Adolescents from Immigrant Families Experience Bicultural Stress: Policies to Promote Youth Mental Health and Well-Being

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Stress from expectations to conform to either the U.S. or a family's cultural norms harms adolescent mental health. Promoting family stability, improving access to education and health care, and creating culturally responsive schools and communities can help improve the well-being of adolescents from immigrant families.

Key Points

Approximately 27% of all children in the United States are from immigrant families, most of whom (> 85%) are born in the U.S. to at least one immigrant parent (U.S. Census Bureau, 2023). As these children age, they frequently experience stressors stemming from their need to navigate and balance the different expectations placed on them by both the dominant culture (i.e., the U.S.) in which they live and their family's cultural heritage (McCord et al., 2019). These stressors, known as bicultural stressors, can be especially detrimental for youth mental health as they enter and age through adolescence, a period marked by critical emotional regulation, stress management, and identity development needed for a successful transition into adulthood. As the proportion of youth in the United States who are born to immigrant families continues to grow, there is a critical need to understand the origins of this conflict between individual family cultural expectations and dominant societal expectations and how that conflict can impact adolescent mental health. This review aims to (1) overview typical bicultural stressors experienced by adolescents from immigrant families and how that stress relates to mental health and well-being outcomes; (2) delineate how immigration policy changes influence immigrant families’ stability and safety, potentially exacerbating the relations between bicultural stress and outcomes, and (3) provide recommendations for policy and community actions aimed at reducing the negative impacts of these effects on adolescent mental health and well-being.

Bicultural Stress and Adolescent Development

Bicultural stress is conceptualized as tension stemming from a person's need to navigate differing sets of expectations, norms, and values between the dominant culture and one's own origin culture (McCord et al., 2019). Bicultural stress comprises two distinct influences: acculturative stress, resulting from the pressure to adopt the norms, values, and behaviors of the dominant culture (Berry, 2006), and enculturative stress, stemming from pressure to retain or preserve the values, norms, and behaviors of one's own cultural heritage (Berry, 2003). This stress can arise from multiple sources, including difficulties with language acquisition, adapting to unfamiliar cultural practices and social cues, discrimination, and navigating conflicting expectations between dominant and heritage cultural norms (Araújo Dawson & Panchanadeswaran, 2010; Kim et al., 2014). Additionally, broader structural and social barriers may exacerbate this stress, such as economic strain (e.g., limited employment opportunities, unstable housing, insufficient income), minority and/or legal status (e.g., undocumented status), and experiences of prejudice and/or discrimination toward immigrants in mainstream society (Kim et al., 2014; Torres et al., 2012). Most adolescents from immigrant families report experiencing some form of bicultural stress, with some studies indicating that up to 66% of youth report experiencing at least one component of bicultural stress (Sladek et al., 2025). Given the prevalence, bicultural stress should be examined and addressed as a typical yet difficult set of circumstances these adolescents face during a pivotal point in their lives, with potentially lasting consequences for their well-being.

Adolescence is a pivotal stage for identity formation, when adolescents begin to solidify the roles, values, and relationships that form the identities they will continue to refine as they transition into adulthood (Branje et al., 2021); these processes are substantially influenced by close family relationships. For youth from immigrant families, this process is complicated by competing expectations between one's heritage culture and the dominant culture (Medina et al., 2018; Zhang & Qin, 2023). This tension may disrupt identity development, contributing to confusion regarding a person's fit in society, or it may be internal conflict regarding what values to prioritize (Lerias et al., 2024; Oshri et al., 2014; Williams & Berry, 1991). The stress resulting from these conflicting feelings, coupled with a heightened sensitivity to stress stemming from typical neurological and biological changes in adolescence (Sisk & Gee, 2022), leaves adolescents from immigrant families at greater risk for mental health and well-being problems. Youth who experience greater mental health problems are more likely to engage in risky and criminal behaviors (Brooks et al., 2002), are less likely to complete their education (Veldman et al., 2015), and are more likely to be unemployed (Clayborne et al., 2019), all outcomes which can have detrimental social and financial effects for communities. Thus, understanding how bicultural stress impacts adolescent mental health and well-being allows policymakers to more effectively act to promote better outcomes for those youth, their families, and the broader community.

