1
|
Causevic S, Ekström AM, Orsini N, Kagesten A, Strömdahl S, Salazar M. Prevalence and associated factors for poor mental health among young migrants in Sweden: a cross-sectional study. Glob Health Action 2024; 17:2294592. [PMID: 38180014 PMCID: PMC10773640 DOI: 10.1080/16549716.2023.2294592] [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: 06/21/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Young migrants face multiple challenges that can affect their mental, sexual and reproductive health. OBJECTIVE To assess the prevalence of self-reported poor mental health and its associated demographic, post-migration and sexual risk behaviour factors among young migrants (aged 15-25) in Sweden. METHODS Data were drawn from a cross-sectional survey conducted with migrants aged 15-65 years old in Sweden between December 2018 and November 2019 (n = 6449). Among these, 990 participants aged 15-25 were eligible for the study. Mental health was measured using the Refugee Health Screener-13. Missing data indicator analysis and multivariable logistic regression models were conducted to estimate the association between mental health, sexual risk behaviour, demographic and migration-related variables. RESULTS Of the 990 participants, 59% reported poor mental health. Participants reporting poor mental health were more likely to be female (AOR:1.63, 95% CI:1.18-2.25), to have lived in Sweden more than three years (AOR:2.16, 95% CI:1.17-3.97), to engage in any sexual risk behaviour (AOR:1.99, 95% CI:1.25-3.17), and to live alone (AOR:1.95, 95% CI:1.25-3.03) or with friends they already knew (AOR:1.60, 95% CI:1.37-4.91). People arriving from the Americas (AOR:0.54, 95% CI:0.33-0.88), Asia (AOR:0.44, 95% CI:0.22-0.86), Europe (AOR:0.30, 95% CI:0.14-0.61) and Africa (AOR 0.37, 95% CI: 0.23-0.60) had lower odds of poor mental health than those arriving from Syria. CONCLUSION The prevalence of poor mental health among young migrants in Sweden was high, with specific subgroups (women, asylum seekers, people arriving from Syria, and those residing longer in Sweden) being particularly vulnerable. Our results indicate the interconnectedness between poor mental health and sexual risk behaviour in this population. Thus, policies targeting young migrants should ensure that healthcare services screen for both poor sexual and mental health at the same time.
Collapse
Affiliation(s)
- Sara Causevic
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Anna Mia Ekström
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
- Department of Infectious Diseases, South Central Hospital, Stockholm, Sweden
| | - Nicola Orsini
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
| | - Anna Kagesten
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
| | - Susanne Strömdahl
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
- Department of Medical Sciences, Infectious Medicine, Uppsala University, Uppsala, Sweden
- Swedish Public Health Agency, Stockholm, Sweden
| | - Mariano Salazar
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
| |
Collapse
|
2
|
de Montgomery CJ, Cullen AE, Taipale H, Krasnik A, Norredam M, Mittendorfer-Rutz E. Incidence of non-affective psychotic disorders in refugees and peers growing up in Denmark and Sweden: a registry linkage study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1153-1165. [PMID: 37919440 PMCID: PMC11178564 DOI: 10.1007/s00127-023-02578-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE Higher rates of non-affective psychotic disorders (NAPD) in minority groups have been reported in many countries. However, few studies have explored how rates differ between refugees and other minority groups and none with an international comparative angle. A comparative perspective makes it possible to relate group differences to aspects national context that underpin the social determinants of disease. METHODS We compared the incidence of treated NAPD among youth born in or who immigrated to Denmark/Sweden before turning 18. Youth aged 18-35 during 2006-2018 were included (NDenmark/NSweden = 1,606,423/2,614,721) and were followed until first NAPD treatment (cases [Denmark/Sweden] = 12,193/9,641), 36th birthday, emigration or death. Incidence rates (IR) and ratios (IRR) comparing refugees, non-refugee migrants, descendants of non-refugee migrants and majority youth were obtained through Poisson regression on data aggregated by country, sex and age, contrasted by sex and country. Complementary analyses on individual-level data adjusting for further socio-demographic factors were conducted in each country separately. RESULTS Incidence rates were higher in all groups compared with the majority group (IRRrange = 1.4-2.9, 95% CI[min, max] = 1.2-3.1). Relative differences between the three minority groups were smaller (IRRrange = 0.7-1.0, 95% CI[min, max] = 0.5-1.2). Although incidence rates were higher in Denmark than Sweden, relative group differences were similar. CONCLUSION Exposures shared between young refugees and other minority groups growing up in Denmark and Sweden may be especially important for their excess risk of NAPD. Further studies should investigate the mechanisms behind the elevated rates in minority groups with special paid attention to factors such as discrimination, social exclusion and acculturation stress.
Collapse
Affiliation(s)
- Christopher J de Montgomery
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health (MESU), University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Alexis E Cullen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Heidi Taipale
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Niuvanniemi Hospital, Kuopio, Finland
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Allan Krasnik
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health (MESU), University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Marie Norredam
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health (MESU), University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
- Section of Immigrant Medicine, Department of Infectious Diseases, University Hospital Hvidovre, Copenhagen, Denmark
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
3
|
Arifoglu AT, Artan T. A systematic review of the factors influencing the risky behaviors of syrian forced migrant children and adolescents in Turkey. Clin Child Psychol Psychiatry 2024; 29:1195-1212. [PMID: 38330210 DOI: 10.1177/13591045241231336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Risky behaviors are defined as emotional and behavioral problems that harm mental and physical health. The present study aimed to systematically review and synthesize research investigating the risky behaviors of Syrian children living in Turkey. The study was conducted through a systematic review of articles published in the Scopus and Web of Science database between 2013 and the present day, and met the STROBE reporting criteria. The inclusion criteria for studies in the systematic review were established, and studies that focused on Syrian-origin forced migrant child-adolescents aged 7-18 years and investigated risky behaviors without a clinical diagnosis and treatment purpose were included. Four studies with a sample of 790 children were examined. According to the findings of this study, there is a measurement issue for risky behaviors. In this study, there are numerous factors influencing risky behaviors, including those related to traumatic life events due to war, psychopathology, acculturation-related factors, and sociodemographic factors. The most significant finding highlighted in the study is the need for methodological improvements and context-specific studies to be repeated in future research, to ensure statistical generalizability and clinical implications in research on this subject.
Collapse
Affiliation(s)
- Ahmed Taha Arifoglu
- Social Work Department, PhD Student at Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Taner Artan
- Faculty of Health Sciences Social Work Department, Istanbul University-Cerrahpasa, Istanbul, Turkey
- UNEC Social Work and Social Innovations Research Center, Azerbaijan State University of Economics, Baku, Azerbaijan
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Osman W, Ncube F, Shaaban K, Dafallah A. Prevalence, predictors, and economic burden of mental health disorders among asylum seekers, refugees and migrants from African countries: A scoping review. PLoS One 2024; 19:e0305495. [PMID: 38913631 PMCID: PMC11195976 DOI: 10.1371/journal.pone.0305495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/30/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Asylum seekers, migrants, and refugees from African countries may have significant health needs, resulting in economic implications for receiving countries around the world. The risk of mental illness is higher in these communities because of factors like violence, deprivation, and post-immigration challenges. OBJECTIVE The purpose of this study was to examine the literature to determine the prevalence, predictors, and economic impacts of mental health (MH) disorders among asylum seekers, migrants, and refugees from African countries. DESIGN AND METHODS In this scoping review, we followed the guidelines from PRISMA and CoCoPop. A modified version of the Appraisal Tool for Cross-Sectional Studies (AXIS) was used to assess study quality for cross-sectional studies, while an appraisal list was used for qualitative studies based on the Critical Appraisal Skills Programme (CASP). Inclusion criteria included peer-reviewed articles published in English, and articles based on official reports from credible institutions and organizations. Among the exclusion criteria were publications that were not peer reviewed or had not been sourced by credible sources, publications that did not meet the study topic or language criteria, mixed populations (including Africans and non-Africans), and research abstracts, reviews, news articles, commentary on study protocols, case reports, letters, and guidelines. DATA SOURCES A systematic search was carried out in Medline (via PubMed), EMBASE, APA PsycINFO, Web of Science and EBSCO, to identify relevant articles that were published between 1 January 2000 and 31 January 2024. RESULTS A total of 38 studies met the inclusion criteria, including 22 from African countries and three qualitative studies. In terms of number of countries contributing, Uganda was the largest (n = 7), followed by Italy (n = 4). The most studied conditions, using multiple diagnostic tools, were Post-Traumatic Stress Disorder (PTSD, n = 19) and depression (n = 17). These studies all revealed elevated rates of mental health disorders among these groups, and these were related to migration, refugee-related factors, and traumatic events. Most of these groups are dominated by young males. There is, however, a prominent presence of minors and women who have suffered a variety of forms of violence, in particular sexual violence. Furthermore, mental illnesses, such as PTSD and depression, are not only persistent, but can also be transmitted to children. In accordance with our inclusion criteria, our review found only one study that examined the economic impact of MH disorders in these groups, leaving a significant knowledge gap. According to this randomized controlled trial, intervention to reduce psychological impairment can help young people stay in school, improve their quality-adjusted life year (QALY), and earn an incremental cost-effectiveness ratio (ICER) of $7260 for each QALY gained. CONCLUSION Asylum seekers, migrants, and refugees from African countries are likely to experience MH needs, according to this scoping review. As well as posing persistent challenges, these disorders can also be transmissible to offspring. In addition to longitudinal studies of these groups, economic impact studies of mental illnesses are necessary.
Collapse
Affiliation(s)
- Wael Osman
- Department of Biological Sciences, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Centre of Biotechnology, Khalifa University, Abu Dhabi, United Arab Emirates
- Liverpool John Moores University in Partnership with UNICAF University, Liverpool, United Kingdom
| | - France Ncube
- Liverpool John Moores University in Partnership with UNICAF University, Liverpool, United Kingdom
- Lupane State University, Bulawayo, Zimbabwe
| | - Kamil Shaaban
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- Suba University Hospital, Khartoum, Sudan
- Ibn Sina University, Khartoum, Sudan
| | - Alaa Dafallah
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
6
|
Grøtvedt HN, Varvin S, Vladisavljević I, Trivuncic B, Brekke I. A cross- sectional study of refugees in Norway and Serbia: Levels of mental distress and social-demographic risk factors. J Migr Health 2024; 10:100238. [PMID: 38983503 PMCID: PMC11231555 DOI: 10.1016/j.jmh.2024.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 08/13/2023] [Accepted: 06/13/2024] [Indexed: 07/11/2024] Open
Abstract
This cross-sectional study has assessed and compared symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) among one refugee group during flight (in Serbia) and another refugee group after flight (in Norway). Results indicate high levels of mental distress in both samples of refugees (Serbia: N = 100, Norway: N = 78). Participants in Serbia reported higher levels of symptoms than the participants in Norway. Moreover, the study found that female gender, low education, refused asylum, high age, and concerns about family correlated with mental distress among the participants.
