., 2019, 2020; Sidamon-Eristoff et al., 2022), which can persist for years following separation (Hampton et al., 2021).

Fears of separation and deportation often persist post-migration due to the constant threat of parental deportation, with adverse consequences for children's mental and physical health (Artiga & Ubri, 2017). Children of undocumented parents in the U.S. experience negative behavioral and emotional changes, as well as drops in academic achievement and an increase in missed days of school, following parental arrests (Chaudry et al., 2010). Migrant parents’ own trauma-related psychopathology can also exacerbate children's trauma-related symptoms, particularly when youth and parents are exposed to shared trauma or separation (Scheeringa & Zeanah, 2001). These findings underscore the profound and lasting impacts that migration-related trauma can have on children's mental health.

Neurobiological Mechanisms Linking Migration-Related Trauma with Mental Health

A growing body of research has delineated the neurobiological processes linking childhood trauma with the development of mental health conditions (Gee, 2021; McLaughlin et al., 2019; Teicher et al., 2016). Although we know of no studies investigating neural effects of trauma among migrant and refugee youth, specifically, we review findings among youth exposed to a range of adversities to elucidate potential effects of complex migration-related traumatic experiences on stress physiology and brain development (see Cohodes, Kribakaran et al., 2021 for review). We specifically focus on the impacts of stress exposure on neurobiology, stress sensitization and its long-term effects, and the buffering role of caregivers.

How Stress Exposure Impacts Neurobiology

Humans’ biological stress response systems have evolved to help cope with stressors. The hypothalamic-pituitary adrenal (HPA) axis plays a central role in stress responding, including by regulating the production of stress hormones such as cortisol (McEwen & Akil, 2020). These stress hormones interact with the brain to prepare humans to contend with threats. While these systems can promote adaptive behaviors in the context of adversity, extreme or chronic stress can dysregulate the HPA axis and interfere with individuals’ ability to cope with future stressors (Gunnar et al., 2009; McLaughlin et al., 2015). In effect, the HPA axis may become less elastic with repeated stressors over time.

Exposure to stress affects the brain and psychological functioning. For example, chronically elevated levels of stress hormones in the brain can have lasting effects on neural structure and function (McEwen, 2012). Brain regions involved in regulating fear and processing threat and safety in one's environment (i.e., amygdala, hippocampus, and medial prefrontal cortex; mPFC) have more stress hormone receptors and are especially sensitive to stress. Specifically, the amygdala detects emotionally salient environmental stimuli and activates the HPA axis in response to threat; the hippocampus supplies and relays contextual information from the environment; and the mPFC guides learning and regulates amygdala-driven emotional reactivity (Fullana et al., 2016). Together, these regions constitute the cortico-limbic circuit that reduces fear and regulates emotion. Exposure to stress during development—such as exposure to migration-related trauma—is associated with distinct structural and functional changes in cortico-limbic circuitry (see Cohodes, Kitt et al., 2021 for review). Stress exposure also alters large-scale brain networks that support cognitive and affective functions, such as detecting salient stimuli, cognitive control, and reward processing (see McLaughlin et al., 2019 for review). Taken together, these neurobiological changes likely contribute to the development of emotional and behavioral difficulties and mental health conditions among migrant and refugee youth following the trauma they experience (Cohodes et al., 2021; Grasser et al., 2023).

Stress Sensitization and Long-Term Effects

In addition to shorter-term effects on neurobiology and mental health, exposure to stress can produce changes in the brain that persist and increase long-term risk for mental health disorders, even years following a stressor. One mechanism by which this occurs is called stress sensitization: Exposure to stress early in life increases vulnerability to future stressors (McLaughlin et al., 2010). Corticolimbic circuitry, specifically hippocampal-mPFC-amygdala circuitry, may contribute to the effects of stress sensitization (Hanson et al., 2015; Weissman et al., 2020) given that these regions are closely involved in stress responding via the HPA axis. Over time, stress can alter hippocampal and mPFC function and thus interfere with their regulation of stress responses (McEwen & Akil, 2020). In these ways, exposure to extreme or chronic stress––such as the persistent adversity that migrant and refugee youth face––can dysregulate (e.g., heighten or blunt) responses to subsequent stressors. Consistent with this idea, youth exposed to early adversity show dysregulated cortisol responses to later stressors (Gunnar et al., 2009). Together, these alterations in HPA axis function and corticolimbic circuitry may explain heightened long-term risk for mental health disorders among youth exposed to migration-related trauma, as well as why children exposed to trauma prior to migration may be at greater risk for PTSD when exposed to trauma during migration.

Buffering Role of Caregivers on Children's Stress Physiology

Caregivers play a critical role in buffering children––to the extent possible––from the consequences of stress exposure. The neural systems that support emotion regulation and stress coping––such as regulatory connections between the mPFC and amygdala––undergo protracted development (Casey et al., 2019). Caregivers can modulate children's HPA axis and cortico-limbic circuitry to support these systems while they are still developing (Gee, 2021). Consistent with behavioral and psychological evidence of caregivers’ role in helping to regulate children's emotions and stress reactivity (Eisenberg et al., 1998), children show reduced cortisol reactivity (Gunnar & Donzella, 2002) and amygdala reactivity (Gee et al., 2014) in their caregivers’ presence. On average, youth exposed to early adversity show disruptions in the buffering effects of caregivers at the neural level (Callaghan et al., 2019), providing mechanistic insight into the ways that adversity can disrupt children's development and their ability to optimally benefit from caregiver inputs throughout development. Together, these findings suggest that support from caregivers has the potential to buffer the effects of migration-related stress on children's neurobiological development, highlighting an important protective factor for migrant and refugee children.

Policy Implications to Promote Migrant and Refugee Youth Mental Health

The scientific evidence base reviewed here yields several key findings that inform policy for migrant and refugee youth. First, converging evidence demonstrates that trauma can have negative consequences on neurobiology and that early-life trauma is particularly detrimental. Across many studies, the types of trauma that are inherent to children's migration experiences have been associated with dysregulation in stress response systems, altered structural and functional brain development, and increased risk for mental health disorders (Cohodes et al., 2021). Given that the developing brain is especially plastic, trauma experienced during development confers stronger risk (Gee, 2021; McLaughlin et al., 2015; Teicher et al., 2016).

Second, children exposed to trauma are at heightened risk for the development of mental health disorders, both immediately and longer term. Despite the potential for change and intervention, neurobiological and behavioral effects of trauma can persist long after the experience occurs, as is demonstrated in studies of adults who experienced trauma during childhood (Teicher et al., 2016). These findings further highlight that youth exposed to previous trauma––which, definitionally, describes most children whose families are seeking asylum––are at heightened risk for mental health problems such as PTSD following subsequent migration-related trauma.

The third primary takeaway from this broad evidence base is that caregivers play an essential role in buffering children from the consequences of trauma exposure, both neurobiologically and behaviorally (Callaghan et al., 2019; Gee et al., 2014; Gunnar & Donzella, 2002). Studies demonstrating the protective influences of caregivers highlight both the important role that caregivers can play in supporting children during stressful experiences of migration, as well as the compounded trauma of forcibly separating families during migration (Cohodes et al., 2021).

Together, this body of evidence points to the importance of policies that prioritize intervention for youth exposed to trauma, prevention of further stress during and following youths’ migration, and, critically, keeping families together throughout the migration experience. To this end, this section provides detailed policy recommendations related to (1) the provision of mental health care, (2) services that address chronic stressors following migration, and (3) the prevention of migration-related trauma.

Implementation and Dissemination of Mental Health Services

Given the short- and long-term neurobiological and psychological consequences of early-life adversity (McLaughlin et al., 2019; Teicher et al., 2016), early intervention for migrant and refugee youth and their caregivers is essential to mitigate the effects of trauma faced during and after migration (Baily, 2017). Although effective therapies can treat trauma-related symptoms following migration-related trauma (e.g., Abdi, 2018; Ellis et al., 2013; Patel et al., 2022), the majority of migrant and refugee youth do not receive mental health screening or therapy (Fazel et al., 2012). Thus, policies should both address key barriers to mental health care and ensure effective implementation of interventions at each stage of the migration and resettlement journey.

Recommendation #1: Mental Health Assessments and Interventions Should be Trauma-Informed and Address Barriers to Care

During the migration and resettlement periods, migrant and refugee children and families face numerous barriers to appropriate mental health care, including the need to prioritize daily basic needs (e.g., housing, food, employment), stigma related to mental health, and cultural and linguistic barriers (Ellis et al., 2011). Thus, the mental health care they receive should both directly address psychological distress in the context of trauma and stressors and tackle barriers to care (Ellis et al., 2013). To this end, care for migrant and refugee youth should be (1) trauma-informed as well as developmentally (Rojas-Flores et al., 2017) and culturally (Abdi, 2018) appropriate; (2) delivered in families’ native languages by providers who practice cultural humility (e.g., understanding the influences of systemic factors and cultural elements; Fisher-Borne et al., 2015); and (3) provide resources and support to address basic needs. For example, the Trauma Systems Therapy for Refugees (TST-R) model ensures that trauma-informed mental health services and psychoeducation are provided at the community and individual level in families’ native languages and in partnership with trained community members who can function as a bridge by providing vital cultural context for service provision (Ellis et al., 2013). Further, TST-R supports families in accessing resources such as housing and school placement to relieve daily resettlement-related stressors. Critically, TST-R implemented in refugee communities has been shown to reduce symptoms of PTSD and depression (Ellis et al., 2013), and similar models could be effective in migrant and refugee communities across the U.S.

