A Path to Meeting the Medical and Mental Health Needs of Unaccompanied Children in U.S. Communities

The number of immigrant children traveling to the United States without a parent or legal guardian has increased considerably over the last decade, reaching a historic high in 2022. When these children leave government custody to live with a family member or other sponsor while they await the outcome of their immigration proceedings, many find it difficult to access the services and supports they need to thrive. Medical and mental health services are among the most critical, and having limited access to these services can harm both children and the communities in which they live.

This report is the culmination of a joint initiative by the American Academy of Pediatrics and MPI to study unaccompanied children’s access to medical and mental health services in U.S. communities. It draws on field visits to three cities (Houston, Los Angeles, and New Orleans) and interviews and focus groups with more than 100 professionals working with this population, as well as unaccompanied children themselves.

This report examines the barriers unaccompanied children face to accessing medical and mental health care—including those related to official policies, the complexities of the U.S. health-care system, and individual and community factors—and highlights promising practices that some regions have adopted to address these barriers. It also presents recommendations for governments, health systems, schools, and communities that, if implemented, would substantially strengthen services for unaccompanied children.