Collapse
Affiliation(s)
- Halldis Niesser Grøtvedt
- OsloMet – Oslo Metropolitan University, Faculty of Health Sciences – Department of Nursing and Health Promotion., Oslo, Norway
| | - Sverre Varvin
- OsloMet – Oslo Metropolitan University, Faculty of Health Sciences – Department of Nursing and Health Promotion., Oslo, Norway
| | - Ivana Vladisavljević
- University of Prishtina Kosovska Mitrovica, Faculty of Philosophy, Department of Psychology, Pristina, Kosovo
| | | | - Idunn Brekke
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
- OsloMet – Oslo Metropolitan University, Faculty of Health Sciences – Department of Nursing and Health Promotion., Norway
| |
Collapse
|
7
|
Balogun-Katung A, Artis B, Alderson H, Brown E, Kaner E, Rankin J, Lingam R, McGovern R. Practitioner perspectives on the nature, causes and the impact of poor mental health and emotional wellbeing on children and young people in contact with children's social care: A qualitative study. CHILD ABUSE & NEGLECT 2024; 154:106867. [PMID: 38852432 DOI: 10.1016/j.chiabu.2024.106867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/09/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Children and young people (CYP) who are in contact with social care are at higher risk of developing mental health difficulties compared to the general population. This has been attributed to their experience of significant childhood adversity. With an increased likelihood of experiencing poorer health outcomes which can persist into adulthood, it is crucial that key factors for their positive mental health development are identified. OBJECTIVE To identify factors associated with the poor mental health of CYP in contact with social care from the perspective of practitioners working in children's social care and mental health. PARTICIPANTS AND SETTING Social care and mental health practitioners; three Local Authorities across the North-East of England. METHODS Four focus groups were conducted with 23 practitioners between April and May 2022. A semi-structured topic guide exploring the nature and associated factors of mental health was used to focus discussion. Data were thematically analysed and informed by the four levels of the socio-ecological model. RESULTS Individual level risk factors were associated with the CYP's emotional health and included what practitioners described as the 'sense of shame'. Interpersonal level risk factors were most recurrent and included parental factors within the home environment. Community level risk factors consisted of characteristics of settings and institutions that increased the risk of the CYP developing mental health and wellbeing difficulties. Societal level risk factors included broader societal factors such as poverty. Practitioners maintained that certain protective factors possessed or developed by CYP including secure attachments, prevent the development of mental health difficulties. CONCLUSIONS Our current study provides strong evidence for the interlinkage between multiple levels of risk and their interacting impact on the CYP's mental health and emotional wellbeing. It is imperative that this, and the need to strengthen protective factors, whilst reducing risks are carefully considered for the development of effective support interventions for CYP in contact with social care.
Collapse
Affiliation(s)
- A Balogun-Katung
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland.
| | - B Artis
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - H Alderson
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - E Brown
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| | - R Lingam
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland; Population Child Health Research Group, UNSW, Australia
| | - R McGovern
- Population Health Sciences Institute, Newcastle University, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
8
|
Mohammed SEE, Warner G. The Cantril Ladder as a Measure of Well-Being and Life Satisfaction Among Refugee Youth Experiencing Symptoms of Post-Traumatic Stress. J Immigr Minor Health 2024; 26:539-545. [PMID: 37882971 PMCID: PMC11096234 DOI: 10.1007/s10903-023-01563-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
Given the number of refugee youth whom require mental health support, there is a need to provide community-based interventions that can be easily scaled-up at a low cost. Yet, safety procedures associated with community-based intervention require careful consideration. The Cantril Ladder is a visual scale used to assess life satisfaction. It could be a useful tool to track the well-being of participants throughout an intervention. However, concerns have been raised about the validity of single-item life satisfaction measures and it is recommended they are tested when used in specific populations. This is particularly relevant to the refugee youth population who experience ongoing stress due to concern for family, friends, housing, and schooling and whose perceptions of life satisfaction may differ to the cohorts the Cantril Ladder has previously been tested with. The purpose of this study was to explore the validity of the Cantril Ladder as a measure of well-being and life satisfaction in refugee youth experiencing post-traumatic stress symptoms by exploring the relationship between how the youth scored on the Cantril Ladder with their scores on measures of depression and self-efficacy. Hierarchical multiple linear regression was applied to self-reported survey data in order to test how refugee youth experiencing post-traumatic stress symptoms (n = 51) score on the Cantril Ladder compared with Patient Health Questionnaire-9 (PHQ-9) and General Self Efficacy Scale (GSE) scores. The mean Cantril Ladder score in the present sample was 5.33 (SD = 2.77). The PHQ-9 and GSE total scores together explained 19.1% of the variability in the Cantril Ladder score. The Cantril Ladder showed moderate concurrent validity with validated measures of depression and self-efficacy. These findings have important implications for intervention programs designed to support refugee youth experiencing post-traumatic stress, as the Cantril Ladder offers a promising way to track well-being throughout the program as part of a wider safety protocol procedure. Additional research is required to not only confirm these findings, but also to test the face validity of the Cantril Ladder for a more complete validation of life satisfaction.
Collapse
Affiliation(s)
- Salma Elmukashfi Eltahir Mohammed
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Box 564, BMC, Husargatan 3, Uppsala, Sweden
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Box 564, BMC, Husargatan 3, Uppsala, Sweden.
| |
Collapse
|
9
|
Gubi E, Hollander AC, Bäärnhielm S. "I had no idea there were psychiatric clinics for children": A qualitative study of how migrant parents reach Swedish mental health services for their children. Transcult Psychiatry 2024:13634615241250203. [PMID: 38780532 DOI: 10.1177/13634615241250203] [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: 05/25/2024]
Abstract
Migrant children have repeatedly been shown to underutilize psychiatric services and to face barriers to care, yet few studies have examined the experience of migrant parents who are successful in their help-seeking efforts for their children's mental health. The aim of this study was to gain a deeper understanding of facilitators and obstacles to reaching care among migrant parents in contact with child psychiatric services. We explored how migrant parents in Stockholm, Sweden, experienced the process of reaching child mental health services. Participants were recruited from out-patient mental health clinics. Ten in-depth interviews were conducted; qualitative analysis of transcripts was undertaken using thematic content analysis. Parents described a desire to reach services but difficulties doing so on their own. We identified a strong dependence on referring agents, such as schools and child health centers, for parents to gain contact. Informants expressed a high degree of trust toward these agents. Contrary to previous studies, stigma was not described as an obstacle to help-seeking but was recognized by informants as a potential barrier to care had they not emigrated. Although participants in our study had differing educational backgrounds and residency times in Sweden, a common experience of reliance on others for reaching services was evident in the data. Our findings highlight the role of referring agents as bridging contacts between different welfare services. Understanding the specific local resources and services that are available to migrant parents, and strengthening these across different sectors, could potentially help reduce barriers to care.
Collapse
Affiliation(s)
- Ester Gubi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Sofie Bäärnhielm
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI) and Transcultural Centre, Stockholm Health Care Services, Stockholm, Sweden
| |
Collapse
|
10
|
Punjani NS, Okeke-Ihejirika PE, Salami BO, Yohani S, Olukotun M. "The Children Are Not Controllable Because They Follow Western Values" - Narratives of the Parenting Experiences of African Immigrants in Alberta, Canada. J Immigr Minor Health 2024:10.1007/s10903-024-01598-2. [PMID: 38647630 DOI: 10.1007/s10903-024-01598-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
African immigrants are moving to high-income nations such as Canada in greater numbers in search of a better life. These immigrants frequently struggle with several issues, including limited social support, shifts in gender roles/status, cultural conflicts with their children, and language barriers. We used participatory action research (PAR) to gather data about Sub-Saharan African immigrants residing in Alberta, Canada, with a focus on their viewpoints, difficulties, and experiences of parenting children in Canada. We contextualized our study and its findings using both postcolonial feminism and transnationalism approaches. Study findings show African immigrant parents place a high priority on respect between generations. The absence of assistance, conflicts caused by culture, and language barriers are notable difficulties they encountered in parenting. An additional factor is a lack of acquaintance with and comprehension of the culture of their new home nation. Several implications stem from our findings, including the need for interventional research that explores effective, culturally relevant strategies for enhancing parenting among African immigrants. Our findings demonstrate the need for culturally sensitive policies and practices that support the transition and integration of African immigrant families into Canadian society. It is imperative for health care providers and policy makers to develop and revise culturally appropriate policies that take into consideration the importance of African immigrants in destination countries. Adopting culturally relevant policies and practices will improve the wellbeing of this growing but underprivileged minority of Canadians.
Collapse
Affiliation(s)
- Neelam Saleem Punjani
- Faculty of Nursing, University of Alberta, 5-172 Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
| | - Philomina E Okeke-Ihejirika
- Pan African Collaboration for Excellence (PACE), University of Alberta, 1-13 Assiniboia Hall, Edmonton, AB, T6G 2E7, Canada
| | | | - Sophie Yohani
- Counselling Psychology, Faculty of Education, School of Social Sciences and Humanities, University of Alberta, 6-107D Education North, 11210 87 Avenue, Alberta, Canada
| | - Mary Olukotun
- Faculty of Nursing, University of Alberta, 5-172 Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada
| |
Collapse
|
11
|
Schumacher L, Echterhoff J, Zindler A, Barthel D. Depression among refugee youth in an outpatient healthcare center-prevalence and associated factors. Front Psychiatry 2024; 15:1367799. [PMID: 38707619 PMCID: PMC11067052 DOI: 10.3389/fpsyt.2024.1367799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/26/2024] [Indexed: 05/07/2024] Open
Abstract
Background Due to armed conflict and other crises, many children worldwide have to flee their home country and are, consequently, at a high risk for mental health problems. Objective As the majority of previous research on refugee minors focused on post-traumatic stress disorder (PTSD), we aimed to assess the prevalence and risk factors for depression in a clinical sample of refugee youth. Methods Data were collected during the standard diagnostic process in an outpatient refugee clinic in Germany. We assessed the prevalence of depression based on a diagnostic interview and investigated the association between age, gender, duration of flight, accompanying status, number of interpersonal traumatic experiences, residence status, and PTSD diagnosis with a depression diagnosis. More specifically, we conducted a Bayesian logistic regression with these associated factors as predictors and the presence of depression as the outcome. Additionally, we conducted a Bayesian network analysis including all these variables. Results The majority of the 575 included refugee children were male (n = 423, 73.6%) and, on average, 15.1 years old (SD = 2.69). Nearly half of the children (n = 243, 42.3%) met the diagnostic criteria for depression, of which most also showed a comorbid PTSD diagnosis. We found strong evidence that age, gender, number of traumatic experiences, and a diagnosis of PTSD were related to depression. The network analysis indicated that only age, gender, and PTSD were directly associated to depression. Flight-related factors were only indirectly associated with depression due to their associations with number of traumatic experiences and PTSD diagnosis. Conclusion The high prevalence of depression and its strong associations with PTSD suggest that refugee minors are likely to experience depressive symptoms which might develop from PTSD symptoms. This implies a need for monitoring depressive symptoms in refugee minors, especially when these have a PTSD diagnosis.
Collapse
Affiliation(s)
- Lea Schumacher
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jette Echterhoff
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Areej Zindler
- Outpatient Center GmbH, Refugee Outpatient Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dana Barthel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
12
|
Leeuwestein H, Kupers E, Boelhouwer M, van Dijk M. Differences in Well-Being at School Between Young Students With and Without a Refugee Background. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01690-6. [PMID: 38578583 DOI: 10.1007/s10578-024-01690-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
Students with a refugee background are a vulnerable group in education. Adverse experiences and unsafe circumstances that they encounter prior, during and after their flight can place a great burden on their mental health and psychological well-being. Little is known about the psychological well-being of young refugee students in kindergarten and early years of primary school. The current study examined the psychological well-being of 4- to 8-year-old students with a refugee background residing in the Netherlands (n = 136), compared to Dutch peers without a refugee background (n = 406). Primary school teachers completed three questionnaires which assessed multiple indicators of their students' psychological well-being: Strengths and Difficulties Questionnaire (SDQ), Social-Emotional Questionnaire (SEV) and Risk and Protective factors Trauma Observation School Situations (RaPTOSS). In line with the hypothesis, results showed overall lower psychological well-being among refugee students compared to non-refugee students. Teachers observed more total difficulties in socio-emotional functioning, anxious and mood disturbing behavior, ADHD symptoms, problematic social behavior and post-traumatic stress symptoms (small effects), and less developed trauma protective factors and prosocial behavior (medium effects) among students with a refugee background compared to their non-refugee peers. However, the findings also demonstrated that half of the refugee students did not have any scores that fall in the clinical range of the psychological and behavioral problems assessed. The results underline the need to promote protective factors such as positive self-image, self-regulation skills, safety and relations in the classroom and prosocial behavior among students with a refugee background.