Impact of Bicultural Stress on Adolescent Outcomes

Substantial literature has documented the impact of bicultural stress on adolescent mental health and well-being. Bicultural stress often manifests in emotional, behavioral, and physiological challenges that reflect the strain of navigating multiple cultural contexts during a critical developmental period (Romero et al., 2007b). Experiencing bicultural stress is consistently associated with adverse mental health and well-being outcomes, including increased symptoms of depression and anxiety (Crockett et al., 2007; Piña-Watson et al., 2015; Romero et al., 2007a; Wasserman et al., 2021), poorer sleep quality (Sladek et al., 2020), problematic substance use (Cano et al., 2015; Schwartz et al., 2015), more frequent withdrawal from close relationships (Jo et al., 2026), and poorer overall psychological well-being (Lerias et al., 2024; Sirin et al., 2013; Tineo et al., 2021). Beyond the impact on mental health outcomes, these stressors can also have implications for physical health, particularly through chronic stress pathways and reduced engagement in health-promoting behaviors (Lerias et al., 2024), which can then further exacerbate mental health problems. The relations of bicultural stress with mental health and well-being are found both cross-sectionally and longitudinally, indicating that the effect of bicultural stress on youth has both immediate and lasting impact.

Notably, the prevalence and impact of bicultural stress on adolescent outcomes may vary based on adolescents’ generational status and ethnic identity. First-generation youth (i.e., born outside of the United States) often encounter more immediate and direct challenges related to adaptation, including language acquisition, migration-related disruption, and adjustment to unfamiliar social and institutional environments (Alcántara et al., 2016; Schwartz et al., 2018). These youth may experience heightened stress due to the demands of navigating a new cultural context while simultaneously coping with the loss of established social networks and routines (Beutel et al., 2016; Devos et al., 2024). In contrast, second-generation adolescents (i.e., born in the United States to at least one foreign-born parent), although they are typically more familiar with the dominant culture, may face more nuanced forms of bicultural stress, particularly in the form of cultural conflict and identity negotiation within both family and broader societal contexts (Dizon et al., 2021).

Although less research has examined differences in the prevalence of bicultural stress for different ethnic groups, some research suggests that Hispanic and Latine-identifying youth tend to report greater bicultural stress than adolescents from other ethnic backgrounds (Grigsby et al., 2026; Piña-Watson et al., 2019; Romero et al., 2007a). Together, these findings indicate that, although immigrant youth overall are negatively impacted by bicultural stressors to the detriment of their mental health and well-being, some adolescents from immigrant families may experience more frequent bicultural stressors or greater severity of those stressors.

Immigration-Related Policy Impact on Adolescent Well-Being

Immigration in the United States has historically been shaped by anti-immigrant rhetoric and systemic barriers (Cheung-Blunden et al., 2022), creating a sociopolitical context that has profound implications for the well-being of immigrant adolescents (Raymond-Flesch et al., 2022). These structural conditions extend beyond individual experiences, often intensifying bicultural stress into forms of systemic marginalization and violence (Torres et al., 2022). Prejudice is frequently group and ethnic-specific, as evidenced by findings that U.S. citizens are more supportive of penalizing immigration violations among individuals of Mexican descent compared to those of Irish or Canadian backgrounds (Cheung-Blunden et al., 2022). However, such bias against a specific group is not contained to that group, but rather, it has the potential for broader negative repercussions across marginalized communities that may be seen as similar to the targeted group. For example, growing prevalence in Islamophobia is associated with an increase in hostility towards Sikh individuals in Western countries (Abbas, 2019). Likewise, broad anti-Asian hostility increased in the U.S. during the COVID-19 pandemic after the virus was first documented in China (Han et al., 2022). These societal attitudes are further reinforced through policy practices. Recent increases in Immigration and Customs Enforcement (ICE) activity, aggressive deportation practices, and heightened public rhetoric portraying immigrants as threats highlight how policy can institutionalize stigma and fear (Portillos, 2024). Thus, these changes may impact how adolescents experience bicultural stress and the severity of its impact on youth mental health and well-being.

