A new nationwide Finnish register study shows that children with two immigrant parents are significantly less likely to receive mental health services for anxiety and depression than children of Finnish parents. At the same time, children with immigrant fathers and Finnish mothers are up to 60% more likely to use those services, revealing how a single native-born parent can dramatically shape a child's access to care.

Researchers at the Research Centre for Child Psychiatry at the University of Turku examined nearly 172,000 children and adolescents born in Finland between 1992 and 2006, making it the first nationwide register-based study to investigate how parental immigration status affects offspring mental health service utilisation for anxiety disorders and/or depression.

Children with two immigrant parents were 60% less likely to receive treatment for comorbid anxiety and depression, 50% less likely for depression alone, and 20% less likely for anxiety alone. The gap was especially pronounced for children whose parents originated from low Human Development Index (HDI) countries and those with mothers from Sub-Saharan Africa.

"These findings reveal a troubling paradox: the children who may face the greatest mental health stressors due to migration-related adversity are precisely the ones least likely to reach the services that could help them", says Prakash Khanal, the study's lead author and Doctoral Researcher at the Research Centre for Child Psychiatry.

Having a Finnish mother improves access to mental health care services

Children with an immigrant father and a Finnish mother showed consistently higher odds of mental health service use across all diagnostic categories. The pattern reversed when only the father was Finnish, underlining how central maternal familiarity with the healthcare system is for children's access to care.

"Mothers typically act as the primary healthcare navigators for their children. When a mother is Finnish, she knows how the system works and how to seek help. That knowledge is a powerful enabler", Khanal explains.

Timing of immigration and region of origin shape children’s access to services

Mothers who arrived in Finland less than one year before giving birth were less likely to have their children access mental health services. Notably, even mothers with five or more years of residence showed persistently lower odds.

"The barriers do not simply disappear with time. Longer residence can lead to greater reliance on informal or community-based coping, which may delay seeking professional help ", Khanal says.

Regional origin further shaped service use. Children of mothers from Sub-Saharan Africa were up to 90% less likely to receive treatment for depression. In contrast, children with fathers from Central and South America showed higher service use across all outcomes.

"In many societies, particularly those originating from the global south, mental health problems are understood through religious, spiritual, or somatic contexts rather than clinical ones. When both parents share these frameworks and face language barriers, there may be no bridge into mental health care within the family", Khanal explains.

Towards more equitable access to mental health care

The authors call for universal mental health screening in schools and primary care, culturally responsive outreach through community health workers, and system-level adaptations, such as simplified referral pathways and multilingual resources.

"Targeted support for immigrant mothers is particularly important. Improving mental health literacy and addressing stigma within immigrant communities must be part of a national strategy to ensure equitable access for all children in Finland", says professor Andre Sourander, the principal investigator of the study.