Depression and anxiety among multiethnic middle school students: Age, gender, and sociocultural environment.

BACKGROUND: Depression and anxiety-related disorders are common among adolescents. Research attention to early adolescence and low-income ethnically diverse populations is limited. AIM: To conduct screening for depression and anxiety at an early age with attention to gender and socioenvironmental context within a low-income setting. METHOD: Mixed methods included the PHQ-9A and GAD-10 screening instruments and ethnographic interviews. RESULTS: 75 ethnically diverse middle school students were included. Mean years age was 11.2 (0.74). Females had higher PHQ-9A sum scores than males (p = .002, Mann-Whitney test) and higher GAD-10 sum scores than males (p = .016, Mann-Whitney test). After controlling for multiple comparisons, girls had higher mean responses on three PHQ-9A items (p < .006, two-sided t-test) and only one GAD-10 item (p < .005, two-sided t-test). Ethnographic interviews revealed contexts associated with girls' experiences of depression and anxiety, including gender-based violence in both school and home environments. Salient for girls and boys alike were worries about consequences of COVID-19 for family with respect to illness, death, job loss, economic hardship. Fears over student perceptions of intensified discrimination and racism in school and community were prominent. These problems were experienced by students as barriers to educational engagement. CONCLUSION: Specific attention to early adolescence is needed to identify emergence of subsyndromal conditions which may benefit from therapeutic attention to reduce symptom severity, identify sociocultural, structural, and gender-specific stressors, and to enhance educational engagement.

The relationship between violence and depression in migrant women through their experiences in care services.

Based on ethnographic work with undocumented immigrant women who developed depressive episodes due to various forms of violence, this article recovers the women's experience of care in the clinic space of their host country. Through therapeutic itineraries of care, the article focuses on the case studies of two women of Mexican origin in New York City to describe, based on their experience, the communication and the encounter between the doctor and patient; the expectations of migrant women regarding mental health care services; and the explanatory models of depression of both the patients and the treating physicians. This analysis seeks to contribute to the knowledge regarding ways of treating the mental health problems of undocumented women in contexts of violence.

A partir del trabajo etnográfico con mujeres inmigrantes indocumentadas que desarrollaron episodios depresivos a causa de diversas formas de violencia, se recupera su experiencia sobre la atención que recibieron en el espacio clínico del país de acogida. A través de itinerarios terapéuticos de atención, el trabajo se centra en los estudios de caso de dos mujeres de origen mexicano en la ciudad de New York, para describir, con base en su experiencia, la comunicación y el encuentro entre médico y paciente; las expectativas de las migrantes en relación con los servicios de atención en salud mental; y los modelos explicativos sobre la depresión por parte de los pacientes y los médicos tratantes. Con lo anterior, buscamos contribuir al conocimiento sobre las formas de atención de los problemas de salud mental de mujeres indocumentadas en contextos de violencia.

Padecer la depresión como mujer inmigrante mexicana en la ciudad de Nueva York / Suffering from depression as a Mexican immigrant woman in New York City

RESUMEN Objetivo Presentar las condiciones de vida de las mujeres migrantes y su relación con el desarrollo de la depresión en el lugar de destino. Métodos El trabajo etnográfico se desarrolló en la ciudad de Nueva York, específicamente en el barrio Queens. Se trabajó con seis mujeres inmigrantes de primera generación que pertenecían al circuito migratorio de Puebla-Nueva York. Se aplicaron entrevistas a profundidad, el desarrollo de trayectorias migratorias e itinerarios terapéuticos. Finalmente, se realizaron entrevistas con familiares de las informantes principales para controlar sesgos u omisiones de información. Resultados Se identificó que la violencia estaba relacionada con la salud mental de las mujeres. Esta se presentó en diversas etapas de su vida y se presentaron en los espacios que habitan y desarrollaban su vida cotidiana. La violencia se acentuaba por las relaciones jerárquicas en el grupo doméstico y espacio laboral. Además, las crisis económicas y arreglos familiares enmarcaban dicho proceso. Los arreglos familiares para salir adelante y dar continuidad al modelo de familia a pesar de la migración por motivos económicos, también tuvieron relación con las tensiones que se viven en sus hogares. Discusión Discutimos las condiciones de las vidas de las mujeres y su desarrollo de padecimientos mentales con respecto a otros estudios que desde la salud pública han explicado los problemas en salud mental y la migración por medio de conceptos como la aculturación y la asimilación.(AU)

ABSTRACT Objective To describe the living conditions of migrant women and their correlation with the development of depression at the place of destination. Methods Ethnographic work developed in the city of New York, specifically in the Queens borough. Six first-generation immigrant women, part of the migratory circuit of Puebla-Nueva York, were included in this study. In-depth interviews, development of migratory trajectories and therapeutic itineraries were applied. Finally, interviews were conducted with relatives of the main informants to control biases or omissions. Results The relationship between violence and women's mental health was identified. Violence occurred in various stages of their lives and spaces in which they lived and developed their daily living. The violence was accentuated by the hierarchical relationships in the domestic group and work space. Furthermore, economic crisis and family arrangements were detrimental factors. The family arrangements to get ahead and provide continuity to the family model despite migration were also related to the stress they lived in their homes. Discussion The living conditions of women and their influence on the development of mental illnesses were discussed regarding other studies that, from a public health perspective, have addressed the mental health and migration issues through acculturation and assimilation concepts.(AU)

[Suffering from depression as a Mexican immigrant woman in New York City]. / Padecer la depresión como mujer inmigrante mexicana en la ciudad de Nueva York.