Collapse
Affiliation(s)
- Hanneke Leeuwestein
- Department of Developmental Psychology, University of Groningen, Groningen, Netherlands.
| | - Elisa Kupers
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, Netherlands
| | | | - Marijn van Dijk
- Department of Developmental Psychology, University of Groningen, Groningen, Netherlands
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, Netherlands
| |
Collapse
|
13
|
Bleile ACE, Koppenol-Gonzalez GV, Orech B, Verreault K, Jordans MJD. Evaluating a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda: A Quasi-Experimental Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-16. [PMID: 38564186 DOI: 10.1080/15374416.2024.2330073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the movement-based mental health promotion intervention "TeamUp" in Bidibidi refugee settlement, in Northern Uganda. METHOD A quasi-experimental study including four schools (two per arm) assessed the outcomes of 10- to 15-year-old South Sudanese and Ugandan children (n = 549). Randomly allocated, they either participated in up to 11 TeamUp sessions (n = 265) provided by trained facilitators; or belonged to a control group, which continued care as usual (n = 284). Primary outcomes measured psychosocial wellbeing, friendships and attitude to school; secondary outcomes included traumatic distress, depressive symptoms, quality of life, physical health, bullying, interoceptive awareness, and irritability. Data were collected at baseline and endline. RESULTS Children joining TeamUp, showed significantly more improvements on primary outcomes: emotional and psychosocial wellbeing (Mdiff = -1.49, SE = 0.6, p = .01), satisfaction with and attitude toward school (-0.57, SE = 0.2, p = .004); and secondary outcomes: traumatic stress (2.64, SE = 0.8, p < .001), health-related quality of life (-1.56, SE = 0.4, p = .001), physical health (-0.78, SE = 0.3, p = .014) and the TeamUp mechanisms of action scale (-3.34, SE = 0.9, p < .001), specifically the subscales social connectedness (-0.74, SE = 0.3, p = .007) and sense of agency (-0.91, SE = 0.3, p = .005), compared to the control group. No significant differences were found on bullying, interoceptive awareness, irritability and depressive symptoms. CONCLUSION The results are promising for TeamUp as a mental health promotion intervention for children affected by armed-conflict, displacement and on-going adversity. Further research will need to assess the intervention's effectiveness.
Collapse
Affiliation(s)
- Alexandra C E Bleile
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
| | | | - Bruce Orech
- Research and Development Department, War Child
| | | | - Mark J D Jordans
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
| |
Collapse
|
14
|
Kevers R, de Smet S, Rober P, Rousseau C, De Haene L. Silencing or silent transmission? An exploratory study on trauma communication in Kurdish refugee families. FAMILY PROCESS 2024. [PMID: 38566251 DOI: 10.1111/famp.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/23/2023] [Accepted: 12/19/2023] [Indexed: 04/04/2024]
Abstract
Trauma communication in refugee families is increasingly recognized as an important relational dynamic influencing psychosocial well-being, yet studies exploring interactional dynamics and meaning making at play in intra-family trauma communication remain scarce. This article reports on a qualitative study with Kurdish refugee families including parents (N = 10) and children (N = 17) resettled in Belgium, aiming to explore practices on trauma communication within refugee family relationships. In a multiple-phased qualitative design, semi-structured family interviews and participant observation administered in the homes of the participant families are followed by parental interviews involving a tape-assisted recall procedure to investigate observed intergenerational trauma communication and parent-child interactions. Data analysis shows parents and children seldom explicitly talked about the families' lived experiences of trauma. This silence was especially related to parental wishes to avoid their children's future involvement in violence. However, findings also indicate how the intra-family transmission of memories of collective violence occurs in many subtle ways. Four modes of indirect trauma communication could be distinguished: (1) focusing on the repetition of violence in the present; (2) transmission of the collective trauma history; (3) family storytelling; and (4) interaction with meaningful objects of the past. These findings shed light onto the interwoven nature of personal-familial and collective trauma and loss and illuminate the meanings of silence and disclosure in the context of the Kurdish diaspora. In the final section, we discuss our findings and outline its clinical implications for family therapeutic practices in refugee trauma care.
Collapse
Affiliation(s)
- Ruth Kevers
- Parental and Special Education Research Unit, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- PASO, UPC KU Leuven University Psychiatric Center, Kortenberg, Belgium
| | - Sofie de Smet
- Parental and Special Education Research Unit, Faculty of Psychology and Educational Sciences and Faculty Clinical Centre PraxisP, University of Leuven, Leuven, Belgium
| | - Peter Rober
- Interfaculty Institute of Family and Sexuality Studies, University of Leuven, Leuven, Belgium
| | - Cécile Rousseau
- Division of Social and Cultural Psychiatry, McGill University, Montréal, Quebec, Canada
| | - Lucia De Haene
- Parental and Special Education Research Unit, Faculty of Psychology and Educational Sciences and Faculty Clinical Centre PraxisP, University of Leuven, Leuven, Belgium
| |
Collapse
|
15
|
Krzyż EZ, Lin HR. Meta-synthesis of mental healthcare-seeking behavior - Perspectives of refugees and asylum seekers. Arch Psychiatr Nurs 2024; 49:10-22. [PMID: 38734444 DOI: 10.1016/j.apnu.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 10/31/2023] [Accepted: 01/13/2024] [Indexed: 05/13/2024]
Abstract
The number of refugees and asylum seekers worldwide is increasing, and these populations often experience significant mental health challenges due to their difficult life experiences. This study aims to explore the perspectives of refugees and asylum seekers regarding their behavior when seeking mental healthcare. We conducted a meta-synthesis of thirteen articles published between January 2000 and January 2023. The study identified four main themes: understanding of mental health, utilization of health services, the role of society, and necessary interventions. Based on our findings, we provided recommendations for healthcare providers, governments, and researchers to improve the mental healthcare-seeking behavior of these populations in the future.
Collapse
Affiliation(s)
- Ewa Zuzanna Krzyż
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hung-Ru Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
| |
Collapse
|
16
|
Norton J, Gandubert C, Pellissier S, Chaudieu I, Gaultier S. Trauma and mental health in young adults who arrived in France as unaccompanied and separated migrant children. L'ENCEPHALE 2024; 50:154-161. [PMID: 37121807 DOI: 10.1016/j.encep.2023.04.003] [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: 12/02/2022] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES The mental health of unaccompanied and separated minors (UASC) has been widely studied but not their first years of adulthood, often characterised by uncertainty after leaving child protection. The aim of this study was to estimate the prevalence of psychiatric disorders using standardised and validated research instruments and examine the effect of exposure to trauma. METHODS One hundred and ten youth (92.7% male, median age 19.7 [18.1-22.8]) from Chambery, Montpellier and La Rochelle were recruited to a cross-sectional exploratory study. During a face-to-face interview, somatoform disorder, anxiety, and depression were assessed using the Patient Health Questionnaire (score≥10) and post-traumatic stress disorder (PTSD) with the PTSD Checklist for DSM-5 (score≥33). Traumatic life events were assessed using the Life Events Checklist. RESULTS Of the youth, 19.3% had a probable somatoform disorder, 17.6% anxiety, 28.7% depression, and 20% PTSD. The number of traumatic life events increased the risk of depression (multi-adjusted OR (95%CI): 1.56 (1.25-1.96)), PTSD (1.60 (1.23-2.08)), somatoform disorder (1.41 (1.10-1.82), and anxiety (1.33 (1.02-1.72)). Physical assault was the type of event positively associated with the most disorders (P≤0.01, except for anxiety), followed by witnessing sudden and violent death (P≤0.01 for depression and PTSD) and sexual assault (P=0.002 for PTSD). CONCLUSION Our study highlights the high prevalence of psychiatric disorders in young adults who arrived as UASC and the impact on their mental health of cumulative trauma and exposure to interpersonal and violent traumatic life events. A greater focus on their mental health with regular assessments is needed in order to provide rapid and adapted care.
Collapse
Affiliation(s)
- Joanna Norton
- University of Montpellier, Inserm U1298, 34295 Montpellier Cedex 5, France.
| | | | - Sonia Pellissier
- Interuniversity Laboratory of Psychology (LIP/PC2S), University Savoie Mont-Blanc, University Grenoble Alpes, 38040 Grenoble Cedex 9, France
| | - Isabelle Chaudieu
- University of Montpellier, Inserm U1298, 34295 Montpellier Cedex 5, France
| | - Sydney Gaultier
- Interuniversity Laboratory of Psychology (LIP/PC2S), University Savoie Mont-Blanc, University Grenoble Alpes, 38040 Grenoble Cedex 9, France; Department of Psychiatry, Lausanne University Hospital, 1004 Lausanne, Switzerland
| |
Collapse
|
17
|
Dähne F, Jervelund SS, Primdahl NL, Siemsen N, Derluyn I, Verelst A, Spaas C, de Haene L, Skovdal M. Understanding how classroom drama workshops can facilitate social capital for newly arrived migrant and refugee adolescents: Insights from Denmark. Transcult Psychiatry 2024; 61:260-272. [PMID: 38304985 DOI: 10.1177/13634615231225099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Art-based interventions, such as classroom drama workshops (CDWs), increasingly form part of a collection of mental health-promoting activities introduced in school settings. While research points to the potential benefits of CDWs for the mental well-being of refugee and migrant adolescents, the mechanisms to such improvement are less understood. In this article we respond to the need for qualitative evidence of how CDW interventions affect refugee and migrant adolescents' experience. The study draws on eight focus group discussions (FGDs) with 41 adolescents, four semi-structured interviews with teachers and a school coordinator, and written documents from two drama therapists. Our thematic analysis revealed that the CDWs were found to foster trust and improve social relations in the classroom-key facets of bonding social capital. Several processes were described as being linked to these changes. Participants spoke about how the CDWs were facilitated in an emancipatory and safe manner, creating social spaces where the adolescents could have fun together, share, and bear witness to each other's stories, as well as experiencing a sense of agency. In some cases, however, activities in the CDWs crossed the learners' psychological boundaries, which led to withdrawal and a loss of trust. We conclude that whilst CDWs have the potential to facilitate bonding social capital amongst refugee and migrant adolescents and their teachers, this potential hinges on how the CDWs are facilitated.
Collapse
Affiliation(s)
- Finja Dähne
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Denmark
| | - Signe Smith Jervelund
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Denmark
| | - Nina Langer Primdahl
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Denmark
| | - Nicoline Siemsen
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Denmark
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Centre for the Social Study of Migration and Refugees, Ghent University, Belgium
| | - An Verelst
- Department of Social Work and Social Pedagogy, Centre for the Social Study of Migration and Refugees, Ghent University, Belgium
| | - Caroline Spaas
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium
| | - Lucia de Haene
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium
| | - Morten Skovdal
- Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Denmark
| |
Collapse
|
18
|
Lee K, Kronick R, Miconi D, Rousseau C. Moving Forward in Mental Health Care for Refugee, Asylum-Seeking, and Undocumented Children: Social Determinants, Phased Approach to Care, and Advocacy. Child Adolesc Psychiatr Clin N Am 2024; 33:237-250. [PMID: 38395508 DOI: 10.1016/j.chc.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Given the current political and climate crisis, the number of forcedly displaced individuals continues to rise, posing new challenges to host societies aiming to support and respond to the needs of those fleeing war or persecution. In this article, we turn our attention to current and historical sociopolitical contexts influencing the mental health of forcedly displaced children (ie, refugee, asylum-seeking, and undocumented) during their resettlement in high-income countries, proposing timely ways to respond to evolving needs and recommendations to redress ubiquitous structural inequities that act as barriers to education and care for the children, youth, and families seeking sanctuary.