Recommendation #2: Mental Health Assessments and Interventions Should be Conducted in Both Community and Healthcare Settings

In addition to clinical and hospital settings, assessments and interventions in non-clinical community settings can significantly improve access among migrant and refugee families (Ellis et al., 2011). For example, providing care through community centers could build on existing trust between community organizations and families (Rusch et al., 2015). Schools are also a vital setting for disseminating mental health services, as they can both provide every child the option to receive mental health assessments and care, but also mobilize community-based social supports and help families to manage ongoing stressors (Ellis et al., 2013; Fazel et al., 2012).

To ensure that mental health services are available in multiple settings, more providers trained to provide appropriate care are needed in areas with large migrant and refugee populations. In addition to recruiting additional providers who can deliver care in children's native languages via telehealth (Endale et al., 2020), novel models can be employed to scale up mental health services for migrant and refugee communities. For example, in a task-sharing or task-shifting model, community members (who often speak the youth's native language) receive training in specific tasks (e.g., screening) from experts and carry out these tasks under the supervision of professionals (Javadi et al., 2017). This practice could increase both access to and the efficacy of care, as youth and their families may be more likely to build trust with providers from their community.

Addressing Chronic Daily Stressors in the Lives of Migrant and Refugee Children

In addition to the trauma experienced before and during migration, migrant and refugee youth often face complex post-migration adversities that may further impact their health. Here, recommendations relate to mitigating several chronic stressors that affect youth, namely fear of separation from a loved one, housing instability, and food insecurity.

The Daily Threat of Family Separation

Migrant youth and families who are undocumented face the threat of family separation in their daily lives. The deportation or detention of parents or children through raids by ICE (López et al., 2017) and racial profiling by police (Lind, 2015) are only two of the ways that migrant families confront potential separation of family members. In addition to driving fear and uncertainty, this constant threat of separation can impact the ways that migrant families access vital resources.

Recommendation #3: End Deportations of Migrant Youth and Family Members

The scientific evidence documenting the neurobiological and psychological consequences of forcibly separating families (Cohodes, Kribakaran et al., 2021)––via deportation, separate placements in detention centers, or other mechanisms––strongly indicates that such practices should end immediately. The UNHCR should also strengthen its enforcement of protections against refoulement for refugees in the U.S. This includes prohibiting deportation to countries where refugees face ill treatment, persecution, and violence (Sy, 2015). These urgent needs underscore the importance of systemic legal changes, in addition to temporary mitigatory solutions.

Recommendation #4: Implement Protocols That Protect Migrant Families in Accessing Vital Resources

Migrant and refugee families are often unable to access resources fundamental to their well-being, due to the threat of deportation or family separation (Artiga & Ubri, 2017). Until deportation and family-separation practices end, policies should protect migrant and refugee families, so that they can access critical health resources. For example, in cities in which migrants are not protected from federal immigration authorities (i.e., non-sanctuary cities), clinics, mental health centers, community centers, and hospitals should implement policies that address migrant safety (e.g., clearly displaying migrants’ rights at clinics, discussing confidentiality policies during phone screening; Dawson-Hahn & Cházaro, 2019). They should also develop safety protocols in the event that immigration officials make families unsafe (Dawson-Hahn & Cházaro, 2019). Making information about these safety plans (e.g., protocols developed by the National Immigration Law Center, 2017) publicly available and accessible (e.g., translated into all languages native to the patient population) can promote greater trust among migrant and refugee families seeking care.

The Chronic Stress of Housing and Food Insecurity

Recommendation #5: The State Should Provide Essential Resources to Migrant and Refugee Families

Housing instability and food insecurity can have significant consequences for the health and development of migrant and refugee children (Potochnick & Arteaga, 2018). Although the Office of Refugee Resettlement provides some vital support (e.g., housing, medical, and social services) to refugee families, these services are not available to all migrant youth even if their pre-migration experiences are consistent with those of documented refugees (Kennedy, 2013). Thus, these vital forms of support should be made available to all migrant children, regardless of refugee status. Governing bodies should enact legal changes that account for inconsistencies in the determination of refugee status (Paris et al., 2018).

Recommendation #6: Temporary, Community-Based Solutions Should be Provided to Migrant and Refugee Families

Community-based organizations (CBOs) have historically provided services relating to health, education, social support, and housing for migrant communities. For example, formal medical-legal partnerships between healthcare professionals and lawyers can effectively increase access to health, social, and legal services (Weintraub et al., 2010); mutual aid programs are another resource that serves the immediate needs of migrant and refugee families (Gardner, 2020). Although local institutions (e.g., medical centers) have an obligation to develop programming and provide resources that support migrant and refugee families, programs offered through CBOs are historically relatively better trusted by migrants due to their integration in local communities (Yoshikawa, 2011) and should be financially supported by the state and local institutions.

Preventing the Infliction of Trauma Upon Migrant and Refugee Children

While evidence regarding the detrimental effects of trauma on children's neurodevelopment and mental health clearly underscores the urgent need for interventions that mitigate the stressors that migrant and refugee children face, developmental neuroscience also points directly to the importance of preventing further trauma exposure among migrant and refugee youth. To this end, scientists—alongside community organizations and national agencies (e.g., American Civil Liberties Union)—have called for the immediate suspension of family separation and migrant child detention and the minimization of time spent in detention centers (Cohodes et al., 2020; Pompa, 2019), but these practices continue (Castillo, 2023; Montoya-Galvez, 2022; Morrissey, 2022). The evidence is clear: Experiences of detention exacerbate children's mental health difficulties (A. S. Keller et al., 2003; Sidamon-Eristoff et al., 2022); forcible separation has traumatic effects while also depriving children of the buffering effect of their caregiver's presence (Cohodes, Kribakaran et al., 2021; Sidamon-Eristoff et al., 2022); and, critically, these psychological consequences can persist for years following separation (Hampton et al., 2021). Thus, the psychological need for systemic change is undeniable: Terminate detention and deportation practices and dismantle the policies that separate and detain families (i.e., ICE and CBP; Cohodes, Kribakaran et al., 2021).

Conclusions

Migrant and refugee youth experience profound adversity throughout migration. Foundational research from brain and behavioral science elucidates the psychobiological mechanisms that may link migration-related trauma with mental health-related suffering, underscoring the critical need for systemic changes to promote the well-being of migrant and refugee youth. Local, state, and federal legislators should act swiftly to implement the outlined recommendations. In addition to aligning with fundamental humanitarian and moral considerations underscored throughout this paper, these recommendations align with practical and economic considerations raised by others (Mattingly et al., 2020). Preventing migration-related trauma and providing critical mental health resources will both reduce the staggering burden of mental health disorders on societal well-being (SAMHSA, 2022; Vos et al., 2020) and the immense economic burden of mental health disorders (Knapp & Wong, 2020; Mattingly et al., 2020). In doing so, policymakers can continue to build a society that fundamentally values and promotes the health and well-being of the most vulnerable individuals among us––children desperately needing safety and care from situations and trauma beyond their control.

Summary

Over half of the world's migrants and refugees are under 18 years old. These young people face very difficult experiences before, during, and after they move to a new country. These experiences can deeply affect their mental and physical health, sometimes for a long time. Trauma from migration can change how the brain works and lead to mental health issues like post-traumatic stress disorder (PTSD).

It is important for policies to consider these effects to better support the mental health of migrant and refugee children. Recommended policies include providing mental health services, reducing daily stresses, and preventing trauma related to migration. Lawmakers at all levels of government should use these recommendations to help migrant children and prevent further harm.

Trauma Exposure Associated with Migration

Migrant and refugee children often experience trauma at every stage of their journey. Before they even leave their home countries, many are exposed to violence, which is often why their families decide to migrate. The journey itself is very stressful, and many parents worry about their family's safety. During migration, families may face forced separation, human trafficking, kidnapping, injuries from border officers, sexual violence, racism, and witnessing violent crimes.

After arriving in the United States, families are often held in detention centers. Reports describe harsh conditions in these centers, including poor food, lack of hygiene, and limited medical and psychological care. There are also reports of constant light, cold temperatures, forced family separation, sexual assault, verbal abuse, physical threats, and shackling during deportations.

Even after migration, children may live with the ongoing fear that their families could be separated or deported. Systemic racism and anti-immigrant policies can also lead to problems like not having enough food or a stable home, and difficulty getting healthcare. These ongoing stresses can negatively affect mental and physical health. All these traumatic experiences put children at high risk for mental health problems and long-term well-being issues.

