Migrant children in transit: health profile and social needs of unaccompanied and accompanied children visiting the MSF clinic in Belgrade, Serbia

Abstract

Background Thousands of children migrate to Europe each year in search of safety and the promise of a better life. Many of them transited through Serbia in 2018. Children journey alone or along with their family members or caregivers. Accompanied migrant children (AMC) and particularly unaccompanied migrant children (UMC) have specific needs and experience difficulties in accessing services. Uncertainty about the journey and daily stressors affect their physical and mental health, making them one of the most vulnerable migrant sub-populations. The aim of the study is to describe the demographic, health profile of UMC and AMC and the social services they accessed to better understand the health and social needs of this vulnerable population. Methods We conducted a retrospective, descriptive study using routinely collected program data of UMC and AMC receiving medical, mental and social care at the Médecins sans Frontières clinic, in Belgrade, Serbia from January 2018 through January 2019. Results There were 3869 children who received medical care (1718 UMC, 2151 AMC). UMC were slightly older, mostly males (99%) from Afghanistan (82%). Skin conditions were the most prevalent among UMC (62%) and AMC (51%). Among the 66 mental health consultations (45 UMC, 21 AMC), most patients were from Afghanistan, with 98% of UMC and 67% of AMC being male. UMC as well as AMC were most likely to present with symptoms of anxiety (22 and 24%). There were 24 UMC (96% males and 88% from Afghanistan) that received social services. They had complex and differing case types. 83% of UMC required assistance with accommodation and 75% with accessing essential needs, food and non-food items. Several required administrative assistance (12.5%) and nearly a third (29%) legal assistance. 38% of beneficiaries needed medical care. Most frequently provided service was referral to a state Centre for social welfare. Conclusion Our study shows that unaccompanied and accompanied migrant children have a lot of physical, mental health and social needs. These needs are complex and meeting them in the context of migration is difficult. Services need to better adapt by improving access, flexibility, increasing accommodation capacity and training a qualified workforce.

Mental Health in the Transit Context: Evidence from 10 Countries

“…Additionally, several other material factors limiting the efficacy of practice in the transit context, such as lack of funding and referrals for people in remote locations where support is not available, were considered important. This echoes findings from other researchers who have emphasized the need to increase accessibility to care in transit [ 47 ].…”

“…The study revealed a need to define suitable MHPSS interventions for the transit context. There was support for developing a more flexible model of care ranging from community-based to specialized care, in accordance with past research on meeting mental health needs in the transit context [ 47 ]. This model should be adjusted to the needs of people on the move, which could be enabled by continuously assessing needs and by including refugees themselves in the design and provision of MHPSS services in the transit context.…”

Mental Health, Alcohol and Substance Use of Refugee Youth

“…It is also noted in literature that psychological distress among UACS was lower when they were placed in high support living arrangements in their resettlement (24). On the other hand, accompanied refugee children and youth, even when they are in an intact family, are influenced by family dynamics and their parents' mental health (8,23,25). We can summarize that proximity of parents, relatives and familiar adults is a strong risk or protective factor for children's mental health.…”

“…In a recent study also conducted in Serbia, similar findings were reported. The authors stated that UASC in Serbia most frequently reported that they suffered from anxiety, adjustment difficulties and PTSD, while accompanied youths surprisingly had slightly higher rates of depression and behavioral symptoms (23). However, it is important to emphasize that psychological distress of UASC depends on various factors that they are being exposed to during their transition and resettlement.…”

“…However, it is important to emphasize that psychological distress of UASC depends on various factors that they are being exposed to during their transition and resettlement. During their transition, UASC usually move in groups and are sometimes supported by adults who are not their family members, and despite numerous challenges, they succeed in building flexibility and resilience (23). It is also noted in literature that psychological distress among UACS was lower when they were placed in high support living arrangements in their resettlement (24).…”