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Prod'hom D, Rosselet Amoussou J, Plessen KJ, Cuissart de Grelle N, Gaultier S. Adaptative Skills and Global Functioning of Unaccompanied Migrant Minors in Europe: A Systematised Review. Int J Public Health 2024; 69:1606625. [PMID: 38988503 PMCID: PMC11233468 DOI: 10.3389/ijph.2024.1606625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 06/10/2024] [Indexed: 07/12/2024] Open
Abstract
Objectives This systematised review aimed to examine European literature reporting data about adaptative skills and global external functioning of unaccompanied minors (UAMs). Methods We conducted a systematised screening of four databases (APA PsycINFO Ovid, Medline Ovid ALL, Embase.com and Web Of Science Core Collection) using a research strategy including social, scholarly and behavioural abilities as well as externalising problems associated with the target population of UAMs. Thirty articles were included using pre-defined inclusion and exclusion criteria. Results Our review showed that despite high levels of internalising disorders, socio-behavioural and educational adjustment of UAMs remained positive. It demonstrated how this population displays a strong desire for academic success and prosocial behaviours instead of aggressivity in everyday life. Nevertheless, our review drew attention to the strong tendency of UAMs to internalise their disorders and display chronic distress and problematic behaviours which increased with time spent in the host country. Conclusion Our study draws attention to the risk of underestimating the real mental health needs of refugees, due to preserved external functioning combined with significant settlement pressures.
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Affiliation(s)
- Dimitri Prod'hom
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Kerstin Jessica Plessen
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Division of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Sydney Gaultier
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Division of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Pinto-Cortez C, Marín-Gutiérrez M, Melis-Rivera C, Contreras-Taibo L, Moya-Vergara R. Victimization, polyvictimization, and depression symptoms among immigrants and native children and youth in Chile. Child Adolesc Psychiatry Ment Health 2024; 18:72. [PMID: 38890679 PMCID: PMC11186072 DOI: 10.1186/s13034-024-00755-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 05/22/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Migration exposes children and youth to vulnerabilities, including uprooting, lack of protection, limited access to services, and violence. Previous studies have shown that victimization experiences impact the mental health of migrant children, including depression, anxiety, and post-traumatic stress disorder. This study aims to examine the co-occurrence of multiple forms of maltreatment (polyvictimization) among migrant and Chilean children and youth and its association with depressive symptoms, addressing a research gap in Latin America. METHODS Secondary data from the National Polyvictimization Survey (NPS) conducted by the Chilean Ministry of the Interior were analyzed. Measures assessing polyvictimization and depressive symptoms were administered to a sample of 1362 participants, with equal group sizes for migrants and Chilean-born individuals. Data analysis included descriptive statistics, group comparisons, correlation analyses, and multiple regression analyses. RESULTS The study revealed marked differences in experiences of conventional crime victimization and polyvictimization between migrant and Chilean-born participants, with migrants facing slightly higher incidences. Correlational analysis indicated variable strengths of association between victimization types and depressive symptoms across groups, with Chilean-born individuals showing stronger correlations for certain victimization forms. Multiple regression analysis highlighted gender, polyvictimization, child maltreatment, internet victimization, sexual victimization, and peer/sibling victimization as significant predictors of depressive symptoms across the sample. Notably, an interaction was observed between child maltreatment and migrant status, indicating a mitigated impact of maltreatment on depressive symptoms among migrant adolescents. This suggests the potential for unique resilience or coping mechanisms in this group. CONCLUSIONS This study elucidates the varied victimization experiences of migrant children and youth in Chile, with a notable emphasis on the mitigating effect of migrant status on the relationship between child maltreatment and depressive symptoms. It highlights the resilience and potential adaptive strategies of migrant minors facing adversity. The findings underscore the necessity of developing support and intervention strategies that recognize the specific needs and strengths of migrant children and youth, advocating for policies that protect and empower this vulnerable demographic amidst new environmental challenges.
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Affiliation(s)
- Cristián Pinto-Cortez
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, 18 de Septiembre 2222, Arica, Chile
| | - Mauricio Marín-Gutiérrez
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, 18 de Septiembre 2222, Arica, Chile.
| | - Carlos Melis-Rivera
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, 18 de Septiembre 2222, Arica, Chile
| | | | - Rodrigo Moya-Vergara
- Escuela de Psicología, Universidad Católica del Norte, Angamos 0610, Antofagasta, Chile
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3
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de Smet S, Spaas C, Derluyn I, Kevers R, Colpin H, De Haene L. The role of school-based creative expression interventions in the aftermath of migration: A qualitative exploration of parents' and teachers' perspectives. J Sch Psychol 2024; 102:101260. [PMID: 38143093 DOI: 10.1016/j.jsp.2023.101260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/01/2022] [Accepted: 10/27/2023] [Indexed: 12/26/2023]
Abstract
This study explored supportive relational processes for immigrant children's well-being between peers, teachers, and parents in the development of school-based creative interventions in European multi-ethnic societies. Within the present study, we integrated the perspectives of teachers and parents to broaden the dominant focus on the assessment of individual symptomatology within the existing body of studies of school-based interventions studies. As a part of a larger multi-method study on the implementation of a creative expression program for immigrant children ages 8-12 years in three schools in Belgium, we conducted focus group discussions to learn parents' and teachers' perspectives on the role of school-based creative interventions in children's coping with histories of migration and life in exile. Parents and teachers identified the need for the intervention to foster emotional expression impacting children's self-esteem and social connectedness with peers and to foster emotional connections between parents, teachers, and children. Parents also stressed the importance of the intervention within society as a forum to engage with social conditions, promote cultural belonging, and social integration. Results identified the importance of school-based interventions in terms of individual benefits as well as connectedness and coherence in entire communities, thereby strengthening the development of transcultural research evidence for school-based interventions in multi-ethnic societies.
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Affiliation(s)
- Sofie de Smet
- KU Leuven, University of Leuven, Belgium; Ghent University, Belgium.
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Gotlib J, Cieślak I, Wawrzuta D, Jaworski M, Theofanidis D, Wójcik G, Małkowski P, Panczyk M. Challenges in Job Seeking and the Integration of Ukrainian War Refugee Healthcare Workers Into the Polish Healthcare System: Facebook Content Analysis. Int J Public Health 2023; 68:1606139. [PMID: 37732329 PMCID: PMC10507166 DOI: 10.3389/ijph.2023.1606139] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Objectives: The full-scale Russian invasion of Ukraine resulted in a refugee crisis. The terms of employment of Ukrainian Refugee background Medical Professionals (UKR-MPs) in the Polish healthcare system were liberalised. The aim of the study was to identify challenges in job seeking and the integration of Ukrainian war refugee healthcare workers into the Polish healthcare system. Methods: A qualitative, descriptive study based on content thematic analysis of Facebook content. We analyzed 1,700 posts published on two public Facebook groups intended for UKR-MPs. Results: The most common problems encountered by UKR-MPs were: 1) lack of easy-to-understand information about the list of documents necessary to apply for a work permit, 2) lack of feedback from those responsible for handling individual cases, and 3) long waiting time for the decision issued by the Ministry of Health. Conclusion: Despite the promptly implemented solutions enabling access to the job market by UKR-MPs, the refugees have encountered considerable administrative difficulties, as well as those arising from insufficient knowledge of the regulations on working as medical professionals in Poland under the EU law.
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Affiliation(s)
- Joanna Gotlib
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Ilona Cieślak
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Dominik Wawrzuta
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Jaworski
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Piotr Małkowski
- Department of Surgical, Transplant Nursing and Extracorporeal Treatment, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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Spaas C, Said-Metwaly S, Skovdal M, Primdahl NL, Jervelund SS, Hilden PK, Andersen AJ, Opaas M, Soye E, Watters C, Verelst A, Derluyn I, Colpin H, Haene LD. School-based Psychosocial Interventions' Effectiveness in Strengthening Refugee and Migrant Adolescents' Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study. PSYCHOSOCIAL INTERVENTION 2023; 32:177-189. [PMID: 37691715 PMCID: PMC10484026 DOI: 10.5093/pi2023a12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/30/2023] [Indexed: 09/12/2023]
Abstract
School-based psychosocial interventions are increasingly put forward as a way to support young refugees' and migrants' well-being and mental health in resettlement. However, the evidence on these interventions' effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth's mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.
