When Johns Hopkins pediatric psychiatrist Rheanna Platt meets with Latino children grappling with behavioral problems, she’s often pondered: Could the ways their parents adjust to life in America be playing a role?

That’s hard to tell, but needs to be known. Current psychosocial research on U.S. immigrants is scant, she says, and studies of Latino families even rarer. Yet more than 80 percent  of Johns Hopkins Bayview Medical Center’s pediatric patients and 45 percent of its obstetric patients are Latino. Anecdotes from the center’s pediatric social workers attest to traumatic events in these parents’ countries of origin, as well as discrimination locally. Such experiences, she says, likely trickle down emotionally to the children.

Fortunately, Platt spotted a prime opportunity to follow Latino parents: well-baby visits. Parents’ being there is nearly guaranteed, she explains. “They may neglect their own health, but most bring their children for the requisite six visits during the first year of life.”

So in 2015, with psychiatric researcher Elisabet Arribas-Ibar, Platt launched a necessary first study of 100 parents of the youngest children—newborns to age 5—to examine possible risk factors and mental health symptoms.

Using surveys, in-depth interviews and childhood records, Platt and Arribas-Ibar gathered data on immigration status, health care access and contextual risk factors. They also explored parental stress in the pediatric primary care setting. Finally, the study aimed to gauge the willingness of parents to meet as a group to discuss risk factors and mental health.

Their findings point to a host of stressors for these parents. Chief are financial struggles, documentation status, fear of violence and relationship discord. Health problems like obesity and asthma may complicate matters, says Platt. Among patients referred to community psychiatry’s Latino Family Clinic, other learning disruptors, like ADHD, are common.

With time, Platt often sees relationships between children and parents deteriorate. “Many Latino parents,” she says, “have trouble advocating for their children’s needs in the school setting because of language barriers.” In families where parents immigrated years before their children did and sent hard-earned money back home, tensions can mount. It’s not uncommon to hear parents, their resentment bubbling up, ask a struggling adolescent, “How can you be depressed after everything we’ve done for you?”

Though many Latinos are beginning to tap the hospital’s health seminars and social services—three Spanish-speaking therapists are available at Johns Hopkins Bayview’s pediatric clinics—“lots of folks are afraid to do so or don’t know where to turn,” Platt says.

All the mothers interviewed for the study expressed interest in a pediatric primary care-based intervention—encouraging news, says Platt, as the survey showed a high prevalence of symptoms like anxiety, PTSD and depression in those with minimal social support.

“Our best hope,” Platt says, “is to learn more about Latino parents’ struggles and design programs to promote their well-being—and in turn, their children’s.”