Psychological Effects of Migration-Related Trauma

Trauma from migration can have lasting impacts on mental health throughout a child's life. It can also worsen the effects of any trauma experienced before migration. Traumatic events in childhood can lead to immediate and long-term mental health conditions, such as PTSD, which is common among migrant and refugee children. Being held in detention centers and experiencing harsh conditions there can directly contribute to the development of symptoms after migration trauma. Children who spend time in detention centers often show higher rates of mental health conditions compared to those who do not.

Parents play a crucial role in helping children cope with stress. Their presence can reduce the impact of migration-related trauma. However, migration often involves the threat or reality of caregiver-child separation in detention centers, which is a major source of distress. When children are forcibly separated from their caregivers, they lose this protective support. Children who are separated from a caregiver during migration often experience more psychological difficulties, which can last for years.

Even after migration, fears of separation and deportation can continue if parents are at risk of being deported. This can negatively affect children's mental and physical health. Children of undocumented parents may experience behavioral and emotional changes, lower academic performance, and more missed school days after a parent is arrested. Additionally, if parents have their own trauma-related mental health issues, this can make children's trauma symptoms worse, especially if they experienced trauma together or were separated. These findings highlight how deeply and lastingly migration-related trauma can affect children's mental health.

Neurobiological Mechanisms Linking Migration-Related Trauma with Mental Health

Research shows how childhood trauma can affect the brain and lead to mental health conditions. While specific studies on migrant and refugee youth are limited, general findings about youth exposed to various hardships can help us understand how complex migration trauma might affect stress response and brain development. This includes how stress affects the brain, how it can make someone more sensitive to future stress, and how caregivers can help.

How Stress Exposure Impacts Neurobiology

The body's stress response systems are designed to help cope with difficult situations. A key system, the hypothalamic-pituitary adrenal (HPA) axis, controls stress hormones like cortisol. These hormones interact with the brain to prepare the body for threats. While these systems are helpful for adapting to challenges, extreme or long-term stress can disrupt the HPA axis, making it harder for individuals to cope with future stressors. The HPA axis may become less flexible after repeated stressful events.

Stress also affects the brain and how people think and feel. High levels of stress hormones in the brain for a long time can change brain structure and function. Brain areas involved in fear, threat processing, and safety, such as the amygdala, hippocampus, and medial prefrontal cortex (mPFC), have many stress hormone receptors and are very sensitive to stress. The amygdala recognizes threats and activates the HPA axis; the hippocampus provides context; and the mPFC helps with learning and controls emotional reactions. Together, these areas form a circuit that reduces fear and manages emotions. Experiencing stress during development, like migration-related trauma, is linked to specific changes in this brain circuit. Stress can also alter larger brain networks that support thinking and emotional functions, such as recognizing important stimuli, self-control, and processing rewards. These brain changes likely contribute to emotional and behavioral problems and mental health conditions in migrant and refugee youth after experiencing trauma.

Stress Sensitization and Long-Term Effects

Beyond immediate effects on the brain and mental health, stress exposure can lead to long-lasting brain changes that increase the risk for mental health disorders, even years later. This is partly due to "stress sensitization," where early life stress makes a person more vulnerable to future stressors. The brain's corticolimbic circuitry, especially the hippocampus, mPFC, and amygdala, may play a role in stress sensitization because these areas are closely involved in the stress response through the HPA axis. Over time, stress can change how the hippocampus and mPFC work, interfering with their ability to regulate stress responses. This means that exposure to extreme or ongoing stress, like the constant hardships faced by migrant and refugee youth, can disrupt how they respond to future stressors, either making them overreact or underreact. This is supported by findings that youth who experienced early hardship show irregular cortisol responses to later stressors. These changes in the HPA axis and corticolimbic circuitry may explain why migrant and refugee youth exposed to trauma have a higher long-term risk for mental health disorders. It also helps explain why children who experienced trauma before migration may be at greater risk for PTSD if they experience trauma during migration.

Buffering Role of Caregivers on Children's Stress Physiology

Caregivers are vital in protecting children from the effects of stress. The brain systems that help manage emotions and cope with stress, such as the connections between the mPFC and amygdala, develop over time. Caregivers can help regulate a child's HPA axis and cortico-limbic circuitry while these systems are still developing. Consistent with behavioral and psychological evidence that caregivers help children manage emotions and stress, children show reduced stress hormone responses and amygdala activity when their caregivers are present. On average, youth who experienced early adversity show disruptions in these protective effects from caregivers at the brain level. This helps explain how adversity can disrupt a child's development and their ability to benefit from caregiver support. These findings suggest that caregiver support can reduce the impact of migration-related stress on a child's brain development, highlighting its importance for migrant and refugee children.

Policy Implications to Promote Migrant and Refugee Youth Mental Health

The scientific information reviewed provides important insights for policies concerning migrant and refugee youth. First, strong evidence shows that trauma can negatively impact brain development and mental health, with early-life trauma being particularly harmful. Studies consistently link the types of trauma experienced during migration to disruptions in stress response systems, altered brain development, and a higher risk for mental health disorders. Because the developing brain is highly adaptable, trauma experienced during childhood carries a greater risk.

Second, children exposed to trauma have an increased risk of developing mental health disorders, both immediately and in the long term. Even though change and intervention are possible, the brain and behavioral effects of trauma can last long after the traumatic experience, as seen in adults who experienced childhood trauma. These findings also highlight that youth who experienced previous trauma, which includes most children seeking asylum, are at higher risk for mental health problems like PTSD after experiencing migration-related trauma.

Third, a major conclusion from this research is that caregivers play an essential role in protecting children from the consequences of trauma, both psychologically and neurologically. Studies showing the protective influence of caregivers emphasize their importance in supporting children during stressful migration experiences. They also highlight the severe additional trauma caused by forcibly separating families during migration.

This evidence collectively points to the need for policies that prioritize helping youth who have experienced trauma, preventing further stress during and after migration, and crucially, keeping families together throughout the migration process. This section provides detailed policy recommendations for: (1) providing mental health care, (2) services addressing ongoing stressors after migration, and (3) preventing migration-related trauma.

Implementation and Dissemination of Mental Health Services

Given the short-term and long-term effects of early trauma on brain development and mental health, early intervention for migrant and refugee youth and their caregivers is vital to lessen the impact of trauma faced during and after migration. Although effective treatments exist for trauma-related symptoms following migration, most migrant and refugee youth do not receive mental health screenings or therapy. Therefore, policies should both remove key barriers to mental health care and ensure that effective interventions are implemented at every stage of the migration and resettlement journey.

Recommendation #1: Mental Health Assessments and Interventions Should be Trauma-Informed and Address Barriers to Care

During migration and resettlement, migrant and refugee children and families face many challenges in getting proper mental health care. These include needing to focus on basic needs (like housing, food, and jobs), the stigma around mental health, and language and cultural differences. Therefore, the mental health care they receive should directly address psychological distress related to trauma and stress, and also overcome these barriers. This means care for migrant and refugee youth should be: (1) trauma-informed, and appropriate for their age and culture; (2) provided in their native languages by providers who are culturally sensitive; and (3) include resources and support for basic needs. For example, the Trauma Systems Therapy for Refugees (TST-R) model provides trauma-informed mental health services and education at both community and individual levels, in native languages. It partners with trained community members who help bridge cultural gaps. TST-R also helps families get resources like housing and school placement to ease daily resettlement stress. Importantly, TST-R has been shown to reduce symptoms of PTSD and depression in refugee communities, and similar models could be effective for migrant and refugee communities throughout the U.S.

Recommendation #2: Mental Health Assessments and Interventions Should be Conducted in Both Community and Healthcare Settings

In addition to traditional clinical and hospital settings, providing mental health assessments and interventions in non-clinical community settings can greatly improve access for migrant and refugee families. For example, offering care through community centers can build on existing trust between these organizations and families. Schools are also crucial places for offering mental health services, as they can provide every child the option for assessments and care, mobilize community social supports, and help families manage ongoing stresses.

To ensure mental health services are available in various settings, more trained providers are needed in areas with large migrant and refugee populations. Besides recruiting more providers who can offer care in children's native languages, potentially through telehealth, new models can be used to expand mental health services. For instance, in a task-sharing model, community members (who often speak the youth's native language) receive training in specific tasks (like screening) from experts and perform these tasks under professional supervision. This approach could increase both access to and effectiveness of care, as youth and their families may be more likely to trust providers from their own community.

Addressing Chronic Daily Stressors in the Lives of Migrant and Refugee Children

Beyond the trauma experienced before and during migration, migrant and refugee youth often face complex challenges after migrating that can further impact their health. Recommendations here focus on reducing several ongoing stressors that affect young people, such as the fear of being separated from a loved one, unstable housing, and not having enough food.