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Affiliation(s)
- Caroline Spaas
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
| | - Sameh Said-Metwaly
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
- Damanhour UniversityEgyptDamanhour University, Egypt;
| | - Morten Skovdal
- University of CopenhagenDenmarkUniversity of Copenhagen, Denmark;
| | | | | | - Per Kristian Hilden
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Arnfinn J. Andersen
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Marianne Opaas
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Emma Soye
- University of SussexSchool of Education and Social WorkUKSchool of Education and Social Work, University of Sussex, UK;
| | - Charles Watters
- University of SussexSchool of Education and Social WorkUKSchool of Education and Social Work, University of Sussex, UK;
| | - An Verelst
- Ghent UniversityBelgiumGhent University, Belgium
| | - Ilse Derluyn
- Ghent UniversityBelgiumGhent University, Belgium
| | - Hilde Colpin
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
| | - Lucia De Haene
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
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Cowling MM, Anderson JR. The effectiveness of therapeutic interventions on psychological distress in refugee children: A systematic review. J Clin Psychol 2023. [PMID: 36634291 DOI: 10.1002/jclp.23479] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To systematically review existing research exploring the effectiveness of psychological interventions in reducing symptoms of distress amongst refugee and asylum-seeker children. METHOD Six databases were searched to identify English studies presenting original empirical quantitative data (published before September 2022) testing the efficacy of psychological interventions for children from refugee and asylum-seeking backgrounds. Quality of studies were assessed through the Appraisal Tool for Cross-Sectional Studies as well as the Cochrane Risk of Bias Tool. Relevant data were extracted to facilitate a narrative synthesis. RESULTS Seventy-one eligible articles were identified (n > 10,000). A number of cognitive-behavioral, psychosocial, and trauma-focused interventions that catered specifically to children and their families were identified. A synthesis of these results suggest that interventions may assist in the reduction of various psychopathologies, although the effects were mixed across intervention types. CONCLUSIONS While the review yielded promising findings, most findings were derived from small pilot and empirical studies, leading to difficulties with drawing conclusions. There remains a need for studies using more rigorous research methodologies to expand and ratify this valuable knowledge base. CLINICAL SIGNIFICANCE Forced displacement is at an all-time high. Many children are being forced to seek asylum and refuge, and they become vulnerable to the development of poor mental health, with limited understanding surrounding how to appropriately intervene. This review aims to equip clinicians with increased knowledge and confidence in working therapeutically alongside clients from refugee or asylum-seeking background, with the goal of fostering positive mental health and wellbeing.
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Affiliation(s)
- Misha M Cowling
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Joel R Anderson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.,Australian Research Centre in Sex, Health, & Society, La Trobe University, Melbourne, Australia
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Costanza A, Amerio A, Aguglia A, Magnani L, Huguelet P, Serafini G, Pompili M, Amore M. Meaning-centered therapy in Ukraine's war refugees: An attempt to cope with the absurd? Front Psychol 2022; 13:1067191. [PMID: 36619113 PMCID: PMC9815542 DOI: 10.3389/fpsyg.2022.1067191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland,Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy,*Correspondence: Andrea Amerio ✉
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Magnani
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Philippe Huguelet
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland,Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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8
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Karamehic-Muratovic A, Sichling F, Doherty C. Perceptions of Parents' Mental Health and Perceived Stigma by Refugee Youth in the U.S. Context. Community Ment Health J 2022; 58:1457-1467. [PMID: 35396648 DOI: 10.1007/s10597-022-00958-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/04/2022] [Indexed: 01/27/2023]
Abstract
Refugees are at an increased risk of mental health problems due to the multiple traumas experienced. Mental health help-seeking and utilization remains low among resettled refugees in the US, however, with stigma as a major barrier. The goal of this paper was to explore second-generation youth's perceptions of parents' mental health and perceived stigma. Data includes in-depth interviews with 62 Bosnian youth resettled in St. Louis. Results indicate that from the perspective of their children, first-generation refugee parents continue to face mental health challenges. The findings show that parents' and youth's understanding of mental health is tied to cultural stigma surrounding mental health. Additionally, intergenerational trauma might be affecting the child-parent relationship. As mass violence around the world continues and people are at continued risk of becoming refugees, this study contributes by advancing research on the long-term mental health and well-being of refugees and their children.
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Affiliation(s)
- Ajlina Karamehic-Muratovic
- Department of Sociology and Anthropology, Saint Louis University, 3700 Lindell Blvd, St. Louis, MO, 63108, USA.
| | - Florian Sichling
- Department of Social Work, University of Missouri St. Louis, One University Blvd., St. Louis, MO, 63121, USA
| | - Caroline Doherty
- Department of Sociology and Anthropology, Saint Louis University, 3700 Lindell Blvd, St. Louis, MO, 63108, USA
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Im H, Swan LET. Factors Influencing Improvement of Trauma-Related Symptoms Among Somali Refugee Youth in Urban Kenya. Community Ment Health J 2022; 58:1179-1190. [DOI: https:/doi.org/10.1007/s10597-021-00928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/29/2021] [Indexed: 06/22/2023]
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10
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Im H, Swan LET. Factors Influencing Improvement of Trauma-Related Symptoms Among Somali Refugee Youth in Urban Kenya. Community Ment Health J 2022; 58:1179-1190. [PMID: 35013831 DOI: 10.1007/s10597-021-00928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/29/2021] [Indexed: 11/03/2022]
Abstract
Somali refugee youth present with a heightened risk for common mental disorders (CMDs), and yet few studies have discussed factors influencing mental health outcomes after psychosocial interventions. This study aimed to identify key factors that contribute to the improvement of CMD symptoms among Somali youth displaced in urban Kenya. Logistic regression analyses revealed that trauma exposure and emotional coping predict overall symptom improvement, pointing to a differential intervention effect on those with differing levels of religious belief and attitudes toward violence. This study provides insights into how psychosocial factors likely contribute to positive intervention outcomes in Somali refugee youth.
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Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Ave., 3rd Floor, Richmond, VA, 23284, USA.
| | - Laura E T Swan
- Department of Population Health Sciences, University of Wisconsin - Madison, 610 Walnut St., Madison, WI, 53726, USA
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Velu ME, Martens I, Shahab M, de Roos C, Jongedijk RA, Schok M, Mooren T. Trauma-focused treatments for refugee children: study protocol for a randomized controlled trial of the effectiveness of KIDNET versus EMDR therapy versus a waitlist control group (KIEM). Trials 2022; 23:347. [PMID: 35461281 PMCID: PMC9034070 DOI: 10.1186/s13063-022-06178-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prevalence of posttraumatic stress disorder (PTSD) in refugees is reportedly higher in comparison to the general population. Refugee children specifically are often coping with trauma and loss and are at risk for mental health difficulties. With staggering numbers of people seeking refuge around the world and 50% being 18 years or younger, research examining the effects of trauma-focused therapies for refugee children with PTSD is highly needed. Both Eye Movement Desensitization and Reprocessing (EMDR) therapy and the child version of Narrative Exposure Therapy (KIDNET) have been used for refugees, although these treatment methods have not been systematically compared. The aim of the current study is to investigate the effectiveness of EMDR and KIDNET, compared to a waitlist control group and with each other, offered to refugee children. METHODS A randomized controlled three-arm trial has been designed. The primary outcome is PTSD diagnosis and symptom severity assessed with the Clinician-Administered PTSD Scale for Children DSM5 (CAPS-CA-5) at baseline (T1), 1 month post-treatment, or after 8 weeks of waiting (T2) and 3 months follow-up (T3). Additionally, instruments to assess posttraumatic stress symptoms, behavioral and emotional problems, and quality of life perception in children aged 8-18 are conducted at T1, T2, and T3. DISCUSSION This is the first RCT that examines the effectiveness of EMDR and KIDNET in refugee children aged 8-18 years specifically, compared to a waitlist control group intended to reduce PTSD diagnosis and severity of posttraumatic stress symptoms and comorbid complaints in a growing and challenging population. TRIAL REGISTRATION Dutch Trial Register NL40769 . Retrospectively registered on June 16, 2021.
