Review: Unaccompanied refugee minors’ perception of mental health services and professionals: a systematic review of qualitative studies

Abstract

Background: Unaccompanied refugee minors (URMs) are a population at risk of mental health problems and a population with whom the therapeutic alliance can be difficult to set up. The therapeutic alliance's quality can impact the result and effectiveness of psychotherapeutic interventions. The aim of the present study was to gather URMs' points of view about mental health services and mental health professionals (MHP) in the host country. A summary of interviews conducted with URMs will allow a better understanding of their perception and expectations. Methods: Seven databases were searched with English and French keywords. In the end, nine studies were selected. Results: The review of the interviews shows that URMs do not have a clear perception of MHPit seems difficult for them to trust MHP, but also to understand the value of sharing past painful experiences to reduce current symptoms. They can have a negative perception of mental health and consider that this is not a priority. URMs prefer to focus on day-to-day problems, do activity-based interventions and do group sessions to value social interactions. Conclusions: Clinical and methodological implications are discussed. The development of an instrument to evaluate therapeutic care for URMs could be interesting for future research and for clinicians. Key Practitioner Message• Unaccompanied refugee minors (URMs) are at risk for developing mental health problems.• They need adapted mental health care, but therapeutic alliance can be difficult to build with them.• URMs have a biased perception of mental health and mental health professionals (MHP), and MHP seem to not fulfil URMs' expectations.• MHP could improve therapeutic alliance with URMs by getting interested in their day-to-day problems in the first place rather than past painful experiences and do activity-based interventions.• Developing an instrument allowing a quantitative assessment of therapeutic care would provide a more precise view of the situation and could have clinical implications.

Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review

“…Moreover, group support and the normalization of experiences were reported as important outcomes. This is in line with the findings of a recent review pointing out that minors prefer attending group interventions as they value social interactions [ 100 ].…”

“…As Demazure et al [ 100 ] have pointed out, mental health is more than the presence or absence of psychopathological symptoms. Thus, studies on interventions that focus more on general wellbeing, integration and strengths and acknowledge the weight of anti-migratory policies on minors’ mental health and life would possibly be very helpful.…”

Learning your limits: Nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care

“…However, young unaccompanied refugees report predominantly negative views of mental health issues and services (Demazure et al . 2021; Majumder et al . 2015).…”

“…Mental health support should acknowledge young unaccompanied refugees' vulnerabilities and resilience by emphasising 'safe recovery, assessment of complex social needs, and prompt psycho-social care' (Maioli et al 2021, p. 6). However, young unaccompanied refugees report predominantly negative views of mental health issues and services (Demazure et al 2021;Majumder et al 2015).…”

Editorial: Going through the slippery landscape of conduct disorder, oppositional defiant disorder and help for children in humanitarian crises

“…First, the viewpoints and worldview of these populations of children and adolescents have important implications for services that are provided for them. For example, a systematic review of qualitative studies by Demazure, Baeyens and Pinsault (2022) , reports that unaccompanied refugee minors are vulnerable to mental ill health and can be difficult to engage possibly due to their biased perception of mental health and mental health professionals. The authors suggest that the development of a quantitative therapeutic care assessment scale to assess their viewpoints and the establishment of adapted mental health care settings for them, where activity‐based interventions are provided, along with interest in their day‐to‐day problems instead of past painful experiences, might improve sustained engagement.…”