The Daily Threat of Family Separation

Migrant youth and undocumented families live with the constant threat of family separation. This can happen through deportations or detentions by immigration authorities, or through racial profiling by police. These actions create fear and uncertainty and can prevent migrant families from accessing vital resources.

Recommendation #3: End Deportations of Migrant Youth and Family Members

Scientific evidence clearly shows the negative brain and psychological effects of forcibly separating families, whether through deportation, separate placements in detention centers, or other means. Such practices should stop immediately. The United Nations High Commissioner for Refugees (UNHCR) should also strengthen its enforcement of protections against forced return for refugees in the U.S. This includes preventing deportation to countries where refugees face mistreatment, persecution, and violence. These urgent needs highlight the importance of lasting legal changes, not just temporary fixes.

Recommendation #4: Implement Protocols That Protect Migrant Families in Accessing Vital Resources

Migrant and refugee families are often unable to access basic resources for their well-being because they fear deportation or family separation. Until deportation and family-separation practices end, policies should protect migrant and refugee families so they can access critical health resources. For example, in cities where migrants are not protected from federal immigration authorities (non-sanctuary cities), clinics, mental health centers, community centers, and hospitals should create policies that address migrant safety. This includes clearly displaying migrants' rights at clinics and discussing confidentiality policies during phone screenings. They should also develop safety plans if immigration officials make families feel unsafe. Making information about these safety plans publicly available and accessible (e.g., translated into all languages spoken by patients) can build greater trust among migrant and refugee families seeking care.

The Chronic Stress of Housing and Food Insecurity

Recommendation #5: The State Should Provide Essential Resources to Migrant and Refugee Families

Unstable housing and not having enough food can greatly harm the health and development of migrant and refugee children. While the Office of Refugee Resettlement offers important support (like housing, medical, and social services) to refugee families, these services are not available to all migrant youth, even if their experiences before migration are similar to documented refugees. Therefore, these essential supports should be made available to all migrant children, regardless of their official refugee status. Governing bodies should make legal changes to address inconsistencies in how refugee status is determined.

Recommendation #6: Temporary, Community-Based Solutions Should be Provided to Migrant and Refugee Families

Community-based organizations (CBOs) have historically provided health, education, social support, and housing services for migrant communities. For example, formal partnerships between healthcare professionals and lawyers can effectively improve access to health, social, and legal services. Mutual aid programs are another resource that meets the immediate needs of migrant and refugee families. While local institutions (like medical centers) have a responsibility to develop programs and provide resources for migrant and refugee families, programs offered through CBOs are often more trusted by migrants because they are integrated into local communities. Therefore, CBOs should receive financial support from state and local institutions.

Preventing the Infliction of Trauma Upon Migrant and Refugee Children

Evidence about the harmful effects of trauma on children's brain development and mental health clearly shows an urgent need for interventions that reduce the stresses faced by migrant and refugee children. Developmental neuroscience also highlights the critical importance of preventing further trauma exposure for these youth. To this end, experts, along with community organizations and national agencies, have called for an immediate halt to family separation and the detention of migrant children, and to minimize the time spent in detention centers. However, these practices continue. The evidence is clear: detention worsens children's mental health problems; forced separation is traumatic and removes the protective effect of a caregiver's presence; and critically, these psychological consequences can last for years after separation. Therefore, the psychological need for systemic change is undeniable: detention and deportation practices must end, and policies that separate and detain families must be dismantled.

Conclusions

Migrant and refugee youth experience significant hardship throughout their migration journeys. Fundamental research from brain and behavioral science clarifies how trauma related to migration can affect the brain and lead to mental health suffering. This underscores the crucial need for systemic changes to improve the well-being of migrant and refugee youth. Lawmakers at local, state, and federal levels should act quickly to put the outlined recommendations into practice. These recommendations are not only consistent with basic humanitarian and moral principles but also align with practical and economic considerations. Preventing migration-related trauma and providing essential mental health resources will reduce the significant burden of mental health disorders on society and the immense economic costs associated with them. By doing so, policymakers can continue to build a society that values and promotes the health and well-being of its most vulnerable members—children who desperately need safety and care from situations and trauma beyond their control.

Summary

More than half of the world's migrants and refugees are under 18 years old, and they often experience traumatic events before, during, and after their journeys. These traumatic experiences can have deep and lasting effects on mental and physical health, influencing brain development and increasing the risk of mental health conditions like post-traumatic stress disorder (PTSD). Policies should consider these psychological and biological effects to improve the well-being of migrant and refugee children. Recommendations focus on providing mental health services, reducing daily stressors, and preventing further trauma related to migration. Lawmakers at all levels should use these recommendations to help migrant children and prevent additional harm.

Over half of the world's migrants and refugees are children, with millions residing in the United States. These children often face difficult situations throughout their migration experiences. Research on early hardship shows how these experiences can affect brain development, psychological well-being, and behavior. This review examines migration-related trauma from a developmental perspective and suggests policy changes.

This document uses the term "migrant and refugee children" to describe children fleeing violence, war, and persecution, as well as those seeking better opportunities or safer living conditions. While migration-related hardship affects children globally, the focus here is on the experiences of children from Mexico, Central America, and Haiti coming to the U.S.

Trauma Exposure Associated with Migration

Migrant and refugee children often experience trauma at every stage of their migration. Before migration, they commonly encounter violence, which is often why families decide to leave their home countries. During migration, which is inherently stressful, many children and their caregivers fear for their safety. Families may face forced separation, trafficking, kidnapping, injuries from border officials, sexual violence, racism, and witness violent acts.

Upon arrival in the U.S., families are often placed in detention centers where violence can continue. Reports have documented harsh conditions in these centers, including inadequate food, poor hygiene, insufficient medical and psychological care, constant light exposure, cold temperatures, forced family separations, sexual assault, verbal abuse, physical threats, deportation threats, and shackling during deportations.

After migration, children continue to face the ongoing threat of family separation and deportation. Systemic racism and anti-immigrant policies can lead to food and housing insecurity, and difficulties accessing healthcare. These factors can harm migrants' mental and physical health. The trauma inherent in the migration experience significantly increases the risk for children's mental health issues and long-term well-being.

Psychological Effects of Migration-Related Trauma

Migration-related trauma can have long-lasting effects on mental health throughout a child's development and may worsen the impact of any previous trauma. Traumatic events in childhood can lead to immediate and long-term mental health conditions, including PTSD, which is common among migrant and refugee children. Being held in detention centers, particularly under harsh conditions, can directly contribute to the development of trauma symptoms. Children in U.S. detention centers tend to have higher rates of mental health conditions compared to migrant and refugee youth not held in detention.

A child's attachment to their parents helps them manage stress. Therefore, a parent's presence or absence during migration can either lessen or intensify the effects on a child's mental health. Caregivers can help reduce the impact of migration-related trauma. However, migration often involves threatened or actual separation of caregivers and children in detention centers, which is a major source of distress. Forced separation from caregivers not only endangers a child's physical safety but also removes the protective effect of a caregiver's presence. Children who are forcibly separated from a caregiver during migration experience more psychological difficulties, which can last for years.

Fears of separation and deportation often continue after migration due to the constant threat of a parent's deportation, harming children's mental and physical health. Children of undocumented parents in the U.S. may show negative behavioral and emotional changes, lower academic performance, and increased school absences following parental arrests. A migrant parent's own trauma-related mental health issues can also worsen a child's trauma symptoms, especially when both parent and child experience shared trauma or separation. These findings highlight the significant and lasting impact of migration-related trauma on children's mental health.

Neurobiological Mechanisms Linking Migration-Related Trauma with Mental Health

Research shows how childhood trauma affects brain biology, leading to mental health conditions. While specific studies on migrant and refugee youth are limited, findings from youth exposed to various hardships can explain the potential effects of complex migration-related trauma on stress physiology and brain development. The focus here is on how stress impacts brain biology, the long-term effects of stress, and the protective role of caregivers.

How Stress Exposure Impacts Neurobiology

The human body's stress response systems are designed to cope with difficult situations. The hypothalamic-pituitary-adrenal (HPA) axis is central to this response, regulating stress hormones like cortisol. These hormones interact with the brain to prepare the body for threats. While these systems can be helpful in difficult times, extreme or chronic stress can disrupt the HPA axis, making it harder for individuals to cope with future stressors. The HPA axis may become less flexible with repeated stress over time.

Stress exposure affects the brain and psychological function. For example, consistently high levels of stress hormones in the brain can have lasting effects on brain structure and function. Brain areas involved in regulating fear and processing threat and safety (the amygdala, hippocampus, and medial prefrontal cortex or mPFC) have more stress hormone receptors and are particularly sensitive to stress. The amygdala detects emotional stimuli and activates the HPA axis in response to danger; the hippocampus provides contextual information; and the mPFC guides learning and regulates emotional reactions from the amygdala. Together, these regions form the cortico-limbic circuit that reduces fear and regulates emotion. Stress during development, such as migration-related trauma, is linked to specific structural and functional changes in this circuit. Stress also alters large-scale brain networks that support thinking and emotional functions, such as detecting important stimuli, cognitive control, and reward processing. These brain changes likely contribute to emotional and behavioral difficulties and mental health conditions in migrant and refugee youth who experience trauma.