Collapse
Affiliation(s)
- Keven Lee
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec.
| | - Rachel Kronick
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec
| | - Diana Miconi
- Department of Educational Psychology and Adult Education, Université de Montréal, 90 Vincent D'Indy Avenue, Outremont, Montréal, QC, Canada
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada
| |
Collapse
|
19
|
Veronese G, Mahamid F, Obaid H, Bdier D, Cavazzoni F. Positive and negative effects of child's agency on trauma symptoms and psychological difficulties in war-like conditions. The mediating role of hope and life satisfaction. J Ment Health 2024:1-10. [PMID: 38526328 DOI: 10.1080/09638237.2024.2332801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/13/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND Children affected by war and political violence deploy agentic competencies to cope with trauma symptoms and psychological difficulties. However, it does not always act as a protective factor to help them adjust to potentially traumatic events. AIMS We expected to explore the association between agency, trauma symptoms and psychological difficulties and the mediating role of hope and life satisfaction in a group of child victims of military violence in Palestine. METHODS 965 children aged 8 to 14 were assessed with self-reported measures, War Child Agency Assessment Scale, Children Revised Impact of events scale, Strengths and difficulties scale, Child Hope Scale and Brief Multidimensional Students Life Satisfaction Scale. Structural Equation Modelling was performed having Agency as a predictor, trauma symptoms, psychological difficulties as an outcome variable and life satisfaction and hope as a mediator. RESULTS We found a direct and positive effect of agency on trauma symptoms, psychological difficulties, and life satisfaction and hope on the two dependent variables. Life satisfaction and hope mediated the association between agency and the outcome variables. CONCLUSION Agency can help defend children from trauma and psychological maladaptation when it acts on life satisfaction and hope. At the same time, it might worsen psychological dysfunctions when working directly on trauma symptoms and difficulties. Clinical interventions must help children to foster agentic resources in activating hope and life satisfaction.
Collapse
Affiliation(s)
- Guido Veronese
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Fayez Mahamid
- Department of Psychology & Counselling, An-Najah National University, Nablus, Palestinian territory
| | - Hania Obaid
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
| | - Dana Bdier
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
- Department of Psychology & Counselling, An-Najah National University, Nablus, Palestinian territory
| | - Federica Cavazzoni
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
| |
Collapse
|
20
|
Abdelhamid S, Kraaijenvanger E, Fischer J, Steinisch M. Assessing adverse childhood experiences in young refugees: a systematic review of available questionnaires. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02367-6. [PMID: 38451312 DOI: 10.1007/s00787-023-02367-6] [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: 04/12/2023] [Accepted: 12/21/2023] [Indexed: 03/08/2024]
Abstract
Today, various questionnaires are available to assess Adverse Childhood Experiences (ACEs) in children; however, it is uncertain if these questionnaires are comprehensive in addressing adversities of vulnerable subgroups, specifically refugee children. This review's objectives are to (1) identify current ACE questionnaires and determine if they are suitable in assessing refugee children's adversities, and (2) identify those previously used within a refugee population. A systematic literature search was conducted across five databases for articles published since 2010, including studies using an ACE-questionnaire that recognized multiple adversities in healthy children and were published in English. A total of 103 ACE questionnaires were identified in 506 studies. Only 14 of the 103 questionnaires addressed a refugee-specific adversity. Their ability to capture refugee children's experiences was limited: available questionnaires used a maximum of three items to assess refugee-specific adversities, covering only a fraction of forms of adversities relevant to refugee children. Psychometric characteristics were rarely reported. In addition, only two ACE questionnaires were used within a refugee population. With the tools currently available, it is not possible to comprehensively assess the exposure to and severity of the adversities faced by refugee children. The perpetuation of ongoing crises necessitates assessing refugee children's adversities to understand how their wellbeing is affected and to identify children at risk.
Collapse
Affiliation(s)
- Shaymaa Abdelhamid
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany.
| | - Eline Kraaijenvanger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Joachim Fischer
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany
| | - Maria Steinisch
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of Public Health, Social and Preventive Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany
| |
Collapse
|
21
|
Seff I, Stark L, Ali A, Sarraf D, Hassan W, Allaf C. Supporting social emotional learning and wellbeing of displaced adolescents from the middle east: a pilot evaluation of the 'forward with peers' intervention. BMC Psychiatry 2024; 24:176. [PMID: 38438860 PMCID: PMC10910802 DOI: 10.1186/s12888-024-05544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/20/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND A growing literature points to the critical role schools can play in promoting improved psychosocial wellbeing and resilience among first- and second-generation Arab immigrant and refugee adolescents, but few evaluations have examined the effectiveness of culturally adapted, school-based interventions. METHODS We conducted a pilot evaluation of a culturally adapted social and emotional learning and life skills program, Forward with Peers (FwP), and examined its potential effectiveness for this population. FwP was evaluated across three high schools in the Detroit Metropolitan Area. Within each school, one Arabic class was randomly assigned to receive FwP programming and another served as a control. The pilot evaluation sought to examine changes in several mental health and psychosocial outcomes of interest. FINDINGS Improvements in overall perceived social support (P = 0.045) and perceived social support from someone special in one's life (0.042) were statistically significant in the treatment as compared to the control group. Comparative improvements were also marginally significant for resilience (P = 0.095) and perceived social support from family (P = 0.074). CONCLUSIONS Findings highlight the potential of FwP and support the growing interest in establishing efficacy of school-based, culturally appropriate SEL programming to improve psychosocial wellbeing among Arab refugee and immigrant adolescents. FwP's demonstrated improvements in resilience and social support have the potential to prevent mental health disorders and bolster coping mechanisms to minimize adverse consequences in this vulnerable population. Employing a strengths-based approach, FwP offers an alternative intervention to traditional treatment-oriented supports for the proliferation of mental health disorders within this vulnerable population.
Collapse
Affiliation(s)
- Ilana Seff
- Brown School, Washington University in St. Louis, One Brookings Drive, 63130, St. Louis, MO, Box 1196, USA.
| | - Lindsay Stark
- Brown School, Washington University in St. Louis, One Brookings Drive, 63130, St. Louis, MO, Box 1196, USA.
| | - Ali Ali
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Danielle Sarraf
- Brown School, Washington University in St. Louis, One Brookings Drive, 63130, St. Louis, MO, Box 1196, USA
| | - Wafa Hassan
- Global Educational Excellence Schools, Ann Arbor, MI, USA
| | - Carine Allaf
- Qatar Foundation International, Washington, DC, USA
| |
Collapse
|
22
|
Korcz A, Cieśla E, Urbański P. The role of school functioning, physical activity, BMI, sex and age in building resilience among Ukrainian refugee children in Poland. Sci Rep 2024; 14:5308. [PMID: 38438464 PMCID: PMC10912741 DOI: 10.1038/s41598-024-55933-6] [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: 10/31/2023] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
The study aims to examine the relationship between school functioning, physical activity (PA), sex, Body Mass Index (BMI), age, and resilience in Ukrainian children who migrated to Poland due to the war. A cross-sectional study was conducted in 2022, focusing on 248 children aged 10-15 years. The findings suggest that school environment, including enjoyment of school and strong support from teachers, plays a significant role in building resilience in children. PA enhanced the resilience of girls, whereas a higher BMI negatively impacted it. A child-friendly school environment that encourages PA and provides social support could be a promising approach for the mental health of Ukrainian refugee children.
Collapse
Affiliation(s)
- Agata Korcz
- Department of Didactics of Physical Activity, Poznan University of Physical Education, Krolowej Jadwigi 27/39, 61-871, Poznan, Poland.
| | - Elżbieta Cieśla
- Institute of Health Sciences, Jan Kochanowski University of Kielce, Żeromskiego 5, 25-369, Kielce, Poland
| | - Piotr Urbański
- Department of Adapted Physical Activity, Poznan University of Physical Education, Krolowej Jadwigi 27/39, 61-871, Poznan, Poland
| |
Collapse
|
23
|
Kapel Lev-Ari R, Aloni R, Ari AB. Children Fleeing War-Exploring the Mental Health of Refugee Children Arriving in Israel after the Ukraine 2022 Conflict. CHILD ABUSE & NEGLECT 2024; 149:106608. [PMID: 38141479 DOI: 10.1016/j.chiabu.2023.106608] [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: 06/14/2023] [Revised: 09/18/2023] [Accepted: 12/13/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND In February 2022, Ukraine suffered a devastating assault by Russia, leading to destruction, casualties, and mass displacement. Among those displaced were over 1.5 million children. Forced displacement exposes children to a heightened risk of mental health issues. OBJECTIVE This study investigated the prevalence of Post-traumatic stress disorder (PTSD) and other mental health issues among child refugees shortly after their displacement from Ukraine to Israel. It aimed to identify factors influencing PTSD development and explore their associations. METHODS The study included 59 child refugees who had arrived in Israel after fleeing the war in Ukraine. Parents completed self-report questionnaires to assess their children's mental health. RESULTS Only three children met the DSM diagnostic criteria for PTSD, with higher scores in the negative cognition and re-experiencing clusters. Over half of the children exhibited general mental health problems, with approximately 40 % showing internalizing problems, and 30 % showing externalizing problems. The study also found a significant comorbidity between PTSD symptoms and internalizing problems. Additionally, internalizing problems emerged as the sole significant predictor of PTSD levels when considering factors such as age, gender, economic status, parents' work status, internalizing problems, and externalizing problems. CONCLUSIONS Child refugees frequently experience psychological distress, even if they do not meet the formal diagnostic criteria for PTSD. They often exhibit other distress symptoms, primarily internalizing problems, which can be challenging to detect. A deeper understanding of the challenges faced by refugee children can inform the development of targeted assistance programs and the recruitment and training of personnel in host countries.
Collapse
Affiliation(s)
| | - Roy Aloni
- Department of Behavioral Sciences, Ariel University, Israel
| | - Amichai Ben Ari
- Department of Behavioral Sciences, Ariel University, Israel; Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
24
|
Mattelin E, Paidar K, Söderlind N, Fröberg F, Korhonen L. A systematic review of studies on resilience and risk and protective factors for health among refugee children in Nordic countries. Eur Child Adolesc Psychiatry 2024; 33:667-700. [PMID: 35445318 PMCID: PMC10894096 DOI: 10.1007/s00787-022-01975-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/09/2022] [Indexed: 11/03/2022]
Abstract
The Nordic welfare model is often used as an example for the promotion of health and wellbeing, even in vulnerable groups of children, such as refugees. Nonetheless, there are no published reviews on resilience and/or risk and protective factors for physical and mental health among refugee children living in Nordic countries. In this systematic review, we identified 5181 studies on the topic, screened titles, and abstracts, viewed 632, and finally included 26 studies. These studies described 18 samples with a total of 34,080 individuals ranging in ages 0-18 years. Overall, the studies were of good quality. Nearly all studies assessed adversity. Six studies reported physical health outcomes and all studies mental health outcomes, most often post-traumatic stress disorder and anxiety. None explicitly studied resilience. While we found that age and sex are the most frequently studied risk- and protective factors, findings are inconclusive, since the direction of the associations was different in the different studies. This systematic review indicates that there is still a need for well-designed and -powered studies using clear definitions of key study concepts to examine health outcomes and resilience among refugee children in Nordic countries.
Collapse
Affiliation(s)
- Erica Mattelin
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kristina Paidar
- Department of Child and Adolescent Psychiatry, Region Halland, Kungsbacka, Sweden
| | - Natalie Söderlind
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Frida Fröberg
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| |
Collapse
|
25
|
Weitzman A, Huss K, Blanton M, Swindle J, Camacho GB, Robles A. International Displacement and Family Stress in Latin America. JOURNAL OF FAMILY ISSUES 2024; 45:531-554. [PMID: 38390475 PMCID: PMC10881208 DOI: 10.1177/0192513x231151291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Family stress theories posit that individual family members are positioned to adapt to external stressors differently and that these differences can strain family systems. Analyzing in-depth interviews with a diverse sample of migrant mothers in Costa Rica, we investigate how families adjust to the stressors of international displacement. Three stages of family stress adjustment emerged from our analysis: (1) parents' prioritization of safety, (2) parents' and children's grappling with new legal, economic, and social circumstances, and (3) parents' protracted uncertainty in one or more of these realms concomitant with children's feeling resettled. A fourth stage of (4) convergent parent and child resettling also emerged, but only among select families who enjoyed stable financial or emotional support from extended kin or local institutions in Costa Rica. Parents' perceptions of their security, and social, economic, and legal circumstances contributed to the progression between stages of stress adjustment.
