Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors

Abstract

Unaccompanied refugee minors are a particularly vulnerable group. The aim of this study is to increase our knowledge about possible pathways to wellbeing and integration for unaccompanied refugee minors as they strive to establish new lives in a host county. The present study followed a group of youth who fled to Norway without their caregivers at three time points; 6 months (n=95; M age=13.8, 80% boys), 2 years (n=78; M age = 16.5, 83% boys), and 5 years (n=47; M age 20.0, 83% boys) after arrival. Linear mixed effects models were used to assess whether age, gender, and trauma exposure prior to arrival were associated with levels and changes in symptoms of posttraumatic stress (PTS), depression, anxiety, and externalizing symptoms over time. Regression analyses were conducted to examine whether daily hassles, perceived social support, and new trauma experiences predict PTS, internalization, externalization, and somatization. The mean levels of depression had decreased significantly at five years but mean levels of anxiety, PTS and externalizing symptoms did not. Females and severely trauma-exposed had higher levels of symptoms. Higher age was associated with less change in symptoms of depression and posttraumatic stress over time. Five years after arrival, many still experienced clinical levels of mental health problems, and level of daily hassles was an important predictor. Support may be needed not only at arrival to handle mental health problems in general and post-traumatic stress in particular, but also after resettlement. Help to manage daily hassles may be especially important to ensure wellbeing and integration.

Children at risk: A nation-wide, cross-sectional study examining post-traumatic stress symptoms in refugee minors from Syria, Iraq and Afghanistan resettled in Sweden between 2014 and 2018

“…The high rates of "at risk" children presented are therefore particularly concerning, as they raise questions regarding whether the PTSD prevalences have declined over time, remained stable or even increased post arrival. Prior longitudinal studies exploring the mental health of unaccompanied refugee minors have found sustained levels of PTSD symptoms over time, even while other measures of mental disorders declined [8,49]. While the present study did not collect longitudinal data, the findings herein might be consistent with these cited studies.…”

“…Indeed, research focusing on refugee children and unaccompanied refugee minors has consistently reported heightened risk for mental health disorders, including posttraumatic stress disorder (PTSD), within this population and existing evidence suggests that mental health disorders tend to be highly prevalent, even several years after resettlement [3][4][5][6][7][8][9][10][11][12]. Prior research has shown that a number of factors are associated with the development of mental health problems in refugee children and adolescents, such as exposure to violence, stress in the postmigration context, family stress, separation from parents, and discrimination [13][14][15][16].…”

“…It has also been suggested that PTSD and depression can lead to poor performance in school, which may in turn lead to a higher likelihood of engagement in risky behaviour [19]. Studies focusing on mental health in minors have also largely been based on small, non-random samples, often with predominantly unaccompanied, male participants [8,[21][22][23][24][25][26], highlighting an underlying problem of convenience sampling. Such samples are often nonrepresentative and might, in some cases, provide biased or incomplete information about the populations in question [17].…”

Cultural Competence of Professionals Working With Unaccompanied Minors: Addressing Empathy by a Shared Narrative

“…Studies report that 52% have posttraumatic disorders, 44% depressive syndromes, and 38% an anxiety disorder (1)(2)(3)(4). For around a third of these adolescents, these disorders go on to become chronic (5), especially those with anxious or posttraumatic symptoms (6).…”

A socio-ecological analysis of risk, protective and promotive factors for the mental health of Burundian refugee children living in refugee camps

“…On the ontogenetic level, a higher exposure to war-related traumatic events is a powerful risk factor for refugee children's mental health across settings [2,9]. Cumulative premigration trauma predicted higher levels of PTSD symptoms, depression, and anxiety in longitudinal studies with refugee minors in Norway [10] and Belgium [11]. Although the way refugee children cope with their adverse experiences is likely crucial for their mental health, there has been little research on the role of coping strategies [7].…”