Research on young Haitian immigrants and refugees has tended to look outward, at substance use, sexual risk and delinquency, leaving depression and anxiety largely unexamined. Fawzi and colleagues set out to correct that imbalance by measuring inward distress and the conditions that accompany it.

A stratified random sample was drawn from Haitian students in Boston's public high schools; 84 percent agreed to a standardised interview, and diagnoses were assigned by best-estimate methods. Depression appeared in 14.0 percent of participants and PTSD in 11.6 percent, with 7.9 percent carrying both.

Regression analysis tied depression to a father's death, schoolwork going badly and time spent away from friends, and PTSD to physical abuse, frequent arguments with parents, and fear about personal safety and the neighbourhood. Because several of these pressures arise only after arrival, the authors argue that support programmes and school-based mental health services should be built around them.