Practitioner Review: Mental health problems of refugee children and adolescents and their management

Abstract

Background: Since 2010, the numbers of refugees have increased and around half are under 18 years of age. It is known that experience of organised violence, displacement and resettlement increases the risk for psychiatric disorders and psychosocial impairment. This review integrates recent research into the risk and protective factors for psychopathology with service and treatment issues. Methods: We draw on and critically evaluate key systematic reviews in the selected areas, innovative robust studies and relevant government reports. Results: Many refugee children show resilience and function well, even in the face of substantial adversities. The most robust findings for psychopathology are that PTSD, and posttraumatic and depressive symptoms are found at higher prevalence in those who have been exposed to war experiences. Their severity may decrease over time with resettlement, but PTSD in the most exposed may show higher continuity. More severe psychiatric disorders including psychosis may also occur. Service delivery needs to take into account socioeconomic and cultural influences but, given the high level of unmet need even in high-income countries, stepped care delivery is required. The evaluation of psychological interventions, often delivered in group settings, suggests that they can be effective for many distressed children; however, for the more impaired, a greater range of disorder-specific therapies will be required. Conclusions: Child and adolescent mental health clinicians and service providers need to be aware of the specific needs of this population and systems for service delivery. There are significant knowledge gaps in understanding risk and vulnerability, service delivery and treatment effectiveness.

Prevention of psychological distress and promotion of resilience amongst unaccompanied refugee minors in resettlement countries

“…The arrival of such numbers of URMs in Europe and in other resettlement countries means that existing treatment services cannot meet their mental health needs. The gap between need and service provision has been exacerbated by the European refugee crisis and the arrival of URMs occurring in the years following financial austerity (Anagnostopoulos, Giannakopoulos, & Christodoulou, ; Hodes & Vostanis, ).…”

Care providers’ views on burden of psychosomatic symptoms of IS-traumatized female refugees participating in a Humanitarian Admission Program in Germany: A qualitative analysis

“…This concept is discussed in a refugee context as a home based primary care in the United States with, until now, missing evidence due to the lack of research [73]. Further, studies show that stepped care delivery with consideration of socioeconomic and cultural influences as well as disorder-specific therapies are important for the health care system of refugees [36]. For that, there are new approaches in offering health care services, such as the HAP we investigated in this study.…”

“…Since there is still need for understanding mental health care systems, service delivery and treatment effectiveness [36], this study aims to describe the views and experiences of professionals working with Yazidi refugees to assess the psychosomatic symptoms of this traumatized sample. Furthermore, the professionals' working experiences were analyzed to offer medical and psychotherapeutic provision and deduce helpful strategies.…”

The Effectiveness of Cognitive Behavioral Therapy on Depressive Symptoms in North Korean Refugees

“…Most refugees share vulnerability to mental health problems as a common feature. However, they have substantial heterogeneity in the nature of stressful experience, the person’s understanding of the events, education state, sociocultural backgrounds, and characteristics of mental health problems [ 18 , 19 ]. Therefore, development of, and study on the efficacy of psychosocial interventions needs to be conducted for specific needs of the certain refugee population in their current health care setting.…”