Collapse
Affiliation(s)
| | | | | | | | | | - Arodys Robles
- (Universidad de Costa Rica, Centro Centroamericano de Población)
| |
Collapse
|
26
|
Bernhardt K, Le Beherec S, Uppendahl JR, Fleischmann M, Klosinski M, Rivera LM, Samaras G, Kenney M, Müller R, Nehring I, Mall V, Hahnefeld A. Young children's development after forced displacement: a systematic review. Child Adolesc Psychiatry Ment Health 2024; 18:20. [PMID: 38303022 PMCID: PMC10835848 DOI: 10.1186/s13034-024-00711-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVES To examine the impact of displacement experiences on 0- to 6-year-old children's social-emotional and cognitive development, as well as influencing factors on reported outcomes. STUDY DESIGN We systematically searched MEDline, Psyndex, Cochrane Library, Web of Science, Elsevier, TandF, Oxford Journal of Refugee Studies, Journal of Immigrant & Refugee Studies, and Canada's Journal on Refugees for existing literature regarding social-emotional and cognitive outcomes in children directly exposed to forced displacement due to political violence. Results were synthesized in the discussion and displayed using harvest plots. RESULTS Our search generated 9,791 articles of which 32 were selected for review and evaluation according to NICE criteria. Included studies provided results for 6,878 forcibly displaced children. Measured outcomes were diverse and included areas such as peer relations, prosocial behavior, family functioning, play, intelligence, learning performance, and language development. Repeated exposure to adverse experiences, separation from parents, parental distress, as well as duration and quality of resettlement in the host country were reported as influencing factors in the reviewed studies. CONCLUSION As protective factors like secure and stable living conditions help to promote children's development, we call for policies that enhance participation in the welcoming society for refugee families. Early integration with low-threshold access to health and educational facilities can help to mitigate the wide-ranging negative consequences of forced displacement on young children's development.
Collapse
Affiliation(s)
- Katharina Bernhardt
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany.
| | - Saskia Le Beherec
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Kbo Kinderzentrum, Heiglhofstrasse 65, 81377, Munich, Germany
| | - Jana R Uppendahl
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Melia Fleischmann
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias Klosinski
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Luisa M Rivera
- Department of Anthropology, Emory University, Atlanta, GA, USA
| | - Georgia Samaras
- Department of Science, Technology and Society, Technical University of Munich, Munich, Germany
| | - Martha Kenney
- Department of Women and Gender Studies, San Francisco State University, San Francisco, CA, USA
| | - Ruth Müller
- Department of Science, Technology and Society, Technical University of Munich, Munich, Germany
- School of Management, Technical University of Munich, Munich, Germany
- School of Life Sciences, Technical University of Munich, Munich, Germany
| | - Ina Nehring
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Volker Mall
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Kbo Kinderzentrum, Heiglhofstrasse 65, 81377, Munich, Germany
| | - Andrea Hahnefeld
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Kbo Kinderzentrum, Heiglhofstrasse 65, 81377, Munich, Germany
| |
Collapse
|
27
|
Schmees P, Braig J, Kilinc Y, Nilles H, El-Awad U, Kerkhoff D, Demir Z, Rueth JE, Lohaus A, Eschenbeck H. Religious Identity and its Relation to Health-Related Quality of Life and COVID-Related Stress of Refugee Children and Adolescents in Germany. JOURNAL OF RELIGION AND HEALTH 2024; 63:765-787. [PMID: 38100002 PMCID: PMC10861600 DOI: 10.1007/s10943-023-01966-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 02/13/2024]
Abstract
Research shows that religious identity is associated with health. The aim of this study was to understand the role of religious identity for refugee minors' health in greater detail. Middle Eastern refugee minors resettled in Germany and aged 8-18 years completed questionnaires at baseline (T1, n = 246) and follow-up (T2, n = 122) measurement between 2019 and 2022. Religious identity was assessed with a 4-item measure (Cronbach's α = .89). Associations of religious identity at T1 with health-related quality of life (HRQoL) at T1, change in HRQoL from T1 to T2, and perceived COVID-related stress at T2, as well as the mediating role of resources were examined. The results showed a positive association between religious identity and HRQoL, which was partially mediated by integration into peer group, but not by ethnic identity, sense of coherence or religious practice. No significant associations between religious identity and change in HRQoL or COVID-related stress occurred. Therefore, cross-sectional analyses support the beneficial role of religious identity for HRQoL and the crucial mediating role of integration into peer group, suggesting the promotion of religious identity or peer group integration. However, the absence of significant effects on change in HRQoL from T1 to T2 and COVID-related stress at T2 do not allow drawing any long-term conclusions.
Collapse
Affiliation(s)
- P Schmees
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany.
| | - J Braig
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Y Kilinc
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - H Nilles
- Department of Psychology, Bielefeld University, Bielefeld, Germany
- Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany
| | - U El-Awad
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - D Kerkhoff
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Z Demir
- Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, Bielefeld, Germany
| | - J-E Rueth
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - A Lohaus
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - H Eschenbeck
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| |
Collapse
|
28
|
Heimli OM, Kvestad I, Bøe T, Sayyad N, Nilsen SA, Randal S, Askeland KG. Protective factors associated with resilience among unaccompanied refugee minors after settling in Norway: a matched cross-sectional study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02364-9. [PMID: 38285170 DOI: 10.1007/s00787-023-02364-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/20/2023] [Indexed: 01/30/2024]
Abstract
This study aimed to examine protective factors associated with resilience among unaccompanied refugee minors in comparison to their Norwegian peers and to examine associations between resilience factors and characteristics related to positive outcomes among unaccompanied minors. Data stem from the Pathways to Independence study conducted in Bergen municipality, Norway in 2018-2019 where 81 unaccompanied minors aged 15-20 participated (83.3% male; 80% response rate). An age- and sex-matched control group of 324 adolescents was retrieved from the youth@hordaland study conducted in Norway in 2012. Resilience factors were assessed by the Resilience Scale for Adolescents. Unaccompanied minors reported lower scores on Goal Orientation (d = 0.4), Social Competence (d = 0.4), and Social Support (d = 0.7) compared to Norwegian adolescents. Being male was associated with lower scores on Goal Orientation (standardized mean difference [SMD] = - 0.9) and Social Support (SMD = - 0.9) among unaccompanied minors, while being in frequent contact with family in the home country was associated with higher scores on all resilience factors (SMD range = 0.6-1.1). The number of leisure activities was associated with Social Competence (SMD = 0.22). There were no significant associations between the resilience factors and amount of support in the living arrangements or contact with the child welfare services. Unaccompanied minors reported fewer resilience factors compared to Norwegian adolescents, indicating that they may have different needs compared to other adolescents. Our study also suggests that frequent contact with family in the home country may be important to bolster positive development for unaccompanied minors after settlement.
Collapse
Affiliation(s)
| | - Ingrid Kvestad
- RKBU Vest, NORCE Norwegian Research Centre, Bergen, Norway
| | - Tormod Bøe
- RKBU Vest, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Nawar Sayyad
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | | | - Sølve Randal
- Child Welfare Services for Unaccompanied Refugee Minors, Bergen Municipality, Bergen, Norway
| | | |
Collapse
|
29
|
Rodriguez J, Radjack R, Moro MR, Lachal J. Migrant adolescents' experience of depression as they, their parents, and their health-care professionals describe it: a systematic review and qualitative meta-synthesis. Eur Child Adolesc Psychiatry 2024; 33:1-19. [PMID: 35301589 DOI: 10.1007/s00787-022-01971-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/03/2022] [Indexed: 11/27/2022]
Abstract
Migrant youth are vulnerable and face a risk of internalised disorders such as depression. This qualitative meta-synthesis explores migrant adolescents' experience of depression. 14 studies (7 qualitative studies and 7 case reports) were selected after a systematic search of PubMed, Embase, Scopus and PsycInfo. Their quality was assessed with the Critical Appraisal Tool (CASP) for qualitative studies and the Joanna Briggs Institute (JBI) checklist for case reports. The analysis identified six themes describing the experience of depression among migrant adolescents: (1) the vulnerability factors underlying depressive distress, before, during and after migration; (2) the subjective experience of depression, combining symptoms associated with a form of depression common in the West with symptoms more common in other cultures; (3) two types of aetiological hypotheses to make sense of their distress; (4) attitudes adopted in response to distress; (5) experience of care, especially reasons discouraging investment in care; and (6) impairment of identity construction by breaks in cultural transmission and intergenerational conflicts. The threat of losing their connections both at the interpersonal (connection to family, peers and community) and intrapsychic levels (construction of identity) is inherently linked to migrant adolescents' experience of depression. We propose to adapt Brandenberger's 3C model (communication, continuity of care, and confidence) for the care of young migrants to promote a therapeutic alliance, foster construction of a coherent bicultural identity, and support the family.
Collapse
Affiliation(s)
- Juliette Rodriguez
- APHP, Hôpital Cochin, Maison de Solenn, 75014, Paris, France.
- Université de Paris, Paris, France.
| | - Rahmeth Radjack
- APHP, Hôpital Cochin, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Marie Rose Moro
- APHP, Hôpital Cochin, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Jonathan Lachal
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Clermont-Ferrand, 63000, Clermont-Ferrand, France
- Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| |
Collapse
|
30
|
Fitzharris L, McGowan E, Broderick J. Barriers and facilitators to refugees and asylum seekers accessing non hospital based care: A mixed methods systematic review protocol. HRB Open Res 2023; 6:15. [PMID: 38606304 PMCID: PMC11007367 DOI: 10.12688/hrbopenres.13671.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 04/13/2024] Open
Abstract
Context Social exclusion is characterised by and represents a form of disadvantage and marginalisation of vulnerable groups of people in society, who cannot fully participate in the normal activities of daily living. People who are socially excluded such as asylum seekers and refugees have complex healthcare needs and tend to present more to the acute hospital setting as emergency presentations. Little is known about barriers and facilitators experienced by this group to accessing nonhospital based care. Objectives This mixed methods systematic review, will critically examine the concept of barriers and facilitators for refugees and asylum seekers to accessing non hospital based care. Methods This methodological review will follow the Joanna Briggs Institute guidance for conducting mixed methods reviews. The following databases will be searched: Central Medline, PubMed, Embase, CINAHL, and the Cochrane Library. Relevant grey literature will be included. Title and abstract screening, followed by full-text screening will be undertaken independently by two reviewers. The Joanna Briggs Institute extraction tool will be adapted for data extraction. Discussion This mixed method review will comprehensively evaluate quantitative and qualitative data, synthesise both barriers and facilitators and follow a systematic approach through establishing use of mixed methods research across asylum seekers and refugees, and how they affect accessing non-hospital based care. It will explore conceptual models of access to healthcare and how they influence these factors.