Stress Sensitization and Long-Term Effects

Beyond immediate effects on brain biology and mental health, stress exposure can cause lasting brain changes that increase the long-term risk for mental health disorders, even years after the stressor. One way this happens is through stress sensitization: early life stress makes a person more vulnerable to future stressors. The corticolimbic circuitry, particularly the hippocampus-mPFC-amygdala connections, may contribute to stress sensitization because these regions are deeply involved in the HPA axis stress response. Over time, stress can change the function of the hippocampus and mPFC, interfering with their ability to regulate stress responses. Thus, exposure to extreme or chronic stress, like the ongoing difficulties faced by migrant and refugee youth, can disrupt (either heighten or blunt) responses to future stressors. Consistent with this, youth exposed to early hardship show irregular cortisol responses to later stressors. These changes in HPA axis function and corticolimbic circuitry may explain the increased long-term risk for mental health disorders among youth exposed to migration-related trauma, and why children exposed to trauma before migration may be at greater risk for PTSD when exposed to trauma during migration.

Buffering Role of Caregivers on Children's Stress Physiology

Caregivers play a vital role in protecting children from the effects of stress. The brain systems that support emotion regulation and stress coping, such as connections between the mPFC and amygdala, develop over an extended period. Caregivers can influence a child's HPA axis and cortico-limbic circuitry to support these developing systems. Consistent with behavioral and psychological evidence, children show reduced cortisol reactivity and amygdala reactivity when their caregivers are present. On average, youth exposed to early hardship show disruptions in the buffering effects of caregivers at the brain level, which helps explain how hardship can disrupt a child's development and their ability to benefit from caregiver support. These findings suggest that caregiver support can help mitigate the effects of migration-related stress on a child's brain development, highlighting an important protective factor for migrant and refugee children.

Policy Implications to Promote Migrant and Refugee Youth Mental Health

The scientific evidence reviewed here provides key insights for policies affecting migrant and refugee youth. First, strong evidence shows that trauma can negatively affect brain biology, and trauma experienced early in life is especially harmful. Studies consistently link the types of trauma experienced during migration to disruptions in stress response systems, altered brain development, and an increased risk for mental health disorders. Because the developing brain is highly adaptable, trauma experienced during this period carries a greater risk.

Second, children exposed to trauma are at a higher risk for developing mental health disorders, both immediately and in the long term. Despite the potential for positive change and intervention, the effects of trauma on the brain and behavior can persist long after the event, as seen in studies of adults who experienced childhood trauma. These findings further emphasize that youth with prior trauma—which includes most children seeking asylum—are at an elevated risk for mental health problems like PTSD after experiencing additional migration-related trauma.

The third main takeaway from this extensive evidence is that caregivers are essential in protecting children from the effects of trauma, both biologically and behaviorally. Studies showing the protective influence of caregivers highlight their important role in supporting children during stressful migration experiences, and also emphasize the compounded trauma of forcibly separating families during migration.

This body of evidence collectively stresses the importance of policies that prioritize early intervention for youth exposed to trauma, prevent further stress during and after migration, and, critically, keep families together throughout the migration process. To this end, this section offers detailed policy recommendations related to (1) providing mental health care, (2) addressing ongoing stressors after migration, and (3) preventing migration-related trauma.

Implementation and Dissemination of Mental Health Services

Given the short- and long-term biological and psychological consequences of early life hardship, early intervention for migrant and refugee youth and their caregivers is essential to lessen the impact of trauma faced during and after migration. While effective therapies can treat trauma-related symptoms, most migrant and refugee youth do not receive mental health screenings or therapy. Therefore, policies should address key barriers to mental health care and ensure that effective interventions are implemented at every stage of the migration and resettlement journey.

Recommendation #1: Mental Health Assessments and Interventions Should be Trauma-Informed and Address Barriers to Care

During migration and resettlement, migrant and refugee children and families face many obstacles to getting appropriate mental health care. These include prioritizing basic needs (like housing, food, and employment), the stigma associated with mental health, and cultural and language barriers. Therefore, the mental health care they receive should directly address psychological distress related to trauma and stressors, and also overcome these barriers. This means care for migrant and refugee youth should be (1) trauma-informed, and appropriate for their age and culture; (2) provided in their native languages by professionals who practice cultural humility (understanding systemic and cultural influences); and (3) include resources and support for basic needs. For example, the Trauma Systems Therapy for Refugees (TST-R) model provides trauma-informed mental health services and education at the community and individual level, in native languages, and with trained community members who bridge cultural gaps. TST-R also helps families access resources like housing and school placement to ease daily resettlement stress. Importantly, TST-R has been shown to reduce PTSD and depression symptoms in refugee communities, and similar models could be effective for migrant and refugee communities throughout the U.S.

Recommendation #2: Mental Health Assessments and Interventions Should be Conducted in Both Community and Healthcare Settings

In addition to clinics and hospitals, mental health assessments and interventions in non-clinical community settings can significantly improve access for migrant and refugee families. For example, providing care through community centers can leverage existing trust between community organizations and families. Schools are also crucial for delivering mental health services, as they can offer every child the option for mental health assessments and care, mobilize community-based social supports, and help families manage ongoing stressors.

To ensure mental health services are available in various settings, more trained providers are needed in areas with large migrant and refugee populations. Besides recruiting more providers who can offer care in children's native languages via telehealth, new models can be used to expand mental health services. For instance, in a task-sharing or task-shifting model, community members (often native language speakers) receive training in specific tasks (like screening) from experts and perform these tasks under professional supervision. This approach could increase both access to and effectiveness of care, as youth and their families may be more likely to trust providers from their own community.

Addressing Chronic Daily Stressors in the Lives of Migrant and Refugee Children

Beyond the trauma experienced before and during migration, migrant and refugee youth often face complex difficulties after migration that can further affect their health. This section provides recommendations for reducing several ongoing stressors that affect youth, including the fear of separation from loved ones, housing instability, and food insecurity.

The Daily Threat of Family Separation

Undocumented migrant youth and families live with the daily threat of family separation. Deportation or detention of parents or children through raids by Immigration and Customs Enforcement (ICE) and racial profiling by police are just some ways migrant families face potential separation. This constant threat not only causes fear and uncertainty but can also affect how migrant families access essential resources.

Recommendation #3: End Deportations of Migrant Youth and Family Members

Scientific evidence documenting the biological and psychological harm of forcibly separating families (through deportation, separate placements in detention centers, or other means) strongly indicates that these practices should stop immediately. The United Nations High Commissioner for Refugees (UNHCR) should also strengthen its enforcement of protections against forced return (refoulement) for refugees in the U.S. This includes prohibiting deportation to countries where refugees face mistreatment, persecution, and violence. These urgent needs highlight the importance of systemic legal changes, not just temporary solutions.

Recommendation #4: Implement Protocols That Protect Migrant Families in Accessing Vital Resources

Migrant and refugee families often cannot access resources essential for their well-being due to the threat of deportation or family separation. Until deportation and family-separation practices end, policies should protect migrant and refugee families so they can access critical health resources. For example, in cities where migrants are not protected from federal immigration authorities (non-sanctuary cities), clinics, mental health centers, community centers, and hospitals should implement policies that ensure migrant safety (e.g., clearly displaying migrants' rights at clinics, discussing confidentiality during phone screenings). They should also develop safety protocols if immigration officials make families unsafe. Making information about these safety plans (e.g., protocols developed by the National Immigration Law Center) publicly available and accessible (e.g., translated into all languages spoken by patients) can build greater trust among migrant and refugee families seeking care.

The Chronic Stress of Housing and Food Insecurity

Recommendation #5: The State Should Provide Essential Resources to Migrant and Refugee Families

Housing instability and food insecurity can significantly harm the health and development of migrant and refugee children. While the Office of Refugee Resettlement provides some essential support (e.g., housing, medical, and social services) to refugee families, these services are not available to all migrant youth, even if their experiences before migration are similar to those of documented refugees. Therefore, these vital forms of support should be made available to all migrant children, regardless of refugee status. Governing bodies should enact legal changes that address inconsistencies in how refugee status is determined.

Recommendation #6: Temporary, Community-Based Solutions Should be Provided to Migrant and Refugee Families

Community-based organizations (CBOs) have historically provided health, education, social support, and housing services for migrant communities. For example, formal partnerships between healthcare professionals and lawyers can effectively increase access to health, social, and legal services. Mutual aid programs are another resource that addresses the immediate needs of migrant and refugee families. While local institutions (e.g., medical centers) have an obligation to develop programs and provide resources for migrant and refugee families, programs offered through CBOs are often more trusted by migrants due to their integration into local communities and should receive financial support from state and local institutions.

