Mapping trauma support onto the shifting landscape of seeking refuge in Sweden: insights from an ongoing programme of research on refugee minors’ mental health

The increase in refugees globally since 2010 and the arrival of many into Europe since 2015, around 50% of whom are under 18 years, have been the stimulus to greater investigation and publications regarding their mental health. This clinical review summarises selected themes in the field as described in the published literature since 2016. The themes include refugee statistics, premigration and postmigration experiences, psychopathology focusing on parent–child relationships, unaccompanied refugee minors and associations between resettlement, acculturation and mental health. Some important reviews and studies are discussed that address service and treatment provision. While there has been a recent increase in research in this field, more is needed into the course of psychopathology, protective factors and the promotion of integration into resettlement countries, as well as models of service delivery and treatment effectiveness.

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Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors

European Child & Adolescent Psychiatry ◽

10.1007/s00787-019-01340-6 ◽

2019 ◽

Vol 28 (12) ◽

pp. 1671-1682 ◽

Cited By ~ 10

Author(s):

Tine K. Jensen ◽

Ane-Marthe Solheim Skar ◽

Elin Sofia Andersson ◽

Marianne Skogbrott Birkeland

Keyword(s):

Mental Health ◽

Unaccompanied Refugee Minors ◽

Refugee Minors

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Drug use and criminality among unaccompanied refugee minors: a review of the literature

International Journal of Migration Health and Social Care ◽

10.1108/ijmhsc-05-2019-0050 ◽

2019 ◽

Vol 16 (1) ◽

pp. 93-107 ◽

Cited By ~ 1

Author(s):

Anna-Karin Ivert ◽

Mia-Maria Magnusson

Keyword(s):

Mental Health ◽

At Risk ◽

Substance Abuse ◽

Drug Use ◽

International Research ◽

Mental Health Problems ◽

Health Problems ◽

Unaccompanied Refugee Minors ◽

Content Type ◽

Refugee Minors

Purpose Organisations working with children have acknowledged that unaccompanied refugee minors (URM) across Europe are exposed to environments and situations that put them at risk for becoming addicted to drugs or becoming involved in crime. The purpose of this paper is to study an examination of existing international research concerning URM and of whether, and if so how, issues relating to drug use and criminality among these children are discussed in the international literature. Design/methodology/approach A literature review was conducted using PsycINFO, PubMed, Sociological abstracts and ERIC databases, which together cover the social and behavioural science and also medicine. Findings Findings from the present review show that the issues of drug abuse and criminality among URM are rarely acknowledged in the international research literature. When the occurrence of substance abuse and/or criminality is discussed, it is often in relation to mental health problems and in terms of self-medication, i.e. that alcohol or drugs are used by the URM to cope with painful experiences or mental health problems, and also with the challenges of integrating into a new society, difficulties finding work, unsuitable living conditions and a lack of social support. Originality/value This review shows that several researchers have emphasised that untreated mental health problems, stressful living conditions and a lack of support and control might put these children at risk for substance abuse and criminality, and this suggests a need for further research in this area.

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The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway

BMJ Open ◽

10.1136/bmjopen-2016-015157 ◽

2017 ◽

Vol 7 (6) ◽

pp. e015157 ◽

Cited By ~ 37

Author(s):

Marianne Jakobsen ◽

Melinda Ashley Meyer DeMott ◽

Tore Wentzel-Larsen ◽

Trond Heir

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Unaccompanied Refugee Minors ◽

The Impact ◽

Refugee Minors

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Posttraumatic stress among Eritrean unaccompanied refugee minors in Ethiopia

International Journal of Migration Health and Social Care ◽

10.1108/ijmhsc-02-2020-0016 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Natnael Terefe Arega

Keyword(s):