Collapse
Affiliation(s)
- Laura Fitzharris
- School of Medicine, Trinity Centre for Health Sciences, St. James Hospital, Dublin, D08W9RT, Ireland
| | - Emer McGowan
- School of Medicine, Trinity Centre for Health Sciences, St. James Hospital, Dublin, D08W9RT, Ireland
| | - Julie Broderick
- School of Medicine, Trinity Centre for Health Sciences, St. James Hospital, Dublin, D08W9RT, Ireland
| |
Collapse
|
31
|
Krzyż EZ, Antunez Martinez OF, Lin HR. Uses of Andersen health services utilization framework to determine healthcare utilization for mental health among migrants-a scoping review. Front Public Health 2023; 11:1284784. [PMID: 38170142 PMCID: PMC10761300 DOI: 10.3389/fpubh.2023.1284784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Background Migration is a worldwide occurrence that carries significant implications for healthcare systems, and it entails challenges to mental healthcare. The Andersen Behavioral Model is widely used by researchers to determine healthcare service utilization among many populations, including migrants. Our study aimed to explore the ways of using the Andersen Health System Utilization Framework in the literature to discover the utilization of mental healthcare by migrants. Methods This scoping review was based on Arksey and O'Malley's framework. A comprehensive search was performed across five electronic databases. Results A total of 12 articles from January 1992 to July 2023 identified various versions of the Andersen Behavioral Model to provide an overview of mental health services utilization among migrants. The analysis identified four significant trends in the literature. First, there is a predominant focus on individual characteristics over contextual factors. Second, researchers tend to integrate multiple versions of the Andersen Behavioral Model, and the most is the version from 1995. Third, additional factors specific to migrant populations are incorporated into the model, but the categorization is sometimes unclear. Finally, the majority of studies have used a quantitative approach and are based in North America, suggesting a focus on the significance of mental health in migrant communities in that context. Conclusion In summary, our scoping review calls for further research using the Andersen Behavioral Model to study mental healthcare utilization among migrants. Notable findings include the adaptation of the model to migrant populations, a focus on individual characteristics, a need for more diverse research methods, and the proposal of a new conceptual model to guide research and policy development in this field.
Collapse
Affiliation(s)
- Ewa Zuzanna Krzyż
- PhD Program, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Hung-Ru Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
32
|
Mendez L, Kerig PK. Newcomers to Unwelcoming Lands: A Conceptual Review of the Dimensions of Discrimination Experienced by Refugee Youth and the Processes Imparting Risk and Resilience. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:903-915. [PMID: 38045850 PMCID: PMC10689638 DOI: 10.1007/s40653-023-00534-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 12/05/2023]
Abstract
In 2018, half of refugees worldwide were under the age of 18. Although often resilient, refugee youth experience chronic and pervasive traumatic events prior to and during migration, and are at risk for continued victimization and stressors while in their host country. In particular, refugee youth encounter ongoing discrimination during resettlement, a primary stressor that reduces their wellbeing and adaptation. Given the relevance of discrimination for refugee youth, the goal of the current review is to increase our understanding of the dimensions of discrimination faced by refugee youth and the risk and resilience processes that may be involved in these negative experiences. Thus, this review presents the existing theoretical and empirical research on this topic and creates a model that organizes these findings. The present review concludes with recommendations for prevention and intervention efforts and considerations for future research.
Collapse
Affiliation(s)
- Lucybel Mendez
- University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT 84112 USA
- Department of Psychology, University of Utah, 380 S 1530 E BEH S 502, Salt Lake City, UT 84112 USA
| | - Patricia K. Kerig
- University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT 84112 USA
| |
Collapse
|
33
|
Parviainen H, Kiviruusu O, Lämsä R, Skogberg N, Castaneda AE, Santalahti P. Psychiatric symptoms and the association with parents' psychiatric symptoms among recently arrived asylum-seeking children in Finland. Child Psychiatry Hum Dev 2023; 54:1699-1709. [PMID: 35587841 PMCID: PMC10582122 DOI: 10.1007/s10578-022-01371-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 03/11/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
Abstract
This study examined psychiatric symptoms and the association with parents' psychiatric symptoms among recently arrived accompanied asylum-seeking children in the age groups of 2-6 years (n = 93) and 7-12 years (n = 91). Children and parents were assessed using mental health and trauma measures (SDQ, HSCL-25 and PROTECT). The prevalence of total difficulties was 34.9% among 2-6-year-olds and 29.6% among 7-12-year-olds. The most common symptoms in both age groups were peer problems, followed by conduct problems among 2-6-year-olds and emotional symptoms among 7-12-year-olds. In both age groups, the children's emotional symptoms were associated with the parents' anxiety and depression as well as the trauma symptoms, while the conduct problems were only associated with the parents' trauma symptoms. In conclusion, peer problems as well as conduct problems and emotional symptoms are common among recently arrived asylum-seeking children. To support the mental health of these children, both children and parents need adequate support.
Collapse
Affiliation(s)
- Heidi Parviainen
- Department of Public Health, University of Turku, FI-20014, Turku, Finland.
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
| | - Olli Kiviruusu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Riikka Lämsä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Natalia Skogberg
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anu E Castaneda
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Päivi Santalahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
| |
Collapse
|
34
|
Tulli-Shah M, Hilario C, Salami B, Pui-Hing Wong J. Caring in the Context of Systems: Service Provider Perspectives on the Mental Health Needs of Newcomer Young Men. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023:2752535X231217211. [PMID: 37991984 DOI: 10.1177/2752535x231217211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
In this study, we applied an intersectional framework to explore service providers' perspectives on the mental health needs of newcomer young men. We conducted focus groups and interviews with 26 service providers in Edmonton, Calgary, and Vancouver, Canada. Findings show that service providers made sense of young men's mental health needs and service access in the context of systems. We identified three interconnected themes: newcomer young men's senses of self in relation to macro-systems, including racism and economic marginalization; settling well as a determinant of mental health; and systems capacities and interdependent resilience. While service providers are engaged in cross-sectoral work in support of newcomer young men's mental health, this work is not being sufficiently supported. Further work is needed around cross-sector capacity bridging and advocacy, as well as the tailoring of services to young men without the assumption and reinforcement of gender stereotypes.
Collapse
|
35
|
Urbański PK, Schroeder K, Nadolska A, Wilski M. Symptoms of depression and anxiety among Ukrainian children displaced to Poland following the outbreak of the Russo-Ukrainian war: Associations with coping strategies and resilience. Appl Psychol Health Well Being 2023. [PMID: 37974535 DOI: 10.1111/aphw.12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
This study sought to discern the association of resilience, coping, and contextual factors on depression and anxiety among Ukrainian children displaced to Poland following the Russo-Ukrainian war. A cross-sectional analysis was undertaken with 284 Ukrainian children, aged 11-15 years, relocated to Poland in 2022 due to the ongoing conflict. Participants were assessed using validated tools for anxiety, depression, resilience, and coping, alongside a study-specific questionnaire. Notable associations emerged between depression and variables including age (Mage = 12.04, 49% females), emotional coping, relational resilience, and significant loss, accounting for 39% of the variance (p < .001). Anxiety was intricately linked with heightened emotional coping and diminished problem-solving capabilities, accounting for notable variances (state: 32%, trait: 45%, p < .001). Resilience, particularly in relational contexts, and the experience of bereavement stood out as paramount determinants of mental health outcomes. Children's mental health in conflict zones is shaped by a convoluted interplay of individual and environmental factors. This study accentuates the pivotal role of relational resilience, bereavement, and coping mechanisms in modulating depression and anxiety amidst war-related adversities. It underscores the imperative for targeted interventions, fostering positive relationship frameworks, and enhancing adaptive coping mechanisms.
Collapse
Affiliation(s)
- Piotr Kazimierz Urbański
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Kingsley Schroeder
- Department of Psychology, Springfield College, Springfield, Massachusetts, USA
| | - Anna Nadolska
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| |
Collapse
|
36
|
Cooper J, Donovan K, Michel H, Peterson L, Todd-Thompson M, Gillette C, Hussaini SS. Screening for post-traumatic stress disorder among Latinx immigrant children. JAAPA 2023; 36:1-6. [PMID: 37884045 DOI: 10.1097/01.jaa.0000979516.10361.7d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
ABSTRACT Latinx children face psychosocial, linguistic, and economic challenges that put them at an increased risk of developing mental health conditions. Primary care providers should be equipped to recognize the complex mental health needs of this growing population. This article explores some of the barriers to mental health screenings in Latinx children and presents culturally sensitive, validated screening tools for primary care providers.
Collapse
Affiliation(s)
- Josseline Cooper
- At the time this article was written, Josseline Cooper, Kelsey Donovan, Halee Michel, Lindsey Peterson , and Megan Todd-Thompson were students in the PA program at Wake Forest School of Medicine in Winston-Salem, N.C. Josseline Cooper now practices in internal medicine palliative care at Cone Health in Greensboro, N.C. Kelsey Donovan practices in hospital medicine at Atrium Health Wake Forest Baptist in Winston-Salem, N.C. Halee Michel practices in internal medicine with Scripps Clinic Medical Group in San Diego, Calif. Lindsey Peterson practices at Legacy Meridian Park Medical Center in Portland, Ore. Megan Todd-Thompson practices at Randolph Health Medical Group in Asheboro, N.C. Chris Gillette is an associate professor and director of scholarship and research at Wake Forest University School of Medicine in Winston-Salem, N.C. Sobia Shariff Hussaini is an assistant professor and director of admissions and academic practice partnerships in the PA program at Wake Forest University School of Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | | | | | |
Collapse
|
37
|
Tippens JA, Erwin S, Eller K, Dutra Gross RM, Bearss B, Kemp B, Mollard E, Njiru L, Okwarah P, Palmer-Wackerly AL, Lakati A. Multisystemic Resilience and Psychosocial Wellbeing among Older Refugees: A Systematic Review with Implications for Mental Health and Psychosocial Support (MHPSS). J Immigr Minor Health 2023; 25:1152-1170. [PMID: 37453972 DOI: 10.1007/s10903-023-01516-y] [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] [Accepted: 06/14/2023] [Indexed: 07/18/2023]
Abstract
Older refugees experience poor mental and emotional health outcomes compared to younger counterparts. Although older adults are instrumental in family/community adjustment in postmigration settings, little is known about how to enhance psychosocial resilience in this population. The aim of this systematic review is to glean deeper insight into the protective factors and processes associated with older refugees' resilience and positive psychosocial health in postmigration settings. We searched eight electronic health and social science databases. Twenty-three articles met the criteria for inclusion; we analyzed these using a multisystemic resilience lens. Studies spanned 1991 to 2022; importantly, 15 of the 23 articles were published in the past decade, indicating growing attention to the mental and psychosocial health of older refugees. Only six of the included articles focused on older refugees living in low- and middle-income countries, revealing a contrast between where most of the world's refugees reside and where the majority of mental health and psychosocial support (MHPSS) research is conducted. We found tremendous variation in determinants of psychosocial resilience based on the politico-historical contexts of migration; sociocultural backgrounds of refugees; and distinct postmigration needs, resources, and settings. Broadly, macrosystem determinants of resilience included security, access to basic services, and maintenance of culture and spirituality. Mesosystem factors were related to social support from families, ethnic communities, religious networks, and host country nationals. Finally, microsystem determinants of older refugees' resilience included language acquisition, cognitive reappraisal, and sense of optimism. Our findings suggest the importance of interdisciplinary, multilevel research designs to highlight how multiple ecosystems interact to promote psychosocial resilience among older refugees. Taken together, this systematic review offers important insight into multilevel protective factors and processes to enhance culturally and contextually meaningful MHPSS for older refugees.
Collapse
Affiliation(s)
- Julie A Tippens
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 391 Carolyn Pope Edwards Hall, Lincoln, NE, 68588, USA.
| | - Sarah Erwin
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 391 Carolyn Pope Edwards Hall, Lincoln, NE, 68588, USA
| | - Kari Eller
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 391 Carolyn Pope Edwards Hall, Lincoln, NE, 68588, USA
| | - R Marie Dutra Gross
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 391 Carolyn Pope Edwards Hall, Lincoln, NE, 68588, USA
| | - Brittany Bearss
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 391 Carolyn Pope Edwards Hall, Lincoln, NE, 68588, USA
| | - Blakelee Kemp
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Elizabeth Mollard
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, USA
| | - Lucy Njiru
- Amref International University, Nairobi, Kenya
| | | | | | | |
Collapse
|
38
|
Phung B. Caring for resettled refugee children in the United States: guidelines, challenges and public health perspectives. Front Public Health 2023; 11:1046319. [PMID: 37818302 PMCID: PMC10561301 DOI: 10.3389/fpubh.2023.1046319] [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: 09/16/2022] [Accepted: 09/07/2023] [Indexed: 10/12/2023] Open
Abstract
The global refugee crisis has become an urgent, pressing humanitarian issue, with an estimated 37 million children forcibly displaced from their homes due to conflict, persecution, violence and other human rights violations by mid-2022. Of these children, only a small percentage are eligible for resettlement in a new country. This narrative review examines the physical health needs of resettled refugee children (RRC) in the United States. By analyzing nutrition and growth, infectious diseases, and general health care/screening measures, a set of comprehensive, evidence-based guidelines and public health perspectives are formulated to facilitate ongoing discussion to ensure that RRC receive equitable health care access. An urgent call to action emphasizes cross-border collaboration between governments, public health experts, refugee populations, and disease preparedness authorities in order to prioritize the physical health of RRC. This review will provide primary care providers, public health professionals, social service workers, and community advocates with up-to-date recommendations to meet the health needs of RRC in the U.S.