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Affiliation(s)
- Merel E Velu
- ARQ Centrum'45, partner in ARQ National Psychotrauma Centre, Diemen, The Netherlands. .,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.
| | - Irene Martens
- ARQ Centrum'45, partner in ARQ National Psychotrauma Centre, Oegstgeest, The Netherlands
| | - Mona Shahab
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.,Department of Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,King Salman Center for Disability Research, Riyadh, Saudi Arabia
| | - Carlijn de Roos
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Ruud A Jongedijk
- ARQ Centrum'45, partner in ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Michaela Schok
- ARQ Centrum'45, partner in ARQ National Psychotrauma Centre, Diemen, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - T Mooren
- ARQ Centrum'45, partner in ARQ National Psychotrauma Centre, Diemen, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
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12
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Examination of PTSD and Depression Levels and Demographic Data of Syrian Refugee Children during the Pandemic. PSYCH 2022. [DOI: 10.3390/psych4020018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The worldwide population of child refugees is estimated to be over 10 million. Refugee children and adolescents are among the most vulnerable groups in the world, and the pandemic created new challenges for them. Objective: This study aimed to examine the PTSD and depression levels of Syrian refugee children and adolescents, the difficulties they experienced in access to food and education, and the changes in their family income, and evaluate the effects of these factors on symptom severities of depression and PTSD. Methods: We used data obtained from 631 Syrian refugee children between the ages of 7 and 15. Assessment measures for exposure to PTSD and depression included a socio-demographic form, stressors related to COVID-19, the Child and Adolescent Trauma Survey (CATS), and the patient-rated Children’s Depression Inventory (CDI). ANCOVA is conducted to evaluate the differences between the symptoms of PTSD and depression. The regression analysis was used to determine the relationship between the scales and the demographic data. Results: The study finds that 40.7% of the refugee children experienced at least one trauma, 24.9% met the criteria for PTSD, and 15.5% met the criteria for depression. The changes in income and food access are associated with PTSD and depression, while access to education is not associated with PTSD and depression. The adolescents aged between 12 and 15 show more depression and PTSD symptoms then the children aged between 7 and 11. Conclusions: The study revealed that the most risky group in refugee children and adolescents in terms of PTSD and depression were the adolescents aged between 12 and 15 and the children and adolescent whose family income was decreased and had limited access to food.
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13
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Kankaanpää R, Aalto S, Vänskä M, Lepistö R, Punamäki RL, Soye E, Watters C, Andersen A, Hilden PK, Derluyn I, Verelst A, Peltonen K. Effectiveness of psychosocial school interventions in Finnish schools for refugee and immigrant children, "Refugees Well School" in Finland (RWS-FI): a protocol for a cluster randomized controlled trial. Trials 2022; 23:79. [PMID: 35086535 PMCID: PMC8793091 DOI: 10.1186/s13063-021-05715-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools are natural environments in which to enhance young people's social and emotional skills, mental health, and contact between diverse groups, including students from refugee and immigrant backgrounds. A layered or tiered provision of services is recommended as it can be effective to meet the needs of war-affected adolescents who variably show mental health problems (such as posttraumatic stress disorder (PTSD)). The current protocol describes the study design for a multi-layered intervention model. The study will test the effectiveness of two interventions: a teacher-training intervention In-Service Teacher Training (INSETT) combined with targeted cognitive-behavioral treatment-based Teaching Recovery Techniques (TRT) and a classroom-focused preventive intervention Peer Integration and Enhancement Resources (PIER). We analyze, first, whether the interventions are effective in decreasing psychological distress and increasing positive resources, i.e., prosocial behavior and resilience among refugee and immigrant students. Second, we analyze which student-, school-, and parent-related factors mediate the possible beneficial changes. Third, we look at which groups the interventions are most beneficial to. METHODS A three-arm cluster RCT with parallel assignment, with a 1:1:1 allocation ratio, is applied in 16 schools that agreed to participate in the Refugees Well School interventions and effectiveness study. Schools were randomized to three conditions of two active interventions and a waiting list control condition. Students, their parents, and teachers in intervention and control schools participated in the study at baseline before the interventions, after the interventions, and at 6 to 12 months after the interventions. The primary effectiveness criterion variables are psychological distress (SDQ) symptoms, resilience (CYRM-12), and prosocial behavior (SDQ). DISCUSSION The current study presents a recommended universal approach of layered interventions aiming to reduce psychological distress and increase resilience among refugee and immigrant students. A combination of promotive, preventive, and targeted interventions may offer a holistic, ecological intervention package for schools to better address the needs of the whole group. TRIAL REGISTRATION ISRCTN ISRCTN64245549 . Retrospectively registered on 10 June 2020.
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Affiliation(s)
- Reeta Kankaanpää
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Sanni Aalto
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Riina Lepistö
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | | | - Emma Soye
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Charles Watters
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Arnfinn Andersen
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Per Kristian Hilden
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Ilse Derluyn
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - An Verelst
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - Kirsi Peltonen
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
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Renkens J, Rommes E, van den Muijsenbergh M. Refugees' Agency: On Resistance, Resilience, and Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020806. [PMID: 35055628 PMCID: PMC8775689 DOI: 10.3390/ijerph19020806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023]
Abstract
This study set out to answer the question ‘Which kinds of agency do refugees perform when dealing with mental health problems of themselves and their children?’. Aiming to gain more insight in why it seems harder for refugee parents and minors than for the native population to talk to health professionals about their mental health and wellbeing, we combined two theoretical notions of agency to investigate a broad spectrum of informants’ behaviour. We conducted 25 interviews with 30 refugees from 8 countries (Syria, Yemen, Iran, Afghanistan, Armenia, Eritrea, Turkish Kurdistan, Vietnam), whose Dutch residence permit varied from 26 years to less than one year. Data were analysed through open and axial coding, followed by pattern analyses. Although sometimes refugees seek (mental) healthcare, at other times they show agency by doing ‘nothing’ or by deliberately using distracting activities to deal with severe stress. Making use of resources available to them, oftentimes refugees show agency in ways that are less visible to healthcare professionals, by surviving, showing resilience, and suffering. In these cases, we think healthcare for refugees should intervene in a non-medical way, e.g., by supporting them to obtain resources that help refugees to (re)gain agency.
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Affiliation(s)
- José Renkens
- Department of Primary and Community Care, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands;
- Gender & Diversity Studies, Radboud University, 6525 GD Nijmegen, The Netherlands;
- School of Oganisation and Development, HAN University of Applied Sciences, 6525 EM Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-6-2819-6221
| | - Els Rommes
- Gender & Diversity Studies, Radboud University, 6525 GD Nijmegen, The Netherlands;
| | - Maria van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands;
- Pharos, Dutch Centre of Expertise on Health Disparities Utrecht, 3507 LH Utrecht, The Netherlands
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15
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Papadopoulos I, Lazzarino R, Sakellaraki O, Dadãu V, Apostolara P, Kuckert-Wöstheinrich A, Mauceri M, Kouta C. Empowering refugee families in transit: the development of a culturally competent and compassionate training and support package. J Res Nurs 2021; 27:200-214. [PMID: 35813174 PMCID: PMC9264421 DOI: 10.1177/17449871211018736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Refugee parents who fled conflicts suffered violence and traumas and face huge challenges in supporting the health and welfare of their children while in transit. Aims To describe the development of a culturally competent and compassionate training and support package (TSP) for nurses, social and health care workers and volunteers, with a focus on parenting needs among unsettled refugees fleeing conflict. Methods The multi-method approach included: a scoping review covering parenting needs of refugees fleeing conflict zones; collection of stories from refugee parents, healthcare workers and volunteers via a mobile application; discussions between team members; a piloted and evaluated curriculum. Results High levels of family distress and deterioration of parental identity were identified. Informed by these results, the curriculum is articulated along 20 bite-sized learning units, covering four age stages of childhood as well as targeting adults’ well-being. Pilot training was evaluated positively, confirming feasibility and usefulness of the TSP. Conclusions Unsettled refugee parents fleeing conflicts face psycho-social and practical difficulties negatively affecting their parenting skills. The care workforce should be trained in order to provide culturally competent and compassionate support to help these families. Open access digital platforms are promising as autodidactic and self-help tools among hard-to-reach populations.
