There are increasing numbers of mothers as well as fathers who engage in long-term migration to support their children and other family members in their home countries. In this article, the current state of the literature about children and adolescents left at home in these transnational families is surveyed and reviewed. The article reviews the effects on children of the process of separation from parents, the impact of gifts and remittances home, communication with distant parents and the quality of life with their substitute caregivers. The effects of immigration in late childhood or adolescence on these separated children are examined, as well as what is known about the processes of adaptation and family reunification, including migration traumas, impact of gender, and educational outcomes. Suggestions are given for pediatric clinicians working with reunifying families. Gaps in the literature are highlighted and the need for research into factors that promote successful family re-engagement and overall adaptation upon reunification.

Topic This article will briefly review screening for depression and suicidal ideation in primary care and school‐based clinics, with a focus on in‐depth screening for imminent suicide risk, developing a safety plan, and incorporating handoffs to urgent and emergency mental health care personnel. The article will cover current definitions of levels of suicidal risk and clinic‐based protocols for a team approach to adolescents in crisis. Purpose To provide primary care and behavioral health nurses with evidence‐based suicide risk screening and assessment tools and best practices for using them in patient‐centered encounters with adolescents with suicidal thinking or behavior. Sources Used Journal articles, books, and reports. Conclusion Past studies have shown that many individuals who died by suicide had seen a primary care provider in 30 days before their deaths. Nurses in primary care settings should develop clinic‐based protocols for screening all adolescents for suicide risk, developing safety plans, and providing suicidal youth and families with monitoring, appropriate referrals, follow‐up, and support.

Realistic simulations of interactions around social determinants of health with adolescent standardized patients demonstrated the need to increase trainee practice in asking sensitive questions, as well as in devising appropriate follow-up responses, and in improving trainee familiarity with local resource referrals. Policy: Policymakers and credentialing boards should promote creation of more dynamic curricular programming that incorporates social determinants of health considerations to ensure that future health care trainees are adept and consistent in their screening and response to unmet social needs. Research: Our preliminary study should be expanded to better understand how explicit integration of social determinants of health into simulation experiences across a range of disciplines and types of trainees can help improve clinical practitioners' abilities to meaningfully integrate social determinants frameworks into their clinical interactions.

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