When we think of mental health we might envision someone lying on a couch undergoing intense psychological therapy to uncover the evil demons that lie within. Thankfully, a more useful understanding of mental health is developing. This process is most evident in Head Start programs serving migrant and seasonal farm workers.

To discuss the mental health needs of migrant farm worker families, you must understand them in context. Migrant farm workers travel thousands of miles to plant, harvest, and weed crops. Parents work long hours in the fields and are often forced to leave young children in child care or in the care of older siblings for eight to twelve hours a day. The pay is poor and in spite of the critical service these skilled laborers bring to communities, migrant farm workers are not always accepted, or, in some communities, even tolerated. They and their children are subjected to racism and classism typical for people that come to an area for a limited time. Sometimes migrant families have to sleep in their cars because no housing is available. When available, it is often substandard. In some instances, banks will not cash their paychecks, and grocery stores have been known not to sell to them. Yet many times each year, migrant farm workers pack up their families to begin the journey over again.

Despite the grueling lifestyle, migrant farm worker families have incredible strengths. They are very family-oriented. The majority of migrant families are two-parent families with close, supportive, extended family members. This dependence on and belief in the strength of family extends to the larger “community family.” Many migrant communities have informal support networks which help protect families from the stress associated with their lifestyle.

Migrant children and families are resilient. In the face of numerous transitions between places and caretakers, most migrant children develop healthy and appropriate attachments to their caregivers. Also, despite their marginalization in the community, parents still seek out services offered by Migrant Head Start programs. Most importantly, migrant parents hope to provide better lives for their children. Hope and resiliency sustain migrant families as they leave their homes to return to areas far away to harvest crops. The trusting relationships that many migrant families have with the Migrant Head Start programs nationwide have added to the network that supports families’ and children’s mental health.

To gain a better understanding of how Migrant Head Start programs respond to the mental health needs of migrant farm workers and their families, we interviewed several programs that provide exemplary mental health services. The programs discussed their challenges and successes serving migrant families and described a complex system of mental health services based on promotion, prevention, and intervention.

Addressing mental health issues in migrant families is complicated by cultural differences, lack of trust, and language barriers. Migrant families are typically not forthcoming with their problems. Often families believe that health concerns should be dealt with within the family, not through formal health care systems. Many families also have strong religious and cultural beliefs that affect their response to mental health concerns. There is a belief among some people of Latin descent that physical and mental health issues arise in children as a punishment for past sins of the parents. Many parents choose to use home remedies and spiritual healing techniques when addressing physical or mental health concerns.

Trust issues arise from a long history of conflict with government agencies regarding immigration and naturalization, even though most migrant farm workers have legal status in this country. Some migrant parents choose not to use formal systems of care because of fear of government action against them, such as being deported or losing benefits.

The vast majority of migrant farm workers speak Spanish. Of the many agencies that provide mental health services to families, most are not equipped to handle the needs of migrant families. Often, there are no Spanish-speaking mental health professionals or no one familiar with migrant families’ culture or needs, especially if intensive intervention is required.

The Migrant Head Start program is in the unique position to become a “hub” of services because of its level of trust and sensitivity to culture and language. Families often take advantage of community services because of the link that Migrant Head Start programs provide.

Most Migrant Head Start programs approach mental health needs through promotion, prevention, and intervention. They support mental health promotion by training staff and parents and working with community partners. One program instituted the concept of “wellness” by developing a wellness committee consisting of parents and staff who advise the program on mental health and wellness issues. Some programs include mental health professionals on the Health Services Advisory Committee to serve as links to the community for mental health issues. Most migrant programs address the unique needs of the migrant families by ensuring that information is shared and trainings are conducted in the language of the families, and that the cultural needs of the families are incorporated into all services.

Migrant Head Start programs address prevention of mental health complications in strategic and creative ways. Staff are trained to observe children and administer developmental screenings in the children’s home language, as required by the Head Start Program Performance Standards. Many programs maintain primary caregivers who are responsible for a small group of children. Some programs attempt to provide continuity of care, where a caregiver stays with the same group of children until the age of three. Despite complications related to shortened programs and family mobility, these efforts are made because of the importance of supporting the social-emotional needs of infants and toddlers by creating a trusting and secure environment.

Several programs stress the importance of including all staff in trainings, even bus drivers who are often the first point of contact for parents and children. Parent support groups provide opportunities to share their struggles, questions, and successes. Many Migrant programs hire former Head Start or migrant parents to ensure a bilingual, bicultural staff.

As designated by the Program Performance Standards, Migrant Head Start programs must have access to a mental health professional to observe the children for the purpose of intervention and to make recommendations for further testing or treatment. This person often provides the training for staff and parents, as well as services for the whole family. A number of programs describe the challenges to hiring bilingual, bicultural mental health specialists, especially in rural areas of the country. All of the programs interviewed stressed the critical importance of being able to communicate with families and understand the culture.

Addressing the emotional needs of migrant farm workers is challenging. One of the answers to the challenge lies in the spirit of Migrant Head Start and the desire of each program to optimize service delivery to children and families. Each agency faces similar challenges when working with the mental health needs of migrant families. Programs cannot face these challenges alone and must continue to be creative and pull in community partners, such as community clinics, churches, and other local agencies, whenever possible.

Migrant Head Start programs hold the honorable position of trusted partner to many migrant families. Respect for culture, language, community collaboration, cooperation, and the continual reassessment and improvement of the service approach hold the greatest promise for addressing the mental health needs of migrant farm worker families.

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