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Affiliation(s)
- Irena Papadopoulos
- Head of the Research Centre, Department of Mental Health and Social Work, Middlesex University, UK
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
| | - Runa Lazzarino
- Anthropologist, Department of Mental Health and Social Work, Middlesex University, UK
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
| | - Ourania Sakellaraki
- Independent Consultant, Greece
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
| | - Victor Dadãu
- President, EDUNET Association, Romania
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
| | - Paraskevi Apostolara
- Lecturer, Nursing Department, National and Kapodistrian University of Athens, Greece
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
| | - Andrea Kuckert-Wöstheinrich
- Lecturer, Nursing Department, Vorarlberg University of Applied Sciences, Austria; Senior Project Manager, St. Augustinus Gruppe, Germany
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
| | - Manuela Mauceri
- Neuroscientist and Social Psychologist, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Italy
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
| | - Christiana Kouta
- Associate Professor, Department of Nursing, Cyprus University of Technology, Cyprus
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Mental Health of Refugee and Non-refugee Migrant Young People in European Secondary Education: The Role of Family Separation, Daily Material Stress and Perceived Discrimination in Resettlement. J Youth Adolesc 2021; 51:848-870. [PMID: 34686949 DOI: 10.1007/s10964-021-01515-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
While scholarly literature indicates that both refugee and non-refugee migrant young people display increased levels of psychosocial vulnerability, studies comparing the mental health of the two groups remain scarce. This study aims to further the existing evidence by examining refugee and non-refugee migrants' mental health, in relation to their migration history and resettlement conditions. The mental health of 883 refugee and 483 non-refugee migrants (mean age 15.41, range 11-24, 45.9% girls, average length of stay in the host country 3.75 years) in five European countries was studied in their relation to family separation, daily material stress and perceived discrimination in resettlement. All participants reported high levels of post-traumatic stress symptoms. Family separation predicted post-trauma and internalizing behavioral difficulties only in refugees. Daily material stress related to lower levels of overall well-being in all participants, and higher levels of internalizing and externalizing behavioral difficulties in refugees. Perceived discrimination was associated with increased levels of mental health problems for refugees and non-refugee migrants. The relationship between perceived discrimination and post-traumatic stress symptoms in non-refugee migrants, together with the high levels of post-traumatic stress symptoms in this subsample, raises important questions on the nature of trauma exposure in non-refugee migrants, as well as the ways in which experiences of discrimination may interact with other traumatic stressors in predicting mental health.
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Piñeros-Ortiz S, Moreno-Chaparro J, Garzón-Orjuela N, Urrego-Mendoza Z, Samacá-Samacá D, Eslava-Schmalbach J. Mental health consequences of armed conflicts in children and adolescents: An overview of literature reviews. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2021; 41:424-448. [PMID: 34559491 PMCID: PMC8525875 DOI: 10.7705/biomedica.5447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 02/24/2021] [Indexed: 11/21/2022]
Abstract
Introduction: Armed conflicts affect the mental health of children and adolescents. Their outcomes in these populations have been documented identifying vulnerability and significant biopsychosocial damage as the most common factors. Objective: To identify and synthesize the mental health consequences of armed conflicts in children and adolescents. Materials and methods: We carried out a comprehensive and systematic search of reviews published until July 2019 in the MEDLINE (Ovid), EMBASE, Cochrane Central Register of Controlled Trials, and LILACS databases, as well as in additional sources. The information was retrieved and analyzed narratively by describing the characteristics and objectives of the studies and the mental health consequences of armed conflicts in three periods of time: pre-armed conflict, during the armed conflict, and post-conflict. Results. Out of 587 potentially relevant studies, we finally selected 72. In the pre-armed conflict period, we described in detail the psychological experiences and the anticipatory somatic symptoms. During the conflict, we identified regressive, behavioral, and cognitive symptoms such as enuresis, fear, sadness, aggression, hyperactivity, and inattention, among others. Direct mental health consequences such as adjustment disorders, depression, anxiety, and post-traumatic stress were also identified. Finally, in the postconflict period, we referred to the transmission of mental health consequences and resilience processes. On the other hand, we reviewed in depth the potential consequences of armed conflicts on biopsychosocial development, morality, identity, culture, education, and society. Conclusion. The development of mental health consequences due to the exposure to armed conflicts in these populations is a complex process that depends on the stage of the exposure, the length of the conflict, and contextual factors.
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Affiliation(s)
- Sandra Piñeros-Ortiz
- Grupo de Investigación Violencia y Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Departamento de Psiquiatría, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Jaime Moreno-Chaparro
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Escuela de Medicina, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D. C., Colombia.
| | - Nathaly Garzón-Orjuela
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Zulma Urrego-Mendoza
- Grupo de Investigación Violencia y Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia,Bogotá, D.C., Colombia.
| | - Daniel Samacá-Samacá
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Javier Eslava-Schmalbach
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Hospital Universitario Nacional de Colombia, Universidad Nacional de Colombia, Bogotá, D. C., Colombia.
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Yektaş Ç, Erman H, Tufan AE. Traumatic experiences of conditional refugee children and adolescents and predictors of post-traumatic stress disorder: data from Turkey. Nord J Psychiatry 2021; 75:420-426. [PMID: 33591886 DOI: 10.1080/08039488.2021.1880634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM We aimed to determine traumatic events, mental health problems and predictors of PTSD in a sample of conditional refugee children. METHODS The sociodemographic features, chief complaints, traumatic experiences and psychiatric diagnoses according to DSM-5 were evaluated retrospectively. RESULTS 20.7% (n = 70) of children experienced the armed conflict or exposed to firefights at their country of origin. Most common diagnoses were anxiety disorders (n = 82, 24.3%), major depressive disorder (n = 52, 15.4%) and PTSD (n = 43, 12.7%). Age, number of traumatic experiences, explosion and sexual violence are the most important predictors for PTSD. CONCLUSIONS Our results suggest that the number of traumas exposed as well as their nature predicted PTSD diagnosis. Refugee children have increased risk for psychiatric problems after migration and resettlement underlining the importance of an adequate follow-up for mental health and ensuring social support networks.
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Affiliation(s)
- Çiğdem Yektaş
- Department of Child and Adolescent Psychiatry, Associate Professor in Üsküdar University NP Hospital, Üsküdar University, İstanbul, Turkey
| | - Hakan Erman
- Child and Adolescent Psychiatrist, Güven Hospital, Ankara, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Child and Adolescent Psychiatrist, Abant İzzet Baysal Universtiy, Bolu, Turkey
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19
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Michalek JE, Lisi M, Awad D, Hadfield K, Mareschal I, Dajani R. The Effects of a Reading-Based Intervention on Emotion Processing in Children Who Have Suffered Early Adversity and War Related Trauma. Front Psychol 2021; 12:613754. [PMID: 33841247 PMCID: PMC8024483 DOI: 10.3389/fpsyg.2021.613754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/02/2021] [Indexed: 12/31/2022] Open
Abstract
Early adversity and trauma can have profound effects on children's affective development and mental health outcomes. Interventions that improve mental health and socioemotional development are essential to mitigate these effects. We conducted a pilot study examining whether a reading-based program (We Love Reading) improves emotion recognition and mental health through socialization in Syrian refugee (n = 49) and Jordanian non-refugee children (n = 45) aged 7-12 years old (M = 8.9, 57% girls) living in Jordan. To measure emotion recognition, children classified the expression in faces morphed between two emotions (happy-sad and fear-anger), while mental health was assessed using survey measures of optimism, depression, anxiety, distress, and insecurity. Prior to the intervention, both groups of children were significantly biased to interpret ambiguous facial expressions as sad, while there was no clear bias on the fear-anger spectrum. Following the intervention, we found changes in Syrian refugee children's bias in emotion recognition away from sad facial expressions, although this returned to pre-intervention levels 2 months after the end of the program. This shift in the bias away from sad facial expressions was not associated with changes in self-reported mental health symptoms. These results suggest a potential positive role of the reading intervention on affective development, but further research is required to determine the longer-term impacts of the program.