Collapse
Affiliation(s)
- Binh Phung
- Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
- Department of Epidemiology and Public Health, Yale University, New Haven, CT, United States
| |
Collapse
|
39
|
Li DJ, Chudzicka-Czupała A, Paliga M, Hapon N, Karamushka L, Żywiołek-Szeja M, McIntyre RS, Chiang SK, Chen YL, Yen CF, Man RHC. Rumination about the Russo-Ukrainian War and its related factors among individuals in Poland and Ukraine. Kaohsiung J Med Sci 2023; 39:943-953. [PMID: 37283450 DOI: 10.1002/kjm2.12711] [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: 03/07/2023] [Revised: 04/26/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023] Open
Abstract
The present study aimed to investigate the factors associated with the level of rumination about the war among people living in Poland and Ukraine. This cross-sectional study recruited internet users from advertisements on social media. Levels of rumination, Depression, Anxiety and Stress Scale (DASS), Impact of Event Scale-Revised (IES-R), time spent on news of the war, and related demographic variables were collected. The reliability and construct validity of rumination were estimated. Potential factors associated with the level of rumination were identified using univariate linear regression analysis, and further entered into a stepwise multivariate linear regression model to identify independent factors. Due to the non-normality of distribution, multivariate linear regression with 5000 bootstrap samples was used to verify the results. A total of 1438 participants were included in the analysis, of whom 1053 lived in Poland and 385 lived in Ukraine. The questionnaires on rumination were verified to have satisfactory reliability and validity. After analysis with stepwise and bootstrap regression, older age, female gender, higher DASS and IES-R scores, and longer time spent on news of the war were significantly associated with higher levels of rumination for both people living in Poland and Ukraine. Lower self-rated health status, history of chronic medical illness and coronavirus disease 2019 infection were also positively associated with rumination for people living in Poland. We identified several factors associated with the level of rumination about the Russo-Ukrainian War. Further investigations are warranted to understand how rumination affects individuals' lives during crises such as war.
Collapse
Affiliation(s)
- Dian-Jeng Li
- Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | | | - Mateusz Paliga
- Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Nadiya Hapon
- Department of Psychology, Faculty of Philosophy, Ivan Franko National University in Lviv, Lviv, Ukraine
| | - Liudmyla Karamushka
- G. S. Kostiuk Institute of Psychology, National Academy of Educational Sciences of Ukraine, Kyiv, Ukraine
| | - Marta Żywiołek-Szeja
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Pharmacology, University of Toronto, Toronto, Canada
- Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Soon-Kiat Chiang
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Cheng-Fang Yen
- Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Roger Ho Chun Man
- Department of Psychological Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| |
Collapse
|
40
|
Smith-Appelson J, Belgrade A, Saleem N, Ali A, Seff I, Stark L. "Hope for a better tomorrow": Using photovoice to understand how Arab adolescents enact critical consciousness. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2537-2562. [PMID: 36961413 DOI: 10.1002/jcop.23031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
We explore how Arab adolescents enact critical consciousness to improve their lives and better their community. Eleven first- and second-generation Arab adolescents participated in a Photovoice study and were asked to reflect on and take photos that represented their well-being, daily life, and sense of belonging and community. The participants discussed their photos over multiple group reflection sessions. Thematic analysis highlights how Arab adolescents make positive change in their community, aided by their connections to community, their awareness of structural challenges they and their communities face, and their sense of agency to make positive change. We contribute to the literature by offering a window into the lived experiences of critical consciousness among Arab adolescents, an underrepresented group in the critical consciousness literature. We also add to the growing body of evidence that highlights the importance of "everyday activism" when considering social change actions.
Collapse
Affiliation(s)
| | - Andrea Belgrade
- Method4Change, USA
- Institutional Research and Academic Planning, Office of the President, University of California, Oakland, California, USA
| | - Noor Saleem
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ali Ali
- The Arab Community Center for Economic and Social Services (ACCESS), Dearborn, Michigan, USA
- School of Social Work, The University of Michigan, Ann Arbor, Michigan, USA
| | - Ilana Seff
- Brown School at Washington University in St. Louis, St. Louis, Missouri, USA
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, St. Louis, Missouri, USA
| |
Collapse
|
41
|
Teixeira-Santos LM, Ventura FIQS, Santos JAO, de Almeida IF, de Abreu WCP. Mental health training programs for non-health professionals and volunteers working with asylum-seekers and refugees: scoping review. Rev Esc Enferm USP 2023; 57:e20220447. [PMID: 37638878 PMCID: PMC10462256 DOI: 10.1590/1980-220x-reeusp-2022-0447en] [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: 12/09/2022] [Accepted: 06/02/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To identify and describe the mental health training programs for non-health professionals and volunteers who work, have worked, or would work with asylum seekers and/or refugees. METHOD Scoping review following JBI methodology. Search carried out in MEDLINE, CINAHL, ERIC, SCOPUS, PsycINFO, Psychology & Behavioral Sciences Collection, RCAAP, ProQuest, and websites of Clinical Trials, UNHCR, International Organization for Migration, WHO, Save the Children, International Migration, Integration and Social Cohesion in Europe, and International Federation of Red Cross and Red Crescent Societies. Studies written in English, Portuguese, French, Spanish and Swedish. RESULTS Of the 8954 articles identified, 16 were included reporting on 11 training programs: Mind-Spring, PM+, MHFA, Cognitive-Behavioral Training for Community and Religious Leaders, EmpaTeach, Suicide Prevention Education Program, Teaching Recovery Techniques, Handbook for Teachers of Vietnamese Refugee Students, PFA, Psychosocial support of volunteers and CBP&MHPSS. CONCLUSION Training programs from scientific literature focus on mental health disorders, while non-governmental organizations' documents focus on resilience and self-care. The current mental health training programs might be insufficient.
Collapse
Affiliation(s)
- Luísa Micaela Teixeira-Santos
- Universidade do Porto, Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
- Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
| | | | | | - Inês Franco de Almeida
- Escola Superior de Enfermagem de Coimbra, Unidade de Investigação em Ciências da Saúde: Enfermagem, Coimbra, Portugal
| | | |
Collapse
|
42
|
Bernhardt K, Le Beherec S, Uppendahl J, Baur MA, Klosinski M, Mall V, Hahnefeld A. Exploring Mental Health and Development in Refugee Children Through Systematic Play Assessment. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01584-z. [PMID: 37624478 DOI: 10.1007/s10578-023-01584-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Abstract
To evaluate a standardized play observation as a measure of young children's mental health and development in a clinical and refugee population. We conducted individual play observations with 70 refugee children aged 3- to 6-years and compared them to a clinical group of 111 age-matched children regarding their level of play development, social interaction during play, traumatic re-enactments, and emotionless-cold play. Additionally, we assessed children's mental health, social-emotional development and markers of adversity by parent and educator report as well as their IQ-test scores and learning performance and related these factors to the play variables. Play variables were significantly correlated with IQ-test scores (r = 0.184, p = 0.037), learning performance (r = 0.208, p = 0.010) and vocabulary (r = 0.208, p = 0.021) in the comparison group and with social-emotional development in educator report (r = 0.368, p = 0.011), time spent in Germany (r = 0.342, p < 0.001) and parental distress (r = - 0.292, p = 0.034) in the refugee group. Children with more parent-reported adverse experiences showed less social-interactive play in the overall sample (r = - 0.178, p = 0.011). Our child-centered approach to standardized play observation augments information obtained from parent and educator reports and can provide valuable insights in subgroups where other commonly used tests are not available or applicable.
Collapse
Affiliation(s)
| | - Saskia Le Beherec
- Technical University of Munich, Munich, Germany
- kbo Kinderzentrum, Munich, Germany
| | | | | | | | - Volker Mall
- Technical University of Munich, Munich, Germany
- kbo Kinderzentrum, Munich, Germany
| | - Andrea Hahnefeld
- Technical University of Munich, Munich, Germany
- kbo Kinderzentrum, Munich, Germany
| |
Collapse
|
43
|
Stewart SL, Dimos T, Poss JW. Treatment Seeking Children and Youth who have Experienced Warzone Trauma: Examining the Mental Health Care Planning Needs. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01570-5. [PMID: 37428420 DOI: 10.1007/s10578-023-01570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 07/11/2023]
Abstract
This study compares mental health treatment-seeking children and youth who have experienced warzone-related trauma to other treatment-seeking children and youth to determine similarities and differences and aid in care planning. Data from 53 agencies across Ontario from 2015-2022 were analysed, resulting in a sample of 25,843 individuals, 188 of which met the warzone and immigration criteria. Individuals who experienced warzone-related trauma were less likely to: (a) have a psychiatric diagnosis; (b) speak English, and; (c) have close friends. Collaborative Action Plans (CAPS) related to traumatic life events, parenting, and informal support were triggered at a higher rate for those who experienced warzone-related trauma compared to those who did not. This study highlights areas where children and youth who have experienced warzone-related trauma require improved access to services. Findings also highlight issues related to a needs-based approach to service delivery to facilitate improved outcomes for these vulnerable children and their families.
Collapse
Affiliation(s)
- Shannon L Stewart
- Faculty of Education, University of Western Ontario, London, ON, Canada
| | - Tatiana Dimos
- Faculty of Education, University of Western Ontario, London, ON, Canada.
| | - Jeffrey W Poss
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
44
|
Stevens A, Kingdon C, Devakumar D. The UK Illegal Migration Bill: a child rights violation and safeguarding catastrophe. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:445-447. [PMID: 37119827 DOI: 10.1016/s2352-4642(23)00104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023]
Affiliation(s)
- Amy Stevens
- Yorkshire and Humber School of Public Health, Leeds, UK; International Child Health Group, London, UK.
| | - Camilla Kingdon
- Royal College of Paediatrics and Child Health, London, UK; Evelina London Children's Hospital, London, UK
| | - Delan Devakumar
- International Child Health Group, London, UK; Institute for Global Health, University College London, London, UK
| |
Collapse
|
45
|
Sim A, Ahmad A, Hammad L, Shalaby Y, Georgiades K. Reimagining mental health care for newcomer children and families: a qualitative framework analysis of service provider perspectives. BMC Health Serv Res 2023; 23:699. [PMID: 37370152 PMCID: PMC10303766 DOI: 10.1186/s12913-023-09682-3] [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: 03/15/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Persistent disparities in access to mental health care for refugee and immigrant children and their families pose unique challenges to policy and practice. This study examined service provider perspectives on the barriers and opportunities for improving mental health supports for newcomer children and families in Canada. METHODS Semi-structured individual and group interviews were conducted with 33 leadership and frontline staff from 14 organizations in the health, education, settlement, and social service sectors in Hamilton, Ontario. Interview data were analyzed using the framework method. RESULTS Participants described barriers at the systems, provider, and individual and family levels that prevented newcomer families from accessing and benefiting from mental health supports. Structural barriers included inadequate services and funding, complexity of systems, cultural tensions, and, lack of prevention and early identification. Provider-level barriers included lack of representation, mental health knowledge and cultural competency, and staff shortages and burnout. Individual and family-level barriers included lack of mental health literacy, primacy of settlement needs, stigma, fear, and the high threshold for help-seeking. Participants' recommendations for "reimagining care" related to newcomer engagement, person- and family-centered care, cultural responsiveness, mental health promotion and prevention, workforce diversity and development, collaborative and integrated care, and knowledge generation and uptake. CONCLUSIONS The intersection of structural, provider, and individual/family-level barriers reduce newcomer families' access to and effectiveness of mental health supports. Reducing disparities in mental health and access to care will require a paradigm shift in the way that mental health care is conceptualized and delivered to newcomer children and families.