Preventing the Infliction of Trauma Upon Migrant and Refugee Children

Evidence on the harmful effects of trauma on children's brain development and mental health clearly shows the urgent need for interventions that reduce the stressors migrant and refugee children face. Developmental neuroscience also highlights the importance of preventing further trauma exposure. To this end, scientists, along with community organizations and national agencies (like the American Civil Liberties Union), have called for an immediate halt to family separation and migrant child detention, and for minimizing time spent in detention centers. However, these practices continue. The evidence is clear: detention worsens children's mental health difficulties; forced separation causes trauma and removes the protective effect of a caregiver's presence; and, critically, these psychological consequences can last for years. Therefore, the psychological need for systemic change is undeniable: detention and deportation practices should end, and policies that separate and detain families (involving ICE and CBP) should be dismantled.

Conclusions

Migrant and refugee youth face profound hardship throughout their migration journeys. Foundational research in brain and behavioral science explains the biological and psychological ways migration-related trauma can lead to mental health suffering. This underscores the critical need for systemic changes to promote the well-being of migrant and refugee youth. Local, state, and federal lawmakers should act quickly to implement the recommendations outlined. These recommendations not only align with fundamental humanitarian and moral considerations but also with practical and economic arguments. Preventing migration-related trauma and providing essential mental health resources will reduce the significant burden of mental health disorders on society and the immense economic costs associated with them. By doing so, policymakers can continue to build a society that values and promotes the health and well-being of its most vulnerable members—children who desperately need safety and care from situations and trauma beyond their control.

Summary

• More than half of the world's migrants and refugees are young people, and they often experience traumatic events before, during, and after their journeys.

• The trauma linked to migration can deeply affect a person's well-being, impacting the brain and mind. This can lead to mental health problems, such as post-traumatic stress disorder (PTSD).

• Understanding how migration-related trauma affects the body and mind should help create policies that support the well-being of migrant and refugee children.

• Policy suggestions focus on providing mental health services, reducing daily stresses, and preventing trauma related to migration.

• Lawmakers at local, state, and federal levels should use these recommendations to improve the lives of migrant children and prevent further harm.

Many migrant and refugee children face hardships before, during, and after their journeys. Research on early difficult experiences shows how these events can impact children's brain development, thoughts, and behaviors. This understanding helps in looking at how trauma from migration affects children's brain development and suggests ways to change policies.

This review uses the term "migrant and refugee children" to describe young people leaving their home countries. This includes those seeking safety from violence, war, or persecution, and also those looking for better opportunities or safer living conditions, even if they are not formally seeking asylum. While migration challenges affect children worldwide, the focus here is on the experiences of migrant and refugee children from Mexico, Central America, and Haiti coming to the U.S.

Trauma Exposure Associated with Migration

Migrant and refugee children often encounter trauma throughout their migration. Exposure to violence is common before migration, often being the reason families leave their homes. During the migration itself, which is naturally stressful, young people frequently face significant trauma. Many caregivers fear for their family's safety during the journey. Families may experience forced separation, human trafficking, kidnapping, injuries from border officials, sexual violence, racism, and witness violent crimes against children.

Upon arrival in the U.S., families are often placed in detention centers where violence can continue. Reports have revealed terrible conditions in these centers, including poor food, hygiene, and medical or psychological care. Other issues include constant light exposure, cold temperatures, forced separation, sexual assault, verbal abuse from immigration officers, physical threats, deportation threats, and being restrained during deportation.

After migration, migrant and refugee children often live with the ongoing threat of family separation and deportation. The violence of systemic racism and anti-immigrant policies also leads to food insecurity, unstable housing, and difficulty getting healthcare. These factors can harm migrants' mental and physical health. The trauma inherent in migration creates a significant risk for children's mental health and long-term well-being.

Psychological Effects of Migration-Related Trauma

Trauma linked to migration can have lasting impacts on mental health throughout a person's life and likely worsens the effects of any previous trauma. Specifically, experiencing traumatic events in childhood can lead to immediate and long-term mental health conditions, including PTSD, which is common among migrant and refugee children. Spending time in detention centers and enduring terrible conditions there can directly affect how these children develop symptoms after migration-related trauma. Children held in U.S. detention centers show higher rates of mental health conditions compared to those who do not experience detention.

A child's connection with their parents helps them manage stress. Therefore, a parent's presence or absence during migration-related stress can either reduce or worsen its effects on a child's mental health. Caregivers can lessen the impact of migration-related trauma. However, migration often involves the threat or reality of caregiver-child separation in detention centers, which is a major source of hardship for families. Besides threatening a child's immediate physical safety, forced separation from caregivers removes the protective effect of a parent's presence. Children forcibly separated from a caregiver during migration experience more psychological difficulties than those who were not separated, and these difficulties can last for years.

Fears of separation and deportation often continue after migration due to the constant threat of a parent's deportation, negatively affecting children's mental and physical health. Children of undocumented parents in the U.S. show negative behavioral and emotional changes, as well as declines in school performance and increased absenteeism, following parental arrests. A migrant parent's own trauma-related mental health issues can also worsen a child's trauma symptoms, especially when both parent and child have experienced the same trauma or separation. These findings highlight the deep and lasting effects that migration-related trauma can have on children's mental health.

Neurobiological Mechanisms Linking Migration-Related Trauma with Mental Health

A growing amount of research shows how childhood trauma is linked to the development of mental health conditions through changes in the brain and nervous system. While there are no specific studies on the brain effects of trauma in migrant and refugee youth, findings from young people exposed to various hardships can help explain how complex migration-related trauma might affect stress responses and brain development. The focus here is on how stress impacts the brain, how stress can make a person more sensitive to future stress, and the protective role of caregivers.

How Stress Exposure Impacts Neurobiology

The human body's stress response systems help individuals cope with difficult situations. The hypothalamic-pituitary-adrenal (HPA) axis is key to this response, controlling the release of stress hormones like cortisol. These hormones interact with the brain to prepare individuals for threats. While these systems can lead to helpful behaviors during hardship, extreme or ongoing stress can disrupt the HPA axis, making it harder to handle future stressors. Essentially, the HPA axis may become less adaptable with repeated stress over time.

Stress impacts the brain and how people function psychologically. For example, consistently high levels of stress hormones in the brain can have lasting effects on brain structure and activity. Brain areas involved in managing fear and recognizing threats and safety in one's surroundings—such as the amygdala, hippocampus, and medial prefrontal cortex (mPFC)—have more stress hormone receptors and are particularly sensitive to stress. Specifically, the amygdala detects important emotional signals and triggers the HPA axis in response to danger; the hippocampus provides contextual information; and the mPFC helps with learning and controls emotional reactions driven by the amygdala. Together, these areas form a circuit that reduces fear and regulates emotion. Exposure to stress during development, like migration-related trauma, is linked to specific changes in the structure and function of this circuit. Stress exposure also alters larger brain networks that support thinking and emotional functions, such as noticing important stimuli, mental control, and processing rewards. These changes in the brain likely contribute to the emotional and behavioral difficulties and mental health conditions seen in migrant and refugee youth after experiencing trauma.

Stress Sensitization and Long-Term Effects

Beyond immediate effects on the brain and mental health, exposure to stress can cause brain changes that last and increase the long-term risk for mental health disorders, even years after the stressful event. One way this happens is called stress sensitization: early life stress makes a person more vulnerable to future stressors. The corticolimbic circuit, specifically the connections between the hippocampus, mPFC, and amygdala, may contribute to stress sensitization because these areas are closely involved in the stress response through the HPA axis. Over time, stress can change how the hippocampus and mPFC work, interfering with their ability to regulate stress responses. In these ways, exposure to extreme or ongoing stress, such as the constant difficulties faced by migrant and refugee youth, can disrupt (either heighten or lessen) responses to later stressors. Consistent with this idea, young people exposed to early hardship show irregular cortisol responses to later stressors. These changes in HPA axis function and corticolimbic circuitry may explain why migrant and refugee youth exposed to trauma have a higher long-term risk for mental health disorders, and why children who experienced trauma before migration might be more susceptible to PTSD if they face trauma during migration.

Buffering Role of Caregivers on Children's Stress Physiology

Caregivers play a crucial role in protecting children from the effects of stress. The brain systems that support emotion regulation and stress coping, such as the connections between the mPFC and amygdala, develop gradually. Caregivers can influence a child's HPA axis and cortico-limbic circuitry, supporting these systems while they are still developing. In line with evidence showing caregivers help children manage emotions and stress, children show reduced stress hormone responses and amygdala activity when their caregivers are present. On average, young people who experienced early hardship show disruptions in this protective effect from caregivers at the brain level. This helps explain how hardship can disrupt a child's development and their ability to benefit fully from caregiver support throughout their growth. These findings suggest that caregiver support can potentially lessen the impact of migration-related stress on children's brain development, highlighting an important protective factor for migrant and refugee children.

Policy Implications to Promote Migrant and Refugee Youth Mental Health

The scientific evidence reviewed here provides several key findings that can guide policies for migrant and refugee youth. First, strong evidence shows that trauma can negatively affect the brain and that early-life trauma is especially damaging. Across many studies, the types of trauma common in children's migration experiences have been linked to problems in stress response systems, altered brain development, and an increased risk for mental health disorders. Because the developing brain is highly adaptable, trauma experienced during this period carries a greater risk.