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Affiliation(s)
- Julia E. Michalek
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | - Matteo Lisi
- Department of Psychology, University of Essex, Colchester, United Kingdom
| | - Deema Awad
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | | | - Isabelle Mareschal
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | - Rana Dajani
- Biology and Biotechnology Department, Hashemite University, Zarqa, Jordan
- Jepson School of Leadership Studies, University of Richmond, Richmond, VA, United States
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20
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Berckmoes L, Turner S. Pursuing futures through children: Crisis, social reproduction, and transformation in Burundi’s transnational families. MIGRATION STUDIES 2021. [DOI: 10.1093/migration/mnab004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Based on multisited fieldwork in Kigali, Rwanda, Belgium, and the Netherlands following the political crisis in Burundi in 2015, we explore decisions and plans for the future among Burundians in exile. In this way, we contribute to research about future making and social reproduction in families in a transnational social field affected by crisis. Adding to the literature, we show the specific effects of crisis on transnational families’ practices and aspirations, such as parental efforts to prevent traumatic world views and the constant need for families to readjust their plans to ongoing crisis dynamics. We argue that as the violence has disrupted the migrant parents’ hopes for a better future for themselves, they redirect their efforts towards their children’s futures. We thus argue that not only future making practices but also aspirations should be seen as social and relational, particularly in times of crisis. In particular, the Burundians living in Rwanda, Belgium and the Netherlands seek to provide their offspring with the skills to become educated, social and moral beings, even it entails sacrificing their own lives and aspirations. Moreover, adding to debates on migrants’ efforts to reproduce their own cultural values and practices in host societies, we find that the Burundian parents attempt to change what they perceive as a ‘culture of hatred and vengeance’ with parenting practices. As such, we argue that many migrant parents explicitly pursue social transformation through their children.
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Affiliation(s)
- Lidewyde Berckmoes
- African Studies Center Leiden, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Simon Turner
- African Studies Center Leiden, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- Advanced Migration Studies, University of Copenhagen, Karen Blixensvej 4, DK-2300 København S, Denmark
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21
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Durbeej N, McDiarmid S, Sarkadi A, Feldman I, Punamäki RL, Kankaanpää R, Andersen A, Hilden PK, Verelst A, Derluyn I, Osman F. Evaluation of a school-based intervention to promote mental health of refugee youth in Sweden (The RefugeesWellSchool Trial): study protocol for a cluster randomized controlled trial. Trials 2021; 22:98. [PMID: 33509268 PMCID: PMC7841907 DOI: 10.1186/s13063-020-04995-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sweden is home to a large and growing population of refugee youths who may be at risk of mental health problems such as post-traumatic stress disorder (PTSD). Thus, there is a need for interventions that address mental health problems in these populations. Schools have been identified as an ideal setting for delivering such interventions as they offer a non-stigmatizing space and are often central to young refugees' social networks. The RefugeesWellSchool trial in Sweden will investigate an intervention comprising two programmes: Teaching Recovery Techniques (TRT) and In-service Teacher Training (INSETT), delivered in a school setting, among refugee youth. TRT is a group-based programme for children and adolescents, informed by Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). INSETT is a multi-module course for teachers providing information on trauma and the refugee experience to build teachers' cultural competence and capacity for supporting refugee youths in schools. METHODS This trial employs a cluster randomized-control design with two arms: (1) the intervention arm in which the TRT and INSETT programmes are offered (n = 350), (2) the wait-list control arm (n = 350) in which services are provided as usual until the TRT and INSETT programmes are offered approximately six months later. Data will be collected prior to the intervention, immediately following the intervention, and at three months post-intervention. Outcomes for the trial arms will be compared using linear mixed models or ANCOVA repeated measures as well as the Reliable Change Index (RCI). DISCUSSION This study will provide knowledge about the effectiveness of an intervention comprising two programmes: a group-based programme for youth reporting symptoms of PTSD and a training course for teachers, in order to build their competence and ability to support refugee youths in schools. TRIAL REGISTRATION ISRCTN, ISRCTN48178969 , Retrospectively registered 20/12/2019.
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Affiliation(s)
- Natalie Durbeej
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Serena McDiarmid
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Inna Feldman
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
| | - Raija-Leena Punamäki
- Faculty of Social Sciences, Psychology, FI- 30014, University of Tampere, Tampere, Finland
| | - Reeta Kankaanpää
- Faculty of Social Sciences, Psychology, FI- 30014, University of Tampere, Tampere, Finland
| | - Arnfinn Andersen
- Norwegian Centre for Violence and Traumatic Stress Studies, NO-0409 Oslo, Norway
| | - Per Kristian Hilden
- Norwegian Centre for Violence and Traumatic Stress Studies, NO-0409 Oslo, Norway
| | - An Verelst
- Faculty of Psychology and Educational Sciences, Department of Social Work and Social Pedagogy, Centre for the Social Study of Migration and Refugees, Ghent University, Ghent, Belgium
| | - Ilse Derluyn
- Faculty of Psychology and Educational Sciences, Department of Social Work and Social Pedagogy, Centre for the Social Study of Migration and Refugees, Ghent University, Ghent, Belgium
| | - Fatumo Osman
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 753 27 Uppsala, Sweden
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden
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22
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Bowe A. The Immigrant Paradox Among the UK’s Adolescents: Data from the LSYPE 2004–2010 Project. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2020. [DOI: 10.1007/s12134-019-00711-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Khawaja NG, Pekin C, Schweitzer RD. Factor structure and psychometric properties of the Hopkins Symptom Checklist: An investigation with culturally and linguistically diverse youth in Australia. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nigar G. Khawaja
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia,
| | - Clare Pekin
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia,
| | - Robert D. Schweitzer
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia,
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Dalexis RD, Cénat JM. Asylum seekers working in Quebec (Canada) during the COVID-19 pandemic: Risk of deportation, and threats to physical and mental health. Psychiatry Res 2020; 292:113299. [PMID: 32702554 PMCID: PMC7362783 DOI: 10.1016/j.psychres.2020.113299] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/10/2020] [Accepted: 07/12/2020] [Indexed: 10/29/2022]
Abstract
• Asylum seekers experienced childhood adversity, domestic violence, extreme poverty and precariousness, armed violence, rape, and detention. • In the context of the COVID-19 pandemic, Quebec (Canada), asylum seekers are on the frontlines, risking their lives to save the lives of others. • In addition to the anxiety associated with COVID-19, these asylum seekers are also concerned about being deported. • Regulation measures should be taken to prevent long-term mental health problems related to anxieties and worries generated by both COVID-19 and asylum status, particularly the fear of deportation.
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25
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McNeely CA, Sprecher K, Bates-Fredi D, Price OA, Allen CD. Identifying Essential Components of School-Linked Mental Health Services for Refugee and Immigrant Children: A Comparative Case Study. THE JOURNAL OF SCHOOL HEALTH 2020; 90:3-14. [PMID: 31779053 DOI: 10.1111/josh.12845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/26/2019] [Accepted: 04/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Foreign-born children rarely use traditional school mental health services. Comprehensive programs that combine mental health services with academic, economic, and socioemotional supports reach more foreign-born children and improve wellbeing. However, little practical guidance exists regarding how to best combine these diverse services. METHODS To identify essential service components and their organization, we interviewed 92 parents, school staff, mental health providers, and community agency staff from 5 school-linked mental health programs designed specifically to serve immigrant and refugee youth. RESULTS Foreign-born parents did not distinguish between academic, behavioral, and emotional help for their children; these western categorizations of functioning were not meaningful to them. Consequently, programs needed to combine 4 components, organized in a pyramid: family engagement, assistance with basic needs, assistance with adaptation to a new culture, and emotional and behavioral supports. Family engagement was the foundation upon which all other services depended. Assistance with economic and cultural stressors directly promoted emotional wellbeing and helped parents trust clinical mental health interventions. CONCLUSIONS Specific strategies to implement the 4 essential components include home visits by program staff, a one-stop parent center located in the school to help with basic needs, working with cultural brokers, and informed consent procedures that clearly explain recommended care without requiring immigrant and refugee parents to internalize western conceptualizations of psychopathology. Future evaluations should assess the cost and effectiveness of these strategies. These data are essential to advocate payment for these nonclinical services by traditional funding mechanisms.
