Children's mental health and collective violence: a binational study on the United States-Mexico border

Objective. To investigate the risk effects of poverty and exposure to collective violence attributed to organized crime on the mental health of children living on the United States-Mexico border. Methods. A repeated, cross-sectional study measured risk effects by comparing scores of psychosocial and behavioral problems among children and adolescents living on the border in the United States or Mexico in 2007 and 2010. Patients living in poverty who responded once to the Pictorial Child Behavior Checklist (P+CBCL) in Spanish were randomly selected from clinics in El Paso, Texas, United States (poverty alone group), and Ciudad Juarez, Chihuahua, Mexico (poverty plus violence group). Only children of Hispanic origin (Mexican-American or Mexican) living below the poverty level and presenting at the clinic for nonemergency visits with no history of diagnosed mental, neurological, or life-threatening disease or disability were included. Results. Exposure to collective violence and poverty seemed to have an additive effect on children's mental health. Children exposed to both poverty and collective violence had higher problem scores, as measured by the P+CBCL, than those exposed to poverty alone. Conclusions. It is important to consider that children and adolescents exposed to collective violence and poverty also have fewer chances to receive treatment. Untreated mental health problems predict violence, antisocial behaviors, and delinquency and affect families, communities, and individuals. It is crucial to address the mental health of children on the border to counteract the devastating effects this setting will have in the short term and the near future.