This paper investigates the mental health stressors experienced by Central American youth immigrants and asylum seekers, including unaccompanied minors, surveyed in the U.S. in 2017. This population is hard to reach, vulnerable, and disproportionately exposed to trauma from a young age. They face numerous challenges to mental health, and increased psychopathological risk, exacerbated by high levels of violence and low state-capacity in sending countries, restrictive immigration policies, the fear of deportation for themselves and their family members, and the pressure to integrate once in the U.S. Using survey data and the validated PHQ-9 questionnaire and Child PTSD Symptom Scale (CPSS), we find that Central American youth have seen improvements in their self-reported mental health after migrating to the U.S. but remain at risk of further trauma exposure, depression, and PTSD. They exhibit a disproportionate likelihood of having lived through traumatizing experiences that put Central American immigrants at higher risk for psychological distress and disorders and may also create obstacles to integration that in turn create new stressors that compound with PTSD and depression. PTSD, depression, or anxiety can be minimized through programs that aid their integration and mental health.