A Whole-child, whole-family approach to health assessments for asylum-seeking children

Abstract

In 2020, 21% of people who sought asylum in the UK were children. This population has complex interconnecting health and social needs. Assessment requires a holistic approach, with consideration of physical and mental health in addition to social and developmental well-being, within the whole family group. A trauma-informed life-cycle and intergenerational care approach is important. This article, aimed at all health professionals who may work with asylum-seeking families, outlines the best practice principles for undertaking health assessments in migrant children and young people.

Optimizing Early Diagnosis of Infectious Diseases in Migrant and Refugee Children: An Overview of Best Practices and Strategies

“…4,11,13 Furthermore, in centers where infection screening happens separately from initial medical assessment, retaking a detailed history to risk assess is time-consuming and may cause retraumatization. 27 A panel-based approach with tailoring based on significant population determiners may be a better pragmatic approach.…”

“…31 There is evidence that community settings are more acceptable to young people than hospital-based settings. 28 Inclusion health (staff trained in strategies to help young people with multiple overlapping risk factors for health problems), 32 continuity of care, 18 and holistic assessment 27 including signposting to health and social support resources 11 are further examples of best practice. The most successful health assessments “make every encounter count” and take the opportunity to support and ask about education, mental health and social determinants of health, whilst providing treatment (and ideally immunizations) in the same setting.…”

“…Asylum-seeking children and young people are known to face multiple barriers in accessing healthcare, including language barriers, 8 unfamiliarity with local health systems, 32 stigmas, psychological trauma 19 and poverty (including digital poverty, meaning a lack of resources to interact with the online world). 27 Ideally, services will be adapted to address these challenges, including bespoke administrative processes, use of materials in other languages, and clear documentation (digital and paper) that follows children throughout their healthcare journey, thus anticipating likely relocation. 33…”

“…4,11,13 Furthermore, in centers where infection screening happens separately from initial medical assessment, retaking a detailed history to risk assess is time-consuming and may cause retraumatization. 27 A panel-based approach with tailoring based on significant population determiners may be a better pragmatic approach. Some European guidelines recommend testing for parasitic diseases that pose long-term health risks and occur with significant prevalence in migrant and refugee children.…”

“…The most successful health assessments "make every encounter count" and take the opportunity to support and ask about education, mental health and social determinants of health, whilst providing treatment (and ideally immunizations) in the same setting. 27 The United Kingdom, 33 the Netherlands, 34 Australia 35 and Sweden 18 have good examples of local provision of an integrated system with treatment in the same setting.…”