Collapse
Affiliation(s)
- Amanda Sim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Afreen Ahmad
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Lina Hammad
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Yasmine Shalaby
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, The Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
46
|
Al-Shatanawi TN, Khader Y, ALSalamat H, Al Hadid L, Jarboua A, Amarneh B, Alkouri O, Alfaqih MA, Alrabadi N. Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan. Front Psychiatry 2023; 14:1184098. [PMID: 37426088 PMCID: PMC10325618 DOI: 10.3389/fpsyt.2023.1184098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/23/2023] [Indexed: 07/11/2023] Open
Abstract
Background Refugees who have fled war zones are at a heightened risk of psychosocial problems that can impact their ability to function in day-to-day life and place a significant burden on the family structure. This study aimed to assess the psychosocial problems and needs and coping mechanisms of Adolescent Syrian refugees in Jordan. Methods Between October and December 2018, we conducted a qualitative study using semi-structured interviews with a sample of key and individual informants. Our sample included 20 primary healthcare professionals, 20 schoolteachers, 20 Syrian parents, and 20 adolescents aged 12-17 years. All interviews were transcribed verbatim, and we utilized thematic analysis to group, categorize, and analyze the original Arabic language transcripts. To ensure thorough analysis, we adopted a bottom-up inductive approach that covered the six-phase iterative process proposed by Braun and Clarke. Results The main psychosocial problems encountered by Syrian adolescents included stress, depression, loneliness, lack of a sense of security, isolation, aggressiveness, fear of war, and family disintegration. Almost all schoolteachers reported that they observed that Jordanian adolescents are more settled, self-confident, and financially stable relative to their Syrian peers. The Jordanian government and community were praised for their support, including education, recreational centers, health services, and awareness campaigns. Going to school, praying and reading the Holy Quran, listening to music, and talking to friends and engaging with them were reported as the main coping mechanisms. The majority of respondents said that more services are still needed for adolescents, including more places for entertainment, psychosocial support and psychological counseling, medical care, job creation, and providing health insurance. Conclusion Syrian refugees are aware of the psychological aspects of their situation, but they are not always able to access clinic-based humanitarian assistance for mental health and psychosocial support. Stakeholders must interact with refugees to learn about their needs and develop services that are appropriate for their culture.
Collapse
Affiliation(s)
- Tariq N. Al-Shatanawi
- Department of Public Health and Community Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Yousef Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Husam ALSalamat
- Department of Public Health and Community Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | | | - Alaa Jarboua
- Department of Legal Medicine, Toxicology and Forensic Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Basil Amarneh
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Osama Alkouri
- Faculty of Nursing, Yarmouk University, Irbid, Jordan
| | - Mahmoud A. Alfaqih
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Department of Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
47
|
Hornfeck F, Eglinsky J, Garbade M, Rosner R, Kindler H, Pfeiffer E, Sachser C. Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety-A secondary analysis of the Better Care study. Front Psychol 2023; 14:1149634. [PMID: 37408964 PMCID: PMC10318408 DOI: 10.3389/fpsyg.2023.1149634] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/09/2023] [Indexed: 07/07/2023] Open
Abstract
Background Unaccompanied young refugees (UYRs) show elevated levels of mental distress such as post-traumatic stress symptoms (PTSS), depression, and anxiety. The individual post-arrival situation in the host country plays an important role in increasing or reducing mental health risks for these vulnerable children and youth. The study aims at examining the impact of pre- and post-migration factors on the mental health of UYRs. Methods A cross-sectional survey of N = 131 young refugees (81.7% male, M = 16.9 years old) was conducted in 22 children and youth welfare service (CYWS) facilities in Germany. The participants provided information about pre- and post-flight experiences. Standardized measures were used to assess post-traumatic stress symptoms (CATS-2), symptoms of depression (PHQ-9), and anxiety (GAD-7). Daily stressors were assessed with the Daily Stressors Scale for Young Refugees (DSSYR), sociocultural adaptation with the Brief Sociocultural Adaptation Scale (BSAS), satisfaction with social support with the Social Support Questionnaire (SSQ6-G). Results Our results demonstrated clinical levels of PTSS in 42.0% of the participants, depression in 29.0%, and anxiety in 21.4%. Hierarchical regression analyses revealed that a higher number of traumatic events and social daily stressors predicted higher levels in all three domains of mental health problems. PTSS and anxiety were also predicted by the distress related to the residence status, depressive symptoms were additionally predicted by sociocultural adaptation, less family contact and length of stay. The satisfaction with social support was not a significant predictor in the regression models. Conclusion Unaccompanied young refugees in CYWS facilities are a highly vulnerable population. As traumatic events, daily stressors and level of contact to family directly impacted UYRs mental health, interventions should be trauma-focused, but also contain modules on how to cope with daily stressors. On the policy and practical level, stakeholders in host countries are called for establishing measures to reduce post-migration stressors and enhance support for UYRs on all levels.
Collapse
Affiliation(s)
| | - Jenny Eglinsky
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Maike Garbade
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | | | - Elisa Pfeiffer
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| |
Collapse
|
48
|
Garbade M, Eglinsky J, Kindler H, Rosner R, Sachser C, Pfeiffer E. Factors affecting the acculturation strategies of unaccompanied refugee minors in Germany. Front Psychol 2023; 14:1149437. [PMID: 37404580 PMCID: PMC10315911 DOI: 10.3389/fpsyg.2023.1149437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/22/2023] [Indexed: 07/06/2023] Open
Abstract
Background Different acculturation strategies might be related to different mental health outcomes and social participation of unaccompanied refugee minors (URMs), but little is known about which factors influence this acculturation process. Therefore, the aim of this investigation was to examine the impact of individual, stress-related, and contextual factors on the acculturation process of URMs in Germany. Methods A sample of N = 132 URMs living in child and youth welfare service facilities in Germany completed questionnaires about their acculturation orientation, traumatic experiences, daily stressors, asylum stress, and perceived social support between June 2020 and October 2021. This investigation is part of the multi-center randomized control trial BETTER CARE. Data were analyzed descriptively and via multiple hierarchical regression. Results Integration (43.5%) and Assimilation (37.1%) were the most common acculturation strategies used by URMs. Multiple hierarchical regression models showed that daily stressors (e.g., the lack of money) were associated with a stronger orientation toward the home country, whereas traumatic events were associated with a weaker orientation toward their home country. No significant predictors were found for the orientation toward the host country. Discussion Overall, URMs in Germany showed favorable acculturation strategies. Nevertheless, daily stressors and traumatic experiences might influence this process. The implications for practitioners and policymakers are discussed with a view to further improving the acculturation process of URMs in Germany.Clinical Trial Registration: German Clinical Trials Register, DRKS00017453 https://drks.de/search/de/trial/DRKS00017453. Registered on December 11, 2019.
Collapse
Affiliation(s)
- Maike Garbade
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jenny Eglinsky
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | | | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Elisa Pfeiffer
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| |
Collapse
|
49
|
Meyer C, Alhaddad L, Stammel N, Sixtus F, Wesche JS, Kerschreiter R, Kanngiesser P, Knaevelsrud C. With a little help from my friends? Acculturation and mental health in Arabic-speaking refugee youth living with their families. Front Psychiatry 2023; 14:1130199. [PMID: 37009112 PMCID: PMC10061544 DOI: 10.3389/fpsyt.2023.1130199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/24/2023] [Indexed: 03/17/2023] Open
Abstract
IntroductionRefugee youth are often faced with the compounding challenges of heightened exposure to traumatic events and acculturating to a new country during a developmental period when their sense of self is still forming. This study investigated whether refugee youth’s acculturation orientation (separation, integration, marginalization, and assimilation) is associated with depressive and posttraumatic stress symptoms and aimed to identify additional indicators of acculturation that may contribute to mental health.MethodsA total of 101 Arabic-speaking refugee youths (aged 14–20 years), who were living with their families and attending school in Germany, took part in the study. They answered questions concerning traumatic exposure and posttraumatic stress symptoms, depressive symptoms, and several indicators of acculturation, including cultural orientation, positive and negative intra- and intergroup contact, language skills and friendship networks. All participants were categorized into one of four acculturation orientations using median splits.ResultsKruskal–Wallis rank sum tests revealed that acculturation orientation was not significantly associated with depressive symptoms [χ2 (3, 97) = 0.519, p = 0.915] or posttraumatic stress symptoms [χ2 (3, 97) = 0.263, p = 0.967]. Regression analysis revealed that German language skills were significantly associated with lower scores of depressive symptoms (p = 0.016) and number of friends in Germany was significantly associated with lower scores of depressive (p = 0.006) and posttraumatic stress symptoms (p = 0.002), respectively.DiscussionPolicies that provide refugee youth with access to language classes and social activities with peers do not only enable them to actively participate in a new society but may also have a positive effect on their mental health.
Collapse
Affiliation(s)
- Caroline Meyer
- Faculty of Education and Psychology, Freie Universität Berlin, Berlin, Germany
- *Correspondence: Caroline Meyer,
| | - Lina Alhaddad
- Faculty of Education and Psychology, Freie Universität Berlin, Berlin, Germany
- Department of Educational Psychology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Nadine Stammel
- Faculty of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Frederick Sixtus
- Faculty of Education and Psychology, Freie Universität Berlin, Berlin, Germany
- Berlin Institute for Population and Development, Berlin, Germany
| | - Jenny Sarah Wesche
- Faculty of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Rudolf Kerschreiter
- Faculty of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | | | | |
Collapse
|
50
|
Weitzman A, Camacho GB, Robles A, Blanton M, Swindle J, Huss K. Costa Rica as a Destination for Migrants in Need of International Protection: IMR Country Report. INTERNATIONAL MIGRATION REVIEW 2023; 57:436-448. [PMID: 37009048 PMCID: PMC10063213 DOI: 10.1177/01979183221104473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this IMR Country Report, we draw attention to Costa Rica as a strategic location for expanding research and theory on migrants in need of protection (MNP), who have migrated abroad primarily to evade an imminent threat to their survival. MNP constitute an increasing share of all international migrants in Costa Rica and worldwide, yet research on these migrants and their migration dynamics remains comparatively underdeveloped relative to research on migrants who relocate abroad primarily in pursuit of material gains, social status, or family reunification. As we highlight, Costa Rica is an instrumental site to deepen understandings of MNP populations and migration dynamics because its large and rapidly growing MNP population is incredibly diverse with respect to national origins, demographic characteristics, and underlying motivations for migration. This diversity presents ample opportunities to better understand heterogeneity in the different types of threats MNP seek to evade; how and why MNP incorporation is shaped by individuals' demographic attributes and pre-migration threats; and how the social networks of various MNP subpopulations develop and overlap with time. Moreover, the geographic concentration of MNP in two regions in Costa Rica lends itself to primary data collection among this population and generates opportunities for estimating local MNPs' demographic characterization, even in the absence of a reliable sampling frame.
Collapse
Affiliation(s)
- Abigail Weitzman
- Department of Sociology & Population Research Center, University of Texas
| | | | - Arodys Robles
- Centro Centroamericano de Población, Universidad de Costa Rica
| | - Matthew Blanton
- Department of Sociology & Population Research Center, University of Texas
| | | | - Katarina Huss
- Department of Sociology & Population Research Center, University of Texas
| |
Collapse
|