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Affiliation(s)
- Clea A McNeely
- College of Nursing, University of Tennessee, Knoxville, Tennessee, 37996
| | | | - Denise Bates-Fredi
- Louisiana State University Health Science Center, MPH program, Shreveport, Louisiana, 71103
| | - Olga Acosta Price
- Center for Health and Health Care in Schools, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052
| | - Chenoa D Allen
- University of Missouri School of Health Professions, Columbia, Missouri, 65211
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26
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Cleary M, West S, Foong A, McLean L, Kornhaber R. Mental Health of Refugee Children: A Discursive Look at Causes, Considerations and Interventions. Issues Ment Health Nurs 2019; 40:665-671. [PMID: 31074671 DOI: 10.1080/01612840.2019.1585494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is a growing need both locally and internationally to manage the effects of traumatic and loss experiences on the development and recovery of refugee children and young people. Trauma, whether active or through deprivation, is degenerative, with crucial impact on developing bodies, brains and minds. This discursive article considers the nature and scope of the problem and draws on literature and current frameworks to suggest the importance of interventions and proactive protection of mental health for this sub-group of refugees. School is discussed as a place of primary intervention but also a player in creative and sophisticated multimodal integrative services. A range of approaches can be, and, indeed are used in response to mental health issues for children in detention or upon resettlement. Schooling represents one such solution, providing a multi-pronged approach to facilitate mental health improvement for these children. For children needing to recover from loss and trauma secondary to experiences as a refugee, school offers a developmentally appropriate space to mobilise and enhance recovery, both at a simple level and as part of more specialised secondary and tertiary level care. The implications for future practice among health care professionals is to understand the mental health plight of refugee children, through both their pre-arrival exposure to trauma and their post-arrival, detention setting, the key role that schooling can play in facilitating mental health, and the capacity to advocate for programmes and services to work collaboratively with schools to achieve greater access for refugee children.
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Affiliation(s)
- Michelle Cleary
- a College of Health and Medicine , University of Tasmania , Sydney , NSW , Australia
| | - Sancia West
- a College of Health and Medicine , University of Tasmania , Sydney , NSW , Australia
| | - Andrew Foong
- a College of Health and Medicine , University of Tasmania , Sydney , NSW , Australia
| | - Loyola McLean
- b Brain and Mind Centre, Faculty of Medicine and Health , The University of Sydney , Sydney , NSW , Australia.,c Westmead Psychotherapy Program, Western Sydney Local Health District and The University of Sydney, Discipline of Psychiatry , The University of Sydney, Cumberland Hospital , Parramatta , NSW , Australia.,d Consultation-Liaison Psychiatry , Royal North Shore Hospital , Sydney , NSW , Australia
| | - Rachel Kornhaber
- a College of Health and Medicine , University of Tasmania , Sydney , NSW , Australia
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Hodes M, Vostanis P. Practitioner Review: Mental health problems of refugee children and adolescents and their management. J Child Psychol Psychiatry 2019; 60:716-731. [PMID: 30548855 DOI: 10.1111/jcpp.13002] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 11/29/2022]
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.
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Affiliation(s)
- Matthew Hodes
- Centre for Psychiatry, Imperial College London, London, UK
| | - Panos Vostanis
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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De Koker R, Lambers S, Vercruysse L. Occupational therapy at ‘Klein Kasteeltje’ in Brussels for children of asylum seekers who cannot participate in the Belgian schooling system. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2019. [DOI: 10.1080/14473828.2019.1570703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Addressing Marginality and Exclusion: The Resettlement Experiences of War-Affected Young People in Quebec, Canada. CHILDREN (BASEL, SWITZERLAND) 2019; 6:children6020018. [PMID: 30704146 PMCID: PMC6406435 DOI: 10.3390/children6020018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/25/2019] [Accepted: 01/27/2019] [Indexed: 11/17/2022]
Abstract
Accessing meaningful forms of support can be an onerous experience for young people resettling from war-affected contexts. In addition to facing linguistic and financial barriers in this process, these young people negotiate care systems that are often structurally and culturally insensitive to their unique needs, values, beliefs, and intersectional experiences of oppression. Drawing on interviews with 22 young people from war-affected areas living in Quebec, Canada, this paper critically examines how dominant cultural norms and social relations in Quebec's health, social and educational services network shape their experiences in seeking care, healing and belonging. Alternative care systems and approaches, as proposed by the participants, are then explored. The findings emphasize the need for spaces and care services where war-affected young people's identities and lived realities are validated and represented.
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Kronick R. Mental Health of Refugees and Asylum Seekers: Assessment and Intervention. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:290-296. [PMID: 29207884 PMCID: PMC5912300 DOI: 10.1177/0706743717746665] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
With unprecedented numbers of displaced persons worldwide, mental health clinicians in high-income countries will increasingly encounter refugee and asylum-seeking patients, many of whom have experienced significant adversity before and after their migration. This paper presents a summary of the recent evidence on the assessment and treatment of refugees across the lifespan to inform clinicians' approaches to care of refugee patients in mental health care settings. Assessment and interventions for refugees are grounded in an ecosystemic approach which considers not only pre-migratory trauma, but social, familial, and cultural determinants of mental health in the host country. Evidence for psychotherapy and pharmacological treatments are reviewed, highlighting promising interventions while acknowledging that further research is needed. Ultimately, serving refugees necessitates a biopsychosocial approach that engages clinicians as medical experts, therapists, and advocates.
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Affiliation(s)
- Rachel Kronick
- Centre for Child Development and Mental Health, Jewish General Hospital, Lady Davis Institute, Montréal, Quebec, Canada
- Division of Social and Transcultural Psychiatry, McGill University, Montréal, Quebec, Canada
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Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools. Eur J Pediatr 2018; 177:163-169. [PMID: 29124447 DOI: 10.1007/s00431-017-3027-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
Abstract
UNLABELLED Currently hundreds of thousands of minor refugees entered Europe. This group has been exposed to traumatic events pre-, during, and post-migration and is at increased risk of developing psychiatric disorders. In this article, we describe the results of our literature search on screening and interventions for post-traumatic stress disorder (PTSD) in minor refugees, in order to make recommendations for clinical practice. Results show that studies on diagnostic accuracy of assessment instruments and efficacy of mental healthcare interventions in this population are lacking. Traumatic experiences pre-flight, during the flight and at resettlement, superimposed by parental PTSD, and other contextual factors, might lead to more than 25% of minor refugees developing PTSD. CONCLUSION To enhance the number of minor refugees recognized with PTSD, we recommend the use of a brief screening instrument. A public health approach, focusing on environmental supportive factors is the first step in treatment for this group, followed by short-term psychological group interventions focusing on psycho-education and stress reduction. Minor refugees with no improvement in PTSD symptoms by these interventions need referral to specialized mental health care services. Mental health providers should be culturally competent. What is Known: • Post-traumatic stress disorder, anxiety, sleeping problems, and depression are the most common psychiatric disorders in minor refugees. • Evidence based methods on screening and interventions in minor refugees with psychiatric disorders are lacking. What is New: • In the absence of validated screening tools a best practice reliable, quick and child-friendly tool is presented. • A layered system for mental health care and psychosocial support in minor refugees is explained.
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Kim SY, Schwartz SJ, Perreira KM, Juang LP. Culture's Influence on Stressors, Parental Socialization, and Developmental Processes in the Mental Health of Children of Immigrants. Annu Rev Clin Psychol 2018; 14:343-370. [PMID: 29401046 DOI: 10.1146/annurev-clinpsy-050817-084925] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Children of immigrants represent one in four children in the United States and will represent one in three children by 2050. Children of Asian and Latino immigrants together represent the majority of children of immigrants in the United States. Children of immigrants may be immigrants themselves, or they may have been born in the United States to foreign-born parents; their status may be legal or undocumented. We review transcultural and culture-specific factors that influence the various ways in which stressors are experienced; we also discuss the ways in which parental socialization and developmental processes function as risk factors or protective factors in their influence on the mental health of children of immigrants. Children of immigrants with elevated risk for mental health problems are more likely to be undocumented immigrants, refugees, or unaccompanied minors. We describe interventions and policies that show promise for reducing mental health problems among children of immigrants in the United States.
