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Daniel-Calveras A, Baldaquí N, Baeza I. Mental health of unaccompanied refugee minors in Europe: A systematic review. CHILD ABUSE & NEGLECT 2022; 133:105865. [PMID: 36095862 DOI: 10.1016/j.chiabu.2022.105865] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Nearly half of the refugee and asylum seeking population in Europe is under the age of 18, and many of these individuals are unaccompanied children and adolescents. OBJECTIVE The aim of this systematic review is both to summarize findings regarding the prevalence of mental health disorders among unaccompanied refugee minors (URM) in European countries since the last available systematic review (October 2017), and to describe associated risk factors. METHODS Five databases were systematically searched for articles published between October 1, 2017 and May 1, 2022. RESULTS The findings from 23 studies conducted in 9 countries which examined 80,651 child and adolescent URM are explained. Afghanistan was the most common country of origin in the majority of studies and >75 % of the subjects were boys. Most of the studies (N = 13, 56.5 %) assessed posttraumatic stress disorder (PTSD) prevalence. We found a high prevalence of mental health disorders among URM children and adolescents, which varied considerably between studies, ranging from 4.6 % to 43 % for (PTSD), 2.9 % to 61.6 % for depression, 32.6 % to 38.2 % for anxiety and 4 to14.3 % for behavioral problems. Two studies looking at suicide attempts and deaths, also observed higher rates in URM compared to the host population of the same age. The studies looking at mental health risk factors suggest that levels of social support in the host country, rearing environment, and other factors are associated with psychopathology. Moreover, a meta-analysis of four studies regarding PTSD in URM and accompanied refugee minors (ARM) showed a lower prevalence among ARM: -1.14 (95%CI:-1.56-0.72). CONCLUSIONS PTSD, depression and anxiety are the most prevalent problems among the URM population in Europe. Early intervention in host countries is needed in order to improve mental health outcomes for this vulnerable population and avoid possible neglect.
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Affiliation(s)
| | - Nuria Baldaquí
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, SGR-881 Barcelona, Spain
| | - Inmaculada Baeza
- Universitat de Barcelona, Barcelona, Spain; Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, ISCIII, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain.
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Magwood O, Kassam A, Mavedatnia D, Mendonca O, Saad A, Hasan H, Madana M, Ranger D, Tan Y, Pottie K. Mental Health Screening Approaches for Resettling Refugees and Asylum Seekers: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3549. [PMID: 35329237 PMCID: PMC8953108 DOI: 10.3390/ijerph19063549] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/24/2022]
Abstract
Refugees and asylum seekers often face delayed mental health diagnoses, treatment, and care. COVID-19 has exacerbated these issues. Delays in diagnosis and care can reduce the impact of resettlement services and may lead to poor long-term outcomes. This scoping review aims to characterize studies that report on mental health screening for resettling refugees and asylum seekers pre-departure and post-arrival to a resettlement state. We systematically searched six bibliographic databases for articles published between 1995 and 2020 and conducted a grey literature search. We included publications that evaluated early mental health screening approaches for refugees of all ages. Our search identified 25,862 citations and 70 met the full eligibility criteria. We included 45 publications that described mental health screening programs, 25 screening tool validation studies, and we characterized 85 mental health screening tools. Two grey literature reports described pre-departure mental health screening. Among the included publications, three reported on two programs for women, 11 reported on programs for children and adolescents, and four reported on approaches for survivors of torture. Programs most frequently screened for overall mental health, PTSD, and depression. Important considerations that emerged from the literature include cultural and psychological safety to prevent re-traumatization and digital tools to offer more private and accessible self-assessments.
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Affiliation(s)
- Olivia Magwood
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON K1N 7K4, Canada
| | - Azaad Kassam
- Department of Psychiatry, University of Ottawa, 75 Laurier Ave E, Ottawa, ON K1N 6N5, Canada;
- Pinecrest-Queensway Community Health Centre, 1365 Richmond Rd #2, Ottawa, ON K2B 6R7, Canada
- Ottawa Newcomer Health Centre, 291 Argyle, Ottawa, ON K2P 1B8, Canada
| | - Dorsa Mavedatnia
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada; (D.M.); (M.M.)
| | - Oreen Mendonca
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
| | - Ammar Saad
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 5B2, Canada
| | - Hafsa Hasan
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON M5T 3M6, Canada
| | - Maria Madana
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada; (D.M.); (M.M.)
| | - Dominique Ranger
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
| | - Yvonne Tan
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Faculty of Arts and Sciences, Queen’s University, 99 University Ave, Kingston, ON K7L 3N6, Canada
| | - Kevin Pottie
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Department of Family Medicine, Western University, London, ON N6A 3K7, Canada
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Zijlstra AE, Menninga MC, van Os ECC, Kalverboer ME. They ask for protection: An exploratory study into experiences with violence among unaccompanied refugee children in Dutch reception facilities. CHILD ABUSE & NEGLECT 2020; 103:104442. [PMID: 32163767 DOI: 10.1016/j.chiabu.2020.104442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 01/20/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Children placed under governmental supervision and staying in residential or foster care are more vulnerable to violence than children who live with their own families. One specific group of children staying in reception facilities under governmental supervision comprises unaccompanied refugee children who have fled to a host country without their parents. OBJECTIVE This qualitative study explores the experiences of unaccompanied children with regard to violence in reception facilities in the Netherlands from the perspective of the children. PARTICIPANTS AND SETTING 183 unaccompanied children (N = 183) sheltered in a variety of reception facilities in the Netherlands. METHOD Semi-structured interviews were conducted focusing on several topics related to their perceived quality of life. The transcripts of the interviews were analyzed for experiences with violence occurring inside the reception facilities. The codebook that was used was based on the categorization of maltreatment in the fourth United States National Incidence Study (NIS-4) and the interpretation of violence by the Committee on the Rights of the Child in General Comment No. 13 (GC 13). RESULTS A large share (66 %) of the unaccompanied children had experienced violence in various reception facilities. Most of the experiences reported had to do with either physical and emotional abuse and neglect or institutional violence. CONCLUSION The breadth of experiences of violence underlines the responsibility of the Dutch state to invest in the safe reception of unaccompanied children in order to protect their development, while also investing in further research on the prevalence of violence in the reception of unaccompanied children.
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Affiliation(s)
- A E Zijlstra
- Study Centre for Children, Migration and Law, Faculty of Behavioural and Social Sciences, University of Groningen, the Netherlands.
| | - M C Menninga
- Study Centre for Children, Migration and Law, Faculty of Behavioural and Social Sciences, University of Groningen, the Netherlands
| | - E C C van Os
- Study Centre for Children, Migration and Law, Faculty of Behavioural and Social Sciences, University of Groningen, the Netherlands
| | - M E Kalverboer
- Study Centre for Children, Migration and Law, Faculty of Behavioural and Social Sciences, University of Groningen, the Netherlands
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