Second, children exposed to trauma are at a higher risk of developing mental health disorders, both immediately and in the long term. Despite the potential for change and intervention, the effects of trauma on the brain and behavior can last long after the event, as seen in studies of adults who experienced trauma in childhood. These findings further emphasize that young people exposed to previous trauma—which describes most children whose families are seeking asylum—are at a greater risk for mental health problems like PTSD following additional migration-related trauma.

The third main conclusion from this broad evidence base is that caregivers are essential in protecting children from the effects of trauma, both on their biology and behavior. Studies showing the protective influence of caregivers highlight their important role in supporting children during stressful migration experiences, as well as the added trauma of forcibly separating families during migration.

Together, this evidence stresses the importance of policies that prioritize help for young people exposed to trauma, prevent further stress during and after migration, and, most importantly, keep families together throughout the migration experience. To achieve this, this section offers specific policy recommendations related to (1) providing mental health care, (2) services that address ongoing stressors after migration, and (3) preventing migration-related trauma.

Implementation and Dissemination of Mental Health Services

Given the immediate and long-term consequences of early-life hardship on the brain and mind, early intervention for migrant and refugee youth and their caregivers is crucial to lessen the effects of trauma faced during and after migration. While effective therapies can treat trauma-related symptoms after migration, most migrant and refugee youth do not receive mental health screenings or therapy. Therefore, policies should address key barriers to mental health care and ensure that interventions are effectively implemented at every stage of the migration and resettlement journey.

Recommendation #1: Mental Health Assessments and Interventions Should Be Trauma-Informed and Address Barriers to Care

During migration and resettlement, migrant and refugee children and families face many obstacles to proper mental health care. These include prioritizing basic needs like housing, food, and jobs, as well as the stigma surrounding mental health, and cultural and language differences. Therefore, the mental health care they receive should directly address psychological distress related to trauma and stress, while also tackling these barriers. To do this, care for migrant and refugee youth should be (1) trauma-informed and appropriate for their age and culture; (2) delivered in families' native languages by providers who are culturally aware; and (3) provide resources and support for basic needs. For example, the Trauma Systems Therapy for Refugees (TST-R) model ensures that trauma-informed mental health services and education are provided at the community and individual level in families' native languages, working with trained community members who can bridge cultural gaps. TST-R also helps families access resources like housing and school placement to ease daily stresses of resettlement. Importantly, TST-R has been shown to reduce symptoms of PTSD and depression in refugee communities, and similar models could be effective in migrant and refugee communities across the U.S.

Recommendation #2: Mental Health Assessments and Interventions Should Be Conducted in Both Community and Healthcare Settings

In addition to traditional clinical and hospital settings, mental health assessments and interventions in non-clinical community settings can significantly improve access for migrant and refugee families. For example, providing care through community centers could build on existing trust between these organizations and families. Schools are also a vital place for offering mental health services, as they can provide every child with the option to receive assessments and care, mobilize community social supports, and help families manage ongoing stressors.

To ensure mental health services are available in various settings, more trained providers are needed in areas with large migrant and refugee populations. Besides recruiting more providers who can offer care in children's native languages through telehealth, new models can be used to expand mental health services for these communities. For instance, in a task-sharing or task-shifting model, community members (often speaking the youth's native language) receive training in specific tasks, like screening, from experts and carry out these tasks under professional supervision. This approach could increase both access to and effectiveness of care, as youth and their families may be more likely to trust providers from their own community.

Addressing Chronic Daily Stressors in the Lives of Migrant and Refugee Children

Beyond the trauma experienced before and during migration, migrant and refugee youth often face ongoing difficulties after migration that can further impact their health. These recommendations aim to reduce several chronic stressors affecting young people: fear of separation from loved ones, unstable housing, and food insecurity.

The Daily Threat of Family Separation

Migrant youth and undocumented families live with the daily threat of family separation. Deportation or detention of parents or children through raids by immigration enforcement and racial profiling by police are just two ways migrant families face potential separation. Besides causing fear and uncertainty, this constant threat can affect how migrant families access vital resources.

Recommendation #3: End Deportations of Migrant Youth and Family Members

The scientific evidence documenting the profound effects of forcibly separating families, whether through deportation, separate detention placements, or other methods, strongly indicates that these practices should stop immediately. International bodies should also strengthen their enforcement of protections against returning refugees to countries where they face mistreatment, persecution, and violence. These urgent needs highlight the importance of systemic legal changes, not just temporary solutions.

Recommendation #4: Implement Protocols That Protect Migrant Families in Accessing Vital Resources

Migrant and refugee families are often unable to access resources essential for their well-being due to the threat of deportation or family separation. Until deportation and family separation practices end, policies should protect migrant and refugee families so they can access critical health resources. For example, in cities where migrants are not protected from federal immigration authorities (i.e., non-sanctuary cities), clinics, mental health centers, community centers, and hospitals should implement policies that ensure migrant safety. This includes clearly displaying migrants' rights at clinics and discussing confidentiality policies during phone screenings. They should also develop safety protocols in case immigration officials make families feel unsafe. Making information about these safety plans publicly available and accessible (e.g., translated into all languages spoken by patients) can build greater trust among migrant and refugee families seeking care.

The Chronic Stress of Housing and Food Insecurity

Recommendation #5: The State Should Provide Essential Resources to Migrant and Refugee Families

Unstable housing and food insecurity can have significant consequences for the health and development of migrant and refugee children. While some support, such as housing, medical, and social services, is provided to refugee families, these services are not available to all migrant youth, even if their experiences before migration are similar to documented refugees. Therefore, these essential forms of support should be made available to all migrant children, regardless of their refugee status. Governing bodies should make legal changes that address inconsistencies in how refugee status is determined.

Recommendation #6: Temporary, Community-Based Solutions Should Be Provided to Migrant and Refugee Families

Community-based organizations (CBOs) have historically offered services related to health, education, social support, and housing for migrant communities. For example, formal partnerships between healthcare professionals and lawyers can effectively increase access to health, social, and legal services. Mutual aid programs also help meet the immediate needs of migrant and refugee families. While local institutions (e.g., medical centers) have a responsibility to create programs and provide resources that support migrant and refugee families, programs offered through CBOs are generally more trusted by migrants due to their integration into local communities and should receive financial support from state and local institutions.

Preventing the Infliction of Trauma Upon Migrant and Refugee Children

Evidence showing the harmful effects of trauma on children's brain development and mental health clearly highlights the urgent need for interventions that lessen the stresses migrant and refugee children face. Developmental neuroscience also directly points to the importance of preventing further trauma exposure for migrant and refugee youth. To this end, experts, along with community organizations and national agencies, have called for an immediate halt to family separation and child detention, and for minimizing time spent in detention centers. However, these practices continue. The evidence is clear: detention worsens children's mental health problems; forced separation is traumatic and removes the protective effect of a caregiver's presence; and, crucially, these psychological consequences can last for years. Therefore, the psychological need for systemic change is undeniable: detention and deportation practices must end, and policies that separate and detain families must be dismantled.

Conclusions

Migrant and refugee youth experience significant hardship throughout their migration journeys. Fundamental research from brain and behavioral science explains the biological and psychological ways that migration-related trauma can lead to mental health suffering. This underscores the critical need for systemic changes to improve the well-being of migrant and refugee youth. Lawmakers at local, state, and federal levels should act quickly to put these recommendations into practice. In addition to aligning with the humanitarian and moral principles highlighted in this paper, these recommendations also make practical and economic sense. Preventing migration-related trauma and providing essential mental health resources will reduce the heavy burden of mental health disorders on society and the enormous financial cost associated with them. By taking these steps, policymakers can continue to build a society that values and promotes the health and well-being of its most vulnerable individuals—children desperately needing safety and care from situations and traumas beyond their control.

Summary

Many young people move from one country to another. They often go through very hard and scary things before, during, and after their journey. These difficult experiences can deeply affect their minds and bodies for a long time. It can lead to serious mental health problems, like strong feelings of fear and sadness that do not go away.

Understanding how these tough times impact the brain and feelings of young people should help create better rules. These rules should aim to make life better for young migrants and refugees. They should help them get mental health care, reduce daily stresses, and stop new bad things from happening to them. Lawmakers at all levels of government should use these ideas to help protect these young people and keep them from further harm.

Key Points

• More than half of the people who move to new countries or flee their homes are young people. They often face very scary events before, during, and after their move.

• These scary events can hurt their minds and bodies for a long time. It can lead to mental health problems, like feeling very scared or sad.

• The way these events affect their minds and bodies should help shape rules to keep young migrants and refugees well.

• Rules should focus on giving mental health help, making daily life less stressful, and stopping bad things from happening.

• Lawmakers should use these ideas to help young migrants and make sure they are not hurt more.