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Affiliation(s)
- Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas, Austin, Texas 78712, USA;
| | - Seth J Schwartz
- Department of Epidemiology and Public Health, University of Miami, Miami, Florida 33136, USA;
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA;
| | - Linda P Juang
- Inclusive Education Group, College of Human Sciences, University of Potsdam, 14476 Potsdam, Germany;
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Tam SY, Houlihan S, Melendez-Torres GJ. A Systematic Review of Longitudinal Risk and Protective Factors and Correlates for Posttraumatic Stress and Its Natural History in Forcibly Displaced Children. TRAUMA, VIOLENCE & ABUSE 2017; 18:377-395. [PMID: 26721887 DOI: 10.1177/1524838015622437] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Posttraumatic stress (PTS) results in significant distress or functional impairment. Prevalence studies report higher rates of PTS in forcibly displaced children (FDC). Current evidence deriving mainly from cross-sectional studies is unable to make causal attributions. Given rising rates of forcible displacement reported by the United Nations High Commissioner for Refugees (UNHCR) in 2014, there is increasing need to determine the best policies and practice for engaging mental health needs of FDC. METHODS This systematic review identifies (1) longitudinal risk and protective factors and correlates for PTS and (2) its natural history in FDC, contributing to research identifying vulnerable subgroups and malleable factors for PTS and understanding its natural history. No meta-analysis was conducted due to heterogeneity; results were analyzed through narrative synthesis. RESULTS Eleven longitudinal studies were identified. All but one were prospective cohort designs. They identified prevalence rates between 20% and 48.7% at baseline, 10% and 48.3% at 1 year ( k = 7), 18% and 48% at 2-3 years ( k = 2), 8% and 38% at 6 years ( k = 2), and 35% at 12 years using nine measurement methods in seven independent samples. Evidence from multiple associations supported the following risk factors: exposure to traumatic stressors or other stress, older age, and prior psychopathology. Evidence predominantly supported the stability of PTS with some decline. CONCLUSION While results should be interpreted with caution given small or unrepresentative samples, they suggest regular mental health screenings should be conducted for FDC, who are a vulnerable subgroup with variable onset and remission. Risk associations with prior psychopathology also suggest that screening upon arrival may be advisable for early intervention and prevention.
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Affiliation(s)
- Stephanie Y Tam
- 1 Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Shea Houlihan
- 1 Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - G J Melendez-Torres
- 1 Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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Factors Affecting Depressive Symptoms among North Korean Adolescent Refugees Residing in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080912. [PMID: 28805719 PMCID: PMC5580615 DOI: 10.3390/ijerph14080912] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/01/2017] [Accepted: 08/08/2017] [Indexed: 11/16/2022]
Abstract
We examined factors affecting the depressive symptoms and the relationship between depression and quality of life among 131 North Korean adolescent refugees aged 12–24 years. We compared sociodemographic, social, and individual characteristics and perceived the quality of life between participants with and without depression. Thirty-seven refugees (28.2%) had clinically significant depressive symptoms. The refugees with depression were younger (t = 2.67; p = 0.009), more likely to be male (χ2 = 6.98; p = 0.009), and more likely to have a Chinese father (χ2 = 9.05; p = 0.003) than those without depression. The refugees with depression had lower levels of psychological social support (t = 2.96; p = 0.004) and resilience (t = 4.24; p < 0.001) and higher levels of alcohol problems (t = −2.08; p = 0.043), aggression (t = −3.15; p = 0.003), and post-traumatic stress disorder (PTSD; t = −2.89; p = 0.004). They also reported lower levels of life satisfaction (t = 3.31; p = 0.001) and had a more negative view of their future (t = 2.68; p = 0.010). Interventions to increase resilience, to decrease the impact of traumatic events, and to provide psychological support may be helpful for North Korean adolescent refugees at risk of depression.
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Yalın Sapmaz Ş, Uzel Tanrıverdi B, Öztürk M, Gözaçanlar Ö, Yörük Ülker G, Özkan Y. Immigration-related mental health disorders in refugees 5-18 years old living in Turkey. Neuropsychiatr Dis Treat 2017; 13:2813-2821. [PMID: 29180867 PMCID: PMC5691958 DOI: 10.2147/ndt.s150592] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study assessed early-onset psychiatric disorders and factors related to these disorders in a group of refugee children after immigration due to war. MATERIALS AND METHODS This study was conducted between January 2016 and June 2016. Clinical interviews were conducted with 89 children and their families, and were performed by native speakers of Arabic and Persian who had been primarily educated in these languages and were living in Turkey. A strengths and difficulties questionnaire (SDQ) that had Arabic and Persian validity and reliability was applied to both children and their families. Independent variables for cases with and without a psychiatric disorder were analyzed using the χ2 test for categorical variables, Student's t-test for those that were normally distributed, and Mann-Whitney U-test for data that were not normally distributed. Data that showed significant differences between groups who had a psychiatric disorder and on common effects in emerging psychiatric disorders were analyzed through binary logistic regression analysis. RESULTS A total of 89 children and adolescents were interviewed within the scope of the study. The mean age of cases was 9.96±3.98 years, and 56.2% (n=50) were girls, while 43.8% (n=39) were boys. Among these children, 47 (52.8%) had come from Syria, 27 (30.3%) from Iraq, 14 (15.7%) from Afghanistan, and 1 (1.1%) from Iran. A psychiatric disorder was found in 44 (49.4%) of the children. A total of 26 children were diagnosed with anxiety disorders, 12 with depressive disorders, 8 with trauma and related disorders, 5 with elimination disorders, 4 with attention deficit/hyperactivity disorder, and 3 with intellectual disabilities. It was determined that seeing a dead or injured person during war/emigration and the father's unemployment increased the risk of psychopathology. The OR was 7.077 (95% CI 1.722-29.087) for having seen a dead or injured individual and 4.51 (95% GA 1.668-12.199) for father's employment status. CONCLUSION Within the context of war and emigration, these children try to cope with the negative circumstances they experience prior to migration, as well as the despair they see their parents experience.
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Affiliation(s)
| | | | | | | | - Gülsüm Yörük Ülker
- Department of Psychology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Yekta Özkan
- Department of Child and Adolescent Psychiatry
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Reinelt T, Vasileva M, Petermann F. Psychische Auffälligkeiten von Flüchtlingskindern. KINDHEIT UND ENTWICKLUNG 2016. [DOI: 10.1026/0942-5403/a000207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Die gestiegenen Flüchtlingszahlen in den letzten Jahren werden von einer erhöhten Forschungstätigkeit begleitet. Viele dieser Studien in der Klinischen Kinderpsychologie und Kinder-/Jugendpsychiatrie beschäftigen sich dabei mit psychischen Auffälligkeiten bei Flüchtlingskindern, insbesondere der Posttraumatischen Belastungsstörung und depressiven Symptomen. Als Ursache dieser Auffälligkeiten werden dabei vor allem traumatisierende Erlebnisse vor oder während der Flucht angenommen. Diese traumafokussierte Sichtweise greift jedoch zu kurz, da sie (a) Prozesse von Resilienz (b) den Einfluss von Akkulturation auf das psychische Befinden und (c) die unmittelbare Erfüllung von primären Grundbedürfnissen nach einer Flucht vernachlässigt.
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Affiliation(s)
- Tilman Reinelt
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Mira Vasileva
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Williams B, Cassar C, Siggers G, Taylor S. Medical and social issues of child refugees in Europe. Arch Dis Child 2016; 101:839-42. [PMID: 27470163 DOI: 10.1136/archdischild-2016-310657] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 07/03/2016] [Indexed: 11/03/2022]
Abstract
In mid-2015, there were an estimated 20.2 million refugees in the world; over half of them are children. Globally, this is the highest number of refugees moving across borders in 20 years. The rights of refugee children to access healthcare and be free from arbitrary detention are enshrined in law. Unaccompanied asylum-seeking children have a statutory medical assessment, but refugee children arriving with their families do not. Paediatricians assessing both unaccompanied and accompanied refugee children must be alert to the possibilities of nutritional deficiencies, infectious diseases, dental caries and mental health disorders and be aware of the national and international health guidance available for support.
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Affiliation(s)
- Bhanu Williams
- Department of Paediatrics, Northwick Park Hospital, London North West Healthcare NHS Trust, UK, Royal College of Paediatrics and Child Health (Global Team), UK
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Barghadouch A, Kristiansen M, Jervelund SS, Hjern A, Montgomery E, Norredam M. Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1125-36. [PMID: 27333980 DOI: 10.1007/s00127-016-1260-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 06/15/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country. METHODS This study compared 24,427 refugee children from Asia, The Middle East, Sub-Saharan Africa and former Yugoslavia, who obtained residency in Denmark between 1 January 1993 and 31 December 2010 with 146,562 Danish-born children, matched 1:6 on age and sex. The study looked at contacts with psychiatric hospitals as well as psychologists and psychiatrists in private practice. RESULTS Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40-0.45) among refugee boys and 0.35 (95 % CI 0.33-0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. CONCLUSIONS Refugee children used fewer psychiatric healthcare services than Danish-born children. This may indicate that refugee children experience barriers in accessing psychiatric healthcare systems and do not receive adequate assessment of their mental health and subsequent referral to specialist services.