Mental Health ◽

Posttraumatic Stress ◽

Life Events ◽

Odds Ratio ◽

Traumatic Events ◽

Stressful Life ◽

Unaccompanied Refugee Minors ◽

Content Type ◽

Traumatic Life Events ◽

Refugee Minors

Purpose Unaccompanied refugee minors (URMs) are known to be subjected to several potentially traumatic life events, risking more mental health problems than other populations of same age. Evidence concerning the mental health of Eritrean URMs in Ethiopia is scarce. This paper aims to present an estimate of probable posttraumatic stress disorder (PTSD) within this group and describes its associations with traumatic life events and participants’ characteristics. Design/methodology/approach This cross-sectional quantitative study surveyed a random sample of 384 Eritrean URMs, aged 12–17 years, in the Shimelba refugee camp. The Stressful Life Events (SLE) questionnaire and the Reactions of Adolescents to Traumatic Stress (RATS) questionnaire were used to assess traumatic events and PTSD symptoms, respectively. Descriptive statistics, the chi-square test with the odds-ratio and stepwise regression were used to analyze data. Findings Large proportions of the URMs had experienced traumatic events including physical abuse (261, 68%), separation from family against will (240, 62.5%), a stressful life event in which they were in danger (198, 51.6%), and important changes in family life (196, 51%). About 38% of the URMs met the criteria for classifying probable PTSD diagnosis, suggesting that they are likely to have PTSD. The odds-ratio statistic revealed that girls and the oldest age group (15–17 years) were at a greater risk for PTSD. The total score on the SLE appeared to be the robust predictor, explaining 28% of the variance in RATS total scores. Research limitations/implications Self-report questionnaires used in this study yield less diagnostic information than extensive interviews. Additional information should be collected from the viewpoint of significant adults (caregivers/ teachers). Such information would be crucial in assessing the degree of impairment in daily functioning and the severity of the symptoms. Originality/value Awareness of the stressful experiences and the mental health status of the URMs has implications for taking preventive and curative measures to provide a broad range of intervention programs and psychosocial support.

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Different Patterns of Mental Health Problems in Unaccompanied Refugee Minors (URM): A Sequential Mixed Method Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.00324 ◽

2020 ◽

Vol 11 ◽

Author(s):

Bernd Hanewald ◽

Michael Knipper ◽

Werner Fleck ◽

Jörn Pons-Kühnemann ◽

Eric Hahn ◽

...

Keyword(s):

Mental Health ◽

Mixed Method ◽

Mental Health Problems ◽

Health Problems ◽

Mixed Method Study ◽

Unaccompanied Refugee Minors ◽

Refugee Minors

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Is the Refugee Health Screener a Useful Tool when Screening 14- to 18-Year-Old Refugee Adolescents for Emotional Distress?

Journal of Refugee Studies ◽

10.1093/jrs/fey072 ◽

2019 ◽

Vol 32 (Special_Issue_1) ◽

pp. i141-i150

Author(s):

Anna Sarkadi ◽

Anna Bjärtå ◽

Anna Leiler ◽

Raziye Salari

Keyword(s):

Mental Health ◽

Health Care ◽

Social Services ◽

Mental Health Problems ◽

Health Problems ◽

Refugee Health ◽

Assessment Tools ◽

Post Traumatic Stress ◽

Unaccompanied Refugee Minors ◽

Refugee Minors

Abstract The high number of asylum seekers in Sweden has highlighted the need for structured assessment tools to screen for refugee mental health problems in clinical services. We examined the utility of the Refugee Health Screener (RHS) in refugee adolescents, aged 14–18, attending routine clinical examinations or staying in group homes/refugee centres (N = 29). Participants completed a survey, including the RHS, administered through iPads in their native language. The RHS showed excellent internal consistency (α = 0.96) and correlated moderately with symptoms of post-traumatic stress disorder (r = 0.41, p = 0.025). Mean scores and prevalence rates were comparable to a study of adult refugees in Sweden. Unaccompanied refugee minors (URMs) scored significantly higher (M = 32.0, SD = 12.9) compared to youth staying with their families (M = 7.5, SD = 8.2, p < 0.001, d = 2.27). Our findings confirm that the RHS can be used in the adolescent population in Sweden. These findings moreover suggest that URMs are a particularly vulnerable group with a large burden of mental health problems. In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs) and another 35,015 children in families (Swedish Migration Agency, 2017). Most URMs (86 per cent) are boys, mainly from Afghanistan, Syria, Somalia and Eritrea, whereas children in families (accompanied refugee minors) more often come from Syria and Iraq with an equal gender distribution. During the asylum process, lasting up to 30 months, children have access to free education and health care. URMs are under the care of the social services and are assigned a legal guardian until they turn 18. Adults are entitled to acute health care and housing but cannot work and have no access to studies. If granted asylum, the person/family is assigned to a municipality that assumes responsibility for them. Thus, on top of adverse events before and during migration, the asylum and resettlement process per se involves stressors and a lack of control for refugees, which increases the risk of developing mental health problems.

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