Although consensus from the broader literature indicates that adolescents’ felt bicultural stress influences their mental health and well-being outcomes, these stressors do not exist in isolation from broader policy changes and actions. The links to youth mental health can be either buffered or exacerbated depending on the intended or unintended effects of those policies. Overall, immigrants who experience greater personal or family suffering due to immigration policies report poorer mental health outcomes (Becerra et al., 2020), and adolescents are not isolated from similar effects. Even when actual immigration actions have not yet been experienced by adolescents or their families, immigration policy-related fears, which can include a fear that you or a family member may be detained or deported, worry about having your family separated, and feeling unsafe due to immigration policies, are related to youth outcomes. These fears have been linked to more severe sleep problems (Eskenazi et al., 2019), more posttraumatic stress symptoms (Cardoso et al., 2023), and more anxiety symptoms, both directly and indirectly through an increase in adolescents’ perceived discrimination (Cardoso et al., 2021). These results indicate that youth who worry about immigration-related policies are both directly negatively impacted by the stress that worry produces and may also feel more discrimination based on their family's immigration status or perceived ethnic or cultural differences. Intense fear or worry may also impact adolescents’ behaviors, such that they begin to withdraw from their typical social and academic behaviors, which can also exacerbate the negative effects immigration policies have on adolescent mental health and well-being (Roche et al., 2021).

When adolescents and their families do experience disruptions in their lives due to immigration policy actions, such as immigration raids, temporary or prolonged detainment, and the threat of or actual deportation, adolescents report significantly poorer mental health outcomes. Having a parent arrested, detained, or deported due to their immigration status is related to adolescents reporting more severe anxiety and depressive symptoms (Giano et al., 2020; Lieberman et al., 2024) and a greater risk of suicidal ideation, alcohol use, and externalizing symptoms such as aggression and rule breaking (Roche et al., 2020). The detrimental effects of family member detainment may be partly explained because parental detainment threatens a high-quality, supportive parent-child relationship, which can then put youth at higher risk of mental health problems (Roche et al., 2024). But the distress and grief an adolescent experiences from having a parent detained cannot be overlooked. Further, youth who are themselves detained report greater depressive symptoms and posttraumatic stress symptoms (Priestley et al., 2025), and this detriment to mental health is more severe for youth who are detained for a long period of time or indefinitely. These results highlight that immigration policy and actions can disrupt family functioning, which then has a detrimental impact on youth mental health and well-being.

As research shows, policy implementation and changes can influence youth and family outcomes, even when those policies do not explicitly dictate law enforcement interaction, detention, or detainment. In states where exclusionary policies, such as those that restrict access to education, workforce training programs, or healthcare, are implemented, youth are more likely to report poorer mental and physical health outcomes (Crookes et al., 2021; Lemon et al., 2023; Luo & Escalante, 2020). These policies not only restrict access to critical support systems that are necessary for promoting mental and physical health in youth, leading to poorer outcomes overall, but they can also exacerbate aspects of bicultural stress (e.g., feelings of discrimination and stress stemming from language use or accents) that then impact youth well-being. Further, federal policies that utilize family separation and prioritize detainment and deportation as primary mechanisms for immigration enforcement are associated with higher rates of youth mental health problems (Naseh et al., 2024). These policies can both cause unnecessary stress on youth and dismantle or disrupt the supportive relationships that can buffer against negative outcomes (Wasserman et al., 2021). Notably, less restrictive and punitive immigration-related policies can improve youth well-being. In states that implement inclusionary immigration policies, such as those aimed at increasing access to education and health care regardless of immigration status, youth reported better mental health and well-being outcomes (Crookes et al., 2021; Hodges et al., 2023), although some of these effects were beneficial only when targeting certain policy domains (i.e., economic, educational, etc.) over others. Because many of these inclusive policies are aimed at decreasing structural barriers, they can make adolescents feel more welcome in their communities, alleviating some sources of bicultural stress.

Although much of the research on the links of immigration-related policy changes with youth mental health and well-being focuses on overall influences regardless of citizenship status or ethnicity, these policy changes do not uniformly impact immigrant youth and their families in the United States. Families that have temporary protected status, undocumented status, or are permanent, non-citizen residents are more likely to report more severe impacts of immigration policy changes on their well-being than do families who are U.S citizens (Roche et al., 2018). Additionally, immigration policies disproportionally target Hispanic and Latine communities (Syracuse TRACImmigration, 2020), meaning these families may be more acutely impacted by policy changes, both positively and negatively. As policymakers adjust and revise immigration-related policies, presumably, the revisions will impact the relations between bicultural stress and adolescent outcomes differently for children based on their family's immigration status or ethnic identity. For adolescents from immigrant families, these policies do not operate in the abstract; they directly heighten stress, anxiety, and fear, particularly related to potential family separation, instability, or psychological safety (Cardoso et al., 2021). These stressors compound existing acculturative challenges, exacerbating difficulties related to adolescents’ mental health and well-being (Wasserman et al., 2024). As a result, legal and policy changes function as system-level forces that both directly impact adolescent well-being and intensify the effects of ongoing acculturative stress (Bekteshi & Kang, 2018). Legal and policy change can also indirectly affect adolescent well-being by heightening fear and anxiety related to an anti-immigration climate.

