Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety–A secondary analysis of the Better Care study

Abstract

BackgroundUnaccompanied young refugees (UYRs) show elevated levels of mental distress such as post-traumatic stress symptoms (PTSS), depression, and anxiety. The individual post-arrival situation in the host country plays an important role in increasing or reducing mental health risks for these vulnerable children and youth. The study aims at examining the impact of pre- and post-migration factors on the mental health of UYRs.MethodsA cross-sectional survey of N = 131 young refugees (81.7% male, M = 16.9 years old) was conducted in 22 children and youth welfare service (CYWS) facilities in Germany. The participants provided information about pre- and post-flight experiences. Standardized measures were used to assess post-traumatic stress symptoms (CATS-2), symptoms of depression (PHQ-9), and anxiety (GAD-7). Daily stressors were assessed with the Daily Stressors Scale for Young Refugees (DSSYR), sociocultural adaptation with the Brief Sociocultural Adaptation Scale (BSAS), satisfaction with social support with the Social Support Questionnaire (SSQ6-G).ResultsOur results demonstrated clinical levels of PTSS in 42.0% of the participants, depression in 29.0%, and anxiety in 21.4%. Hierarchical regression analyses revealed that a higher number of traumatic events and social daily stressors predicted higher levels in all three domains of mental health problems. PTSS and anxiety were also predicted by the distress related to the residence status, depressive symptoms were additionally predicted by sociocultural adaptation, less family contact and length of stay. The satisfaction with social support was not a significant predictor in the regression models.ConclusionUnaccompanied young refugees in CYWS facilities are a highly vulnerable population. As traumatic events, daily stressors and level of contact to family directly impacted UYRs mental health, interventions should be trauma-focused, but also contain modules on how to cope with daily stressors. On the policy and practical level, stakeholders in host countries are called for establishing measures to reduce post-migration stressors and enhance support for UYRs on all levels.

A Systematic Review of Evidence-Based Interventions for Afghan Refugee Mental Health: A Cultural Adaptation Analysis

“…This can sometimes exceed the effects of their past trauma exposure prior to and during their forced migration. Research has indicated that daily stressors can contribute to equal or even higher levels of depression, anxiety, and distress than the adversities that refugees experienced during their displacement (Behrendt et al, 2023; Hornfeck et al, 2023; Miller & Rasmussen, 2010). While the daily stressors that refugees face spans multiple domains, for example, acculturative stress, limited housing, threat of deportation, and restricted social capital, many interventions fail to adequately address them (Behrendt et al, 2023).…”

Psychological and Pedagogical Aspects of Adaptation of Students Who Received Temporary Shelter to the Educational Environment of Another Country

“…On the other hand, a low level of depression indicates successful adaptation of refugee students and their positive psychological state. This indicates effective support from the university community, social integration, successful coping with stress and the development of adaptive strategies (Hornfeck, et al, 2023).…”

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“…Having fled their home countries and endured challenging and traumatic experiences, on reaching safe havens, their relief may be short lived as they begin to grapple with the realities of settling in unfamiliar environments (Brook, Ottemöller, 2020). After arrival in the host country, refugees usually continue to face many challenges and they suggest that the impact of war and forced migration on mental health is compounded or alleviated by the post-migration resettlement context (Hornfeck et al 2023;Hohne et al 2020). According to the World Health Organization, mental health problems, such as anxiety, post-traumatic stress, and depression, are higher among refugee populations than the general population (WHO Regional Office for Europe, 2018).…”

“…Separation from the family in different locations pointed to the heavy emotional burden of learning for the families back in the country of the origin (Integration of young refugees in the EU, 2019). There are several studies about refugee children and adolescents which highlight the protective effect social support after resettlement for mental health and its importance for recovery after trauma (Hornfeck et al, 2023;Verelst et al 2022).…”