Background/Objectives: Depression and anxiety in children pose a significant public health concern, with long-term implications for well-being. Over 10% of children and adolescents are affected by emotional disorders such as depression and anxiety. African American youth face disproportionate exposure to mental health risk factors, including poverty, adverse childhood events, community violence, and racial discrimination, which elevate their vulnerability to these disorders. A particularly at-risk subgroup includes African American children in kinship care arrangements (e.g., grandparents raising grandchildren), who may face additional factors such as family disruption and separation from birth parents. Methods: This mixed-methods sequential study examined how caregiver stress and birth mother-child relationship quality relate to depression and anxiety symptoms in African American children in kinship care. Phase I included survey data from 58 caregivers of children aged 5 to 12; Phase II involved interviews with 16 of these caregivers. Results: Results indicated that lower caregiver stress was associated with reduced child depression and anxiety symptoms. Furthermore, findings suggest that a high quality of the birth mother-child relationship serves as a promotive factor, particularly for depressive symptoms. Qualitative findings highlighted two themes: (1) the weight of kinship care, marked by factors such as ongoing grief and financial strain; and (2) birth parent relationships, defined by a mix of connection, conflict, and loss that affects children’s mental health. Conclusions: These findings underscore the need for greater understanding of the strengths and resources within kinship families that support positive mental health outcomes and highlight the importance of targeted interventions to reduce caregiver stress and foster supportive parent-child relationships.

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