Actions Aimed at Reducing Adolescent Bicultural Stress

Given the nuanced role bicultural stress plays for adolescent mental health and well-being and the impact immigration-related policy can have on these relations, action to eliminate these influences at the community, school, and policy level can have a meaningful, positive impact for youth from immigrant families. For families who encounter immigration law enforcement, legislative action and administrative policies that promote family retention and prohibit family separation during detainment and deportation processes help youth retain the critical support systems they need to foster resilience against stress (Yan et al., 2025).

Policies that promote access to education, work training, and health care for adolescents from immigrant families can also remove systemic barriers that can cause undue stress and exacerbate bicultural stressors. Schools aiming to support youth from immigrant families can employ more mental health professionals trained in culturally responsive counseling practices and implement teacher and staff training to recognize and mitigate potential bicultural stress triggers in the school environment. More generally, schools can envelop culturally responsive practices into the school environment through targeted interventions aimed at improving classmate and parent-school staff relationships to help prevent immigration-specific bullying, victimization, or exclusion (for examples, see Arora et al., 2021). Changes like these at the local, state, and federal levels can directly benefit adolescents and their families while also providing social and economic advantages to the broader community by mitigating factors known to prevent youths’ successful transition to adulthood. These broad impacts demonstrate that implementing bicultural stress prevention efforts is an investment that benefits our entire society.

Action does not have to be limited to large policy changes. Community organizations and partners can also nurture adolescent well-being through local action, and more locally focused actions can be critical for promoting youth resilience when the broader state, federal, or societal climate is less supportive. This can be done through the implementation of mutual aid programs, increased access to community spaces that allow for more frequent positive social interactions for youth, and inclusive signage and language usage to decrease the translation burden many youth experience (Wu & Kim, 2008). Because bicultural stress can stem from feelings of discrimination and a lack of belonging, actions to increase feelings of belonging and access to financial and social support can help lessen the impact of bicultural stressors when they are experienced. Families, although they are also facing similar bicultural stressors and the mental health risks that stem from this stress, also provide valuable support to adolescents. Because of the shared experience of navigating these culture-specific stressors, family members can act as a source of resilience by providing youth with tools and guidance needed to balance opposing perspectives that can cause bicultural stress. Families can also promote practices that help facilitate cultural competence, which is the ability to successfully balance one's own and the dominant culture through adopting aspects of both cultures that match their personal needs and experiences (Schwartz & Unger, 2010). Adolescents who effectively harness cultural competence by retaining and balancing personally meaningful expectations and values from both their heritage and the dominant culture are more likely to have fewer mental health problems (Gusman et al., 2024; Lee et al., 2019). Thus, parents who promote and model behaviors that reflect cultural competence can better support their children's development of cultural competence, which can then lessen the severity and frequency of felt effects of bicultural stressors.

Conclusions

As the population of children born to immigrants in the United States continues to increase, substantial local, state, and federal action must support these youth and promote best outcomes in their mental health and well-being. Research consistently demonstrates that bicultural stress is detrimental to the mental health and well-being of adolescents from immigrant families, and immigration-related policies that threaten either the stability of families or their youths’ sense of safety can further exacerbate these effects. Actions by policymakers and educational officials at the local, state, and federal levels, like those to promote family stability during immigration legal procedures and create supportive and accessible schools and communities, can have widespread beneficial effects for adolescents from immigrant families and the broader community. By eliminating the sources of bicultural stress through the establishment of inclusive policies and community actions, lawmakers, school staff and administrators, and community partners can make a tangible, positive impact on the mental health and well-being of adolescents from immigrant families. Small policy changes can provide crucial support to these adolescents and their families, which will then allow these youth greater opportunities to thrive as community members and leaders of society as they transition into adulthood. As a nation that has historically prided itself on being a “melting pot” of cultures, ideas, and religions, the United States has a responsibility to invest in the future of immigrant families and promote their well-being. Mitigating a key source of stress stemming from discrimination or a lack of belonging should be an early step toward that investment.