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Affiliation(s)
- Amina Barghadouch
- Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark.
| | - Maria Kristiansen
- Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark
| | - Signe Smith Jervelund
- Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark
| | - Anders Hjern
- Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, Stockholm, Sweden.,Clinical Epidemiology, Department of Medicine, Karolinska Institutet/Stockholm University, Stockholm, Sweden
| | | | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark.,Section of Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
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Sleijpen M, Boeije HR, Kleber RJ, Mooren T. Between power and powerlessness: a meta-ethnography of sources of resilience in young refugees. ETHNICITY & HEALTH 2016; 21:158-80. [PMID: 26107385 DOI: 10.1080/13557858.2015.1044946] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE This article reviews available qualitative studies that report young refugees' ways of dealing with adversity to address their sources of resilience. DESIGN We searched five electronic databases. Twenty-six empirical studies were included in the review. A meta-ethnography approach was used to synthesize these qualitative studies. RESULTS Six sources of resilience emerged: (1) social support, (2) acculturation strategies, (3) education, (4) religion, (5) avoidance, and (6) hope. These sources indicated social as well as personal factors that confer resilience in young refugees, but most of them also had counterproductive aspects. CONCLUSION The results, from an ecological developmental perspective, stressed the interplay between protective and risk processes in the mental health of young refugees who had resettled in Western countries, and they emphasized the variability as well as the universality of resilience-promoting processes. Further research is needed to explore the cultural shape of resilience and the long-term consequences of war and migration on young refugees.
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Affiliation(s)
- Marieke Sleijpen
- a Foundation Arq , Diemen , the Netherlands
- b Department of Clinical & Health Psychology , Utrecht University , Utrecht , the Netherlands
| | - Hennie R Boeije
- c Department of Methodology and Statistics , Utrecht University , Utrecht , the Netherlands
| | - Rolf J Kleber
- a Foundation Arq , Diemen , the Netherlands
- b Department of Clinical & Health Psychology , Utrecht University , Utrecht , the Netherlands
| | - Trudy Mooren
- a Foundation Arq , Diemen , the Netherlands
- d Foundation Centrum'45 , Oegstgeest , the Netherlands
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Abstract
Violence has been shown to be a global challenge resulting in long-lasting social, medical, and mental health sequelae. In this article, we focus on massive social violence, such as war and civil war. Social suffering and mental health problems related to violence as a global public health problem can be tackled only with a holistic approach that addresses the specific region, culture and group and the limited resources available in most countries. Research that can give a reliable assessment of complex long-term outcomes is still largely missing, and can be seen as a major and complex challenge for future study.
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Affiliation(s)
- Thomas Wenzel
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Guertel 18, Vienna A-1090, Austria.
| | - Hanna Kienzler
- Department of Social Science, Health and Medicine, King's College London, Strand, London WC2R 2LS, UK
| | - Andreas Wollmann
- Sigmund Freud University, Schnirchgasse 3A, Vienna A-1030, Austria
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Mace AO, Mulheron S, Jones C, Cherian S. Educational, developmental and psychological outcomes of resettled refugee children in Western Australia: a review of School of Special Educational Needs: Medical and Mental Health input. J Paediatr Child Health 2014; 50:985-92. [PMID: 24976219 DOI: 10.1111/jpc.12674] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2014] [Indexed: 12/12/2022]
Abstract
AIM There are limited data regarding the educational backgrounds and associated psychological and developmental outcomes of refugee children resettling in Western Australia (WA). The WA paediatric Refugee Health Service (RHS) revised its first consult questionnaire (August 2011) to increase educational and psychosocial documentation, concurrent with engagement of a School of Special Educational Needs: Medical and Mental Health (SSEN: MMH) liaison teacher. This study aims to utilise these data to increase understanding of this cohort's educational, developmental and psychological needs and to describe SSEN: MMH's role within the RHS. METHODS Retrospective audit and analyses were performed on all initial standardised questionnaires for school-aged refugee children (4-18 years) and SSEN: MMH referrals between August 2011 and December 2012. RESULTS Demographic data from 332 refugees are described (mean age 9.58 ± standard deviation 3.43 years). Detailed educational information was available for 205 children. Prior education was limited (median 2 years), 64.9% experienced likely schooling interruption and 55.8% received education in their primary language. Language development concerns were significantly associated with previous education in a second language (odds ratio (OR) 4.55, P < 0.05). Other severe developmental and schooling issues were uncommon at presentation, with few correlations to prior education. In contrast, several migration factors, including family separation and mandatory detention, were significantly associated with psychological comorbidities such as post-traumatic stress disorder (OR 5.60, P < 0.001 and OR 14.57, P < 0.001, respectively). SSEN: MMH reviewed 59 complex cases. Referral was significantly associated with multiple educational, developmental and psychological concerns. CONCLUSIONS Refugee children have varied migration, trauma and educational backgrounds, impacting on health and psychological outcomes. In-depth multidisciplinary history including prior education and psychosocial issues is recommended. Partnering with education services appears to play an effective, multifaceted role in aiding resettlement; however, longitudinal studies are required.
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Affiliation(s)
- Ariel Olivia Mace
- Department of Paediatric and Adolescent Medicine, Princess Margaret Hospital for Children, Child and Adolescent Health Service, Perth, Western Australia, Australia
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Refugee children and their families: supporting psychological well-being and positive adaptation following migration. Curr Probl Pediatr Adolesc Health Care 2014; 44:208-15. [PMID: 25042433 DOI: 10.1016/j.cppeds.2014.03.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The support of refugee children and their families is a worldwide concern. This article will highlight models of mental health care for refugee children and their families, focusing on collaborative care with primary care providers. Case vignettes are provided to illustrate how collaborative care can support refugee children׳s psychological well-being and positive adaptation following migration.
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Sleijpen M, June ter Heide FJ, Mooren T, Boeije HR, Kleber RJ. Bouncing forward of young refugees: a perspective on resilience research directions. Eur J Psychotraumatol 2013; 4:20124. [PMID: 23671759 PMCID: PMC3644055 DOI: 10.3402/ejpt.v4i0.20124] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 03/28/2013] [Accepted: 04/01/2013] [Indexed: 11/14/2022] Open
Abstract
While studies on the consequences of trauma and forced migration on young refugees have focused mainly on their pathology, a focus on resilience in young refugees is needed to adequately represent their response to adversity and to help understand their needs. The aim of this article is to present a proposed study of resilience in young refugees which has been informed by an overview of achievements and challenges in the field of resilience. IN ORDER TO ADVANCE THE FIELD OF RESILIENCE, SEVERAL TOPICS NEED CLARIFICATION: definition and assessment of resilience, the relation of resilience to other constructs and the underlying biological and external factors influencing resilience. With respect to young refugees, the cross-cultural applicability of resilience has to be examined. Qualitative research, mixed method designs, comparative studies, and longitudinal studies seem especially promising in furthering this goal. The proposed study compares refugee adolescents with Dutch adolescents. Data from qualitative evidence synthesis, interviews, questionnaires, experiments, and DNA analysis will be combined to provide a multifaceted picture of factors contributing to resilience, resulting in a better understanding and efficient use of "resilience" to meet the needs of traumatised youth.
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Affiliation(s)
- Marieke Sleijpen
- Foundation ARQ, Diemen, the Netherlands
- Department of Clinical & Health Psychology, Utrecht University, Utrecht, the Netherlands
| | | | - Trudy Mooren
- Foundation ARQ, Diemen, the Netherlands
- Foundation Centrum'45, Diemen, the Netherlands
| | - Hennie R. Boeije
- Department of Methodology and Statistics, Utrecht University, Utrecht, the Netherlands
| | - Rolf J. Kleber
- Foundation ARQ, Diemen, the Netherlands
- Foundation Centrum'45, Diemen, the Netherlands
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