Trauma During Migration

Young migrants and refugees often go through scary events during their journeys. Many have already faced violence before leaving their home countries. During the trip, which is often very stressful, young people and their families often fear for their safety. Families can be separated, tricked, or even hurt. They may also see violence happening to other children.

When they arrive in a new country, families are sometimes held in special places. Reports show that these places can have bad conditions, like not enough food, clean water, or medical help. People in these places can also face constant light, cold, forced family separation, and mean words from officers.

Even after moving, young migrants and refugees worry about their families being separated or sent away. Racism and rules against immigrants can make it hard to find food, a place to live, or health care. All these stressful events can greatly harm the mental health and well-being of young people for many years.

Mental Effects of Trauma

The scary events young migrants and refugees go through can affect their mental health for a long time. These experiences can make existing problems worse. These events can lead to mental health issues, like feeling very scared or sad. Many young migrants and refugees experience these feelings often. Being held in special places can directly lead to these problems. Young people held in these places often have more mental health issues than those who are not.

Parents can help young people deal with stress. But often, families are forced apart during migration. This separation causes more trauma. When young people are separated from their parents, they have more mental problems. These problems can last for many years.

Even after settling, worries about parents being sent away can continue. This can harm the mental and physical health of young people. Children whose parents are sent away may act differently, have trouble in school, and miss school days. Parents' own struggles can also make young people's problems worse, especially if they went through the same scary events. These findings show that the trauma from migration can have deep and lasting effects on young people's mental health.

How Trauma Changes the Brain

Science shows how scary events in childhood can lead to mental health problems. While there are not many studies on young migrants, looking at children who have faced other hard times helps us understand. We can see how stress affects the body and brain, how it makes people more sensitive to future stress, and how parents can help.

How Stress Affects the Brain

Our bodies have a system that helps us deal with stress. It makes stress hormones that prepare us for danger. While this system helps in hard times, too much or ongoing stress can harm it. This makes it harder for people to deal with stress later on. Over time, the system can become less flexible.

Stress changes the brain and how people think and feel. For example, high levels of stress hormones for a long time can change the brain's structure and how it works. Parts of the brain that handle fear and danger are very sensitive to stress. These brain parts work together to calm fear and manage feelings. When young people face stress, like the trauma of migration, these brain parts can change. This likely leads to emotional and behavior problems and mental health issues for young migrants and refugees.

Being More Sensitive to Stress

Beyond short-term effects, stress can change the brain in ways that increase the risk for mental health problems later in life. This is called stress sensitization. It means that stress early in life makes a person more likely to be affected by stress in the future. Specific brain parts that handle stress may play a role here. Over time, stress can change how these brain parts work, making it harder to control stress responses. So, constant stress, like what young migrants face, can make them more sensitive to stress later on. This may explain why young people who faced trauma before migration are at higher risk for mental health problems when they experience more trauma during migration.

Parents Can Help with Stress

Parents are very important in helping young people deal with stress. The brain systems that help control feelings and handle stress are still growing in young people. Parents can help these systems develop. Studies show that young people are less stressed when their parents are around. They also show less brain activity related to fear. However, when young people have faced hard times early in life, parents may have less of this protective effect. This shows how important parental support is in helping young migrants deal with stress and develop well.

How Rules Can Help Young Migrants

What we have learned about trauma and young people's brains shows several important things for creating better rules. First, trauma can hurt the brain and lead to mental health problems, especially when it happens early in life. The types of trauma young migrants face are linked to problems with how they handle stress, changes in brain development, and a higher risk for mental health issues. Since young brains are still developing, trauma at this time is very damaging.

Second, young people who have faced trauma are more likely to develop mental health problems, both now and in the future. Even with help, the effects of trauma can last a long time. This means that young people who have already faced trauma, like most children seeking safety, are at higher risk for mental health problems after new trauma during migration.

Third, parents are key in helping young people cope with trauma. Studies show that parents protect young people, both in their brains and in their behavior. This highlights how important it is for parents to support young people during migration. It also shows how harmful it is to force families apart during migration.

All this information means that rules should focus on helping young people who have faced trauma. They should also stop more stress from happening during and after migration, and keep families together. This section gives ideas for rules about mental health care, help for daily stresses, and stopping migration trauma.

Getting Mental Health Services

Since early trauma affects the brain and mind for a long time, helping young migrants and their parents early is very important. Even though good treatments exist, most young migrants and refugees do not get mental health screenings or therapy. So, rules should remove barriers to mental health care and make sure help is given at every step of their journey.

Recommendation #1: Mental Health Help Should Understand Trauma and Remove Barriers

During and after moving, young migrants and families face many challenges to getting proper mental health care. They may need to focus on finding food, housing, or jobs. They may also feel ashamed to talk about mental health or have language differences. So, the mental health care they get should deal with both their feelings of sadness and fear and the barriers they face. Care for young migrants and refugees should: (1) understand trauma, be right for their age, and respect their culture; (2) be given in their own language by providers who understand their background; and (3) offer help with basic needs. For example, a special program helps refugees with mental health services and teaches them about trauma in their own language. It also helps families find housing and schools. This kind of program has been shown to reduce sadness and fear.

Recommendation #2: Mental Health Help Should Be Offered in Different Places

Besides clinics and hospitals, mental health help in community places can make it easier for migrant and refugee families to get care. For example, offering help through community centers can build on trust. Schools are also important places to offer mental health services. They can give every child the chance to get help and connect families with support.

To make sure mental health services are available in many places, more trained providers are needed where many migrants and refugees live. Besides hiring more providers who speak the children's languages, new ways to offer services can be used. For example, community members can be trained to do certain tasks like screening, under the watch of experts. This can help more people get care and build trust.

Dealing with Daily Stresses

Beyond the trauma of migration, young migrants and refugees often face ongoing daily challenges that can affect their health. This section talks about ideas to reduce stresses like fear of family separation, not having a stable home, and not having enough food.

The Daily Fear of Family Separation

Young migrants and families who do not have legal papers live with the constant fear of being separated. Parents or children can be sent away by officers or stopped by police because of their background. These are just some ways migrant families face the risk of being separated. This constant fear not only causes worry but also makes it hard for migrant families to get important help.

Recommendation #3: Stop Sending Away Young Migrants and Their Families

Science clearly shows how harmful it is to force families apart, whether by sending them away or putting them in separate holding places. These practices should stop right away. Rules should also make it stronger to protect refugees from being sent back to countries where they face harm. These urgent needs show that we need to change laws, not just have temporary fixes.

Recommendation #4: Put in Place Rules to Protect Migrant Families When Getting Help

Migrant and refugee families often cannot get important resources for their well-being because they fear being sent away or separated. Until these practices stop, rules should protect migrant and refugee families so they can get health care. For example, in cities where migrants are not protected from federal agents, clinics and hospitals should have rules to keep migrants safe. They should clearly show migrants' rights and talk about privacy. They should also have safety plans if immigration officers make families unsafe. Making this information public and in different languages can build trust among migrant and refugee families seeking care.

The Constant Stress of Not Having a Home or Enough Food

Recommendation #5: The Government Should Provide Key Help to Migrant and Refugee Families

Not having a stable home or enough food can greatly affect the health and growth of young migrants and refugees. While some help (like housing, medical, and social services) is given to refugee families, it is not available to all young migrants, even if they faced similar hard times as refugees. So, this important help should be given to all migrant children, no matter if they have refugee status. Governments should make legal changes to fix these differences in who gets refugee status.

Recommendation #6: Provide Temporary, Community-Based Help to Migrant and Refugee Families

Community groups have always helped migrant families with health, education, housing, and support. For example, doctors and lawyers working together can help families get health, social, and legal services. Also, mutual aid programs help migrant and refugee families with their immediate needs. Local groups should create programs and give resources to support migrant and refugee families. Community groups are often more trusted by migrants because they are part of the local community. These groups should get money from the government and local institutions.

Stopping Trauma from Happening to Young Migrants

Science clearly shows that trauma harms young people's brains and mental health. This means it is very important to stop new trauma from happening to young migrants and refugees. Scientists and groups have called for an immediate stop to separating families and holding young migrants, and to reduce the time spent in holding centers. But these practices continue. The evidence is clear: being held in centers makes young people's mental health worse. Being forced apart from caregivers causes trauma and takes away the comfort of a parent. These problems can last for years. So, it is clear that we need big changes: stop holding and sending away families, and get rid of rules that separate and hold families.

Final Thoughts

Young migrants and refugees face many hard times during their journeys. Science about the brain and behavior helps us understand how these traumatic experiences can lead to mental health problems. This shows that we need big changes to help young migrants and refugees. Lawmakers should quickly put these ideas into action. Besides being kind and right, these ideas also make sense from a practical and money-saving point of view. Stopping trauma and giving mental health help will reduce the huge problem of mental health issues and the big costs that come with it. By doing this, lawmakers can build a society that truly cares for and helps the most vulnerable among us—children who desperately need safety and care from situations they cannot control.