Introduction: The study arose out of a growing recognition that the children of parents who have migrated represent a disproportionate number of the referrals to the Child Guidance Clinic, Department of Psychiatry. Method: Both quantitative and qualitative methods were used. A research instrument, the 'Children's Depression Inventory' (tested for cultural relevance and reliability within a Caribbean population) was administered across a population of 400 children aged 13-16 years, to measure depression indicators (negative mood, interpersonal problems, ineffectiveness, anhedonia and negative self-esteem). The data were analyzed to obtain information on prevalence, degree, age, gender and ethnicity. Purposive sampling resulted in 25 children and their caregivers taking part in in-depth structured interviews. Results: Children separated from parents because of migration were twice as likely as other children to have emotional problems although their economic status was improved. One third had serious levels of depression or interpersonal difficulties affecting schooling and leading in some cases to suicidal ideation. Differences were found in relation to gender and ethnicity. In addition to separation through migration, several children had experienced serial losses e.g. bereavement, parental divorce, parental imprisonment, or change of caregiver. Resiliency factors included school performance and belief in family reunification. Parents went abroad to improve the economic conditions of the family. Surrogate care arrangements (usually with relatives) provided for children's material needs but did not address children's emotional problems. Increases in immigration restrictions in countries such as the US and the UK reduced possibilities for contact and family reunification despite these countries actively recruiting labour from the Caribbean. Conclusions: The research has practice and policy implications. It raises questions about the limitations of attachment theory (Bowlby, 1972) in understanding the effects of separation and loss through migration on adolescents. Furthermore it identifies a need for child-centred immigration policy and highlights changes in family structure arising out of migration patterns
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