OBJECTIVE: To describe the living conditions of migrant women and their correlation with the development of depression at the place of destination. METHODS: Ethnographic work developed in the city of New York, specifically in the Queens borough. Six first-generation immigrant women, part of the migratory circuit of Puebla-Nueva York, were included in this study. In-depth interviews, development of migratory trajectories and therapeutic itineraries were applied. Finally, interviews were conducted with relatives of the main informants to control biases or omissions. RESULTS: The relationship between violence and women's mental health was identified. Violence occurred in various stages of their lives and spaces in which they lived and developed their daily living. The violence was accentuated by the hierarchical relationships in the domestic group and work space. Furthermore, economic crisis and family arrangements were detrimental factors. The family arrangements to get ahead and provide continuity to the family model despite migration were also related to the stress they lived in their homes. DISCUSSION: The living conditions of women and their influence on the development of mental illnesses were discussed regarding other studies that, from a public health perspective, have addressed the mental health and migration issues through acculturation and assimilation concepts.

OBJETIVO: Presentar las condiciones de vida de las mujeres migrantes y su relación con el desarrollo de la depresión en el lugar de destino. MÉTODOS: El trabajo etnográfico se desarrolló en la ciudad de Nueva York, específicamente en el barrio Queens. Se trabajó con seis mujeres inmigrantes de primera generación que pertenecían al circuito migratorio de Puebla-Nueva York. Se aplicaron entrevistas a profundidad, el desarrollo de trayectorias migratorias e itinerarios terapéuticos. Finalmente, se realizaron entrevistas con familiares de las informantes principales para controlar sesgos u omisiones de información. RESULTADOS: Se identificó que la violencia estaba relacionada con la salud mental de las mujeres. Esta se presentó en diversas etapas de su vida y se presentaron en los espacios que habitan y desarrollaban su vida cotidiana. La violencia se acentuaba por las relaciones jerárquicas en el grupo doméstico y espacio laboral. Además, las crisis económicas y arreglos familiares enmarcaban dicho proceso. Los arreglos familiares para salir adelante y dar continuidad al modelo de familia a pesar de la migración por motivos económicos, también tuvieron relación con las tensiones que se viven en sus hogares. DISCUSIÓN: Discutimos las condiciones de las vidas de las mujeres y su desarrollo de padecimientos mentales con respecto a otros estudios que desde la salud pública han explicado los problemas en salud mental y la migración por medio de conceptos como la aculturación y la asimilación.

[Mental health of undocumented migrants in transit at the southern border of Mexico]. / Salud mental de migrantes centroamericanos indocumentados en tránsito por la frontera sur de México.

OBJECTIVE: To identify the perception and needs in mental health of Central American migrants in transit through Tapachula, Chiapas. MATERIALS AND METHODS: Qualitative study in a migrant shelter in Tapachula, Chiapas. In 20 semi-structured interviews with migrant men and women, we explored their perceptions on mental health and expectations on care. We used basic notions of phenomenology to guide the analysis. RESULTS: Migrants had several mental health problems related to the conditions at their country of origin and due to their initial transit through Mexico.Their perception on mental health problems was heavily influenced by the biomedical health paradigm. The expectations they had on the provision of services were related to the satisfaction of basic needs. CONCLUSIONS: It is necessary to strengthen the governmental response to mental health needs through collaborative strategies. Also, actions are needed to further the understanding of mental health in order to transcend the biomedical notions that stigmatize, segregate and create a barrier to accessing services.

Salud mental de migrantes centroamericanos indocumentados en tránsito por la frontera sur de México / Mental health of undocumented migrants in transit at the southern border of Mexico

Objetivo. Conocer las necesidades percibidas de salud mental de migrantes centroamericanos indocumentados en tránsito por la ciudad de Tapachula, Chiapas. Material y métodos. Estudio cualitativo realizado en Casa de Migrantes de Tapachula, Chiapas. Se realizaron 20 entrevistas semiestructuradas a diez mujeres y diez hombres migrantes. Se exploró el estado de salud mental y las expectativas de atención. Se retomaron nociones teórico-metodológicas de la fenomenología sociológica. Resultados. Los migrantes presentaban signos y síntomas de daños en su salud mental relacionados con experiencias vividas en el lugar de origen y en el tránsito por México. La percepción sobre su salud mental es influida por el modelo biomédico hegemónico. Las expectativas de servicios se relacionaron con la satisfacción de necesidades básicas. Conclusiones. Es necesario fortalecer la respuesta del sistema de atención en salud mental a partir de estrategias de cooperación y emprender acciones que promuevan la superación de una construcción biomédica de salud mental que estigmatiza, medicaliza, segrega y dificulta el acceso a servicios.

Objective. To identify the perception and needs in mental health of Central American migrants in transit through Tapachula, Chiapas. Materials and methods. Qualitative study in a migrant shelter in Tapachula, Chiapas. In 20 semi-structured interviews with migrant men and women, we explored their perceptions on mental health and expectations on care. We used basic notions of phenomenology to guide the analysis. Results. Migrants had several mental health problems related to the conditions at their country of origin and due to their initial transit through Mexico.Their perception on mental health problems was heavily influenced by the biomedical health paradigm. The expectations they had on the provision of services were related to the satisfaction of basic needs. Conclusions. It is necessary to strengthen the governmental response to mental health needs through collaborative strategies. Also, actions are needed to further the understanding of mental health in order to transcend the biomedical notions that stigmatize, segregate and create a barrier to accessing services.