Association between psychosocial functioning, health status and healthcare access of asylum seekers and refugee children: a population-based cross-sectional study in a German federal state

Abstract Background The mental health condition and healthcare needs of asylum seeking and refugee (ASR) children may go unrecognized if barriers to healthcare access exist accompanied by exclusive focus on somatic illness. We analysed the relationship between psychosocial functioning, health status and healthcare access of ASR children. Methods During 2018, 560 ASR adults in 58 collective accommodations in Germany’s 3rd largest federal state were randomly sampled and assessed. The parent-reported Strengths and Difficulties Questionnaire (SDQ) was used to assess child psychosocial functioning. SDQ dimensions (Emotional, Conduct, Peer, Hyperactivity, Prosocial, Total) were compared by demographics (sex, age, region of origin, time since arrival, subjective social status), health status (long-lasting illness, physical limitation, pain) and healthcare access (utilization: paediatrician, specialist, dentist, psychologist, hospital/emergency department, prescribed medicines; and unmet needs: for paediatrician/specialist, reduced spending to cover healthcare cost). Age and sex-adjusted odds ratios (AOR, 95%CI-Confidence Intervals) for scoring in borderline/abnormal ranges in SDQ dimensions were estimated through logistic regression depending on children’ health status and healthcare access. Results We analysed parents’ answers pertaining to 90 children aged 1–17 years old, 57% of which were girls and 58% with (Eastern or Western) Asian nationality. Scoring in the borderline/abnormal range of the SDQ Total Difficulties score was associated with feeling bodily pain (compared to no pain, AOR, 95%CI = 3.14, 1.21–8.10) and with an unmet need for a specialist during the previous year (4.57, 1.09–19.16). Borderline/abnormal SDQ Emotional scores were positively associated with a long-lasting illness (5.25, 1.57–17.55), physical limitation (4.28, 1.49–12.27) and bodily pain (3.00, 1.10–8.22), and negatively associated with visiting a paediatrician (0.23, 0.07–0.78), specialist (0.16, 0.04–0.69), and the emergency department (0.27, 0.08–0.96). Conclusion Poor psychosocial functioning among ASR children is associated with somatic problems, unmet medical needs, and lower healthcare utilisation. Somatic clinical encounters with ASR should include children’ mental health symptomatology assessment, especially in those with worst physical health conditions.

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Mental health, health and healthcare utilization of asylum seeking and refugee children in Germany

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.343 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Costa ◽

L Biddle ◽

K Bozorgmehr

Keyword(s):

Mental Health ◽

Emergency Department ◽

Psychosocial Functioning ◽

Unmet Need ◽

Emergency Department Visits ◽

Refugee Children ◽

Healthcare Use ◽

Physical Limitation ◽

Medical Needs ◽

Healthcare Needs

Abstract Background The mental health condition and healthcare needs of asylum seeking and refugee (ASR) children are essential aspects of health services organization. We describe the relation between psychosocial functioning, health status and healthcare use of ASR children in Germany using a cross-sectional population-based survey. Methods 560 ASR adults in 58 collective accommodations in Germany's 3rd largest federal state were randomly sampled and assessed in 2018 (response rate: 42%). 126 participants answered the Strengths and Difficulties Questionnaire (SDQ) to assess children' psychosocial functioning with higher scores suggesting poorer functioning. SDQ dimensions (Emotional; Conduct; Peer; Hyperactivity; ProSocial; Total) were compared by demographics, health (long-lasting illness, physical limitation, pain) and healthcare use (unmet need for a pediatrician/specialist, hospital/emergency department visits). Age and sex-adjusted odds ratios (AOR, 95%CI, Confidence Intervals) for presenting borderline/abnormal scores for each SDQ dimension were computed using logistic regression models depending on children' health and healthcare use. Results Valid data of 90 ASR children was analyzed: 57% girls; 40% 10-17 years; 58% from East/West Asia; 56% in Germany for more than a year. A borderline/abnormal SDQ Total score was associated with pain (compared to no pain, AOR, 95%CI=3.14, 1.21-8.10) and with an unmet need for a specialist (4.57, 1.09-19.16). High scores (borderline/abnormal) in the SDQ Emotional dimension were positively associated with a long-lasting illness (5.25, 1.57-17.55), physical limitation (4.28, 2.48-12.27) and pain (3.00, 1.10-8.22), and negatively associated with visiting a pediatrician (0.23, 0.07-0.78), a specialist (0.16, 0.04-0.69) and the emergency department (0.27, 0.08-0.96). Conclusions Somatic clinical encounters with ASR children should include the assessment of mental health symptomatology, especially in those with worst physical health conditions. Key messages Among asylum seeking and refugee children, a poor physical condition and unmet medical needs are linked with poorer mental health. Provision of care to this vulnerable group must include mental health.

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Mental health status of refugee children

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.752 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

N Lemonjava ◽

K Antia ◽

M Lobjanidze ◽

T Lobjanidze

Keyword(s):

Mental Health ◽

Health Status ◽

Psychological Health ◽

Psychological Trauma ◽

Mental Health Status ◽

Stress Factors ◽

Refugee Children ◽

Health State ◽

Post Traumatic Stress ◽

Host Countries

Abstract Background A number of refugees and asylum seekers have increased dramatically in recent years. More than 250 million people worldwide are considered as refugees (United Nations High Commission for Refugees, 2018), among whom more than 50% are children. General health and especially psychological health of the refugee and asylum seeking children are an emerging, however, not well explored issues. In this study, we aimed to review the literature on the psychological health of refugee children. Methods We performed a literature search and descriptive analysis of studies published until July 2019, through MEDLINE and Science Direct databases. We identified literature on psychological health state of refugee and asylum seeking children. We analysed results of 16 studies. Results The study found that refugee children are facing severe psychological health issues, such as Post-traumatic stress disorder (PTSD), depression, anxiety, sleep disorders, behavioural problems. We identified 3 phases of psychological trauma and stress among refugee children: stress due to conflict in their home countries, stress during migration, and upon the arrival to host country. Our analysis reviled integration difficulties such as racism and bulling as important stress factors for the refugee children. Studies found that prevalence of PTSD is more than 54% among refugee children residing in Norway, significantly higher than in reference population. The studies identified the need of regular mental health assessment and preventive care, psychological counselling services for the refugee children. All included studies showed significantly higher stress among refugee children when compared to local children in host countries. Conclusions Rehabilitation services and follow-up supportive programs should be implemented to improve the mental health status of refugee children; these interventions will also contribute to their better integration. Key messages Screening and regular monitoring provided by host countries healthcare system is crucial to identify high risk children. More research is needed to better investigate the psychological health state and needs of refugee children.

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Exploring Mental Health Status and Syndrome Patterns Among Young Refugee Children in Germany

Frontiers in Psychiatry ◽

10.3389/fpsyt.2018.00212 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 15

Author(s):

Thimo Buchmüller ◽

Hanna Lembcke ◽

Julian Busch ◽

Robert Kumsta ◽

Birgit Leyendecker

Keyword(s):

Mental Health ◽

Health Status ◽

Mental Health Status ◽

Refugee Children ◽

Syndrome Patterns

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Mental health status among ethnic albanians seeking medical care in an emergency department two years after the war in Kosovo

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2003.09.012 ◽

2004 ◽

Vol 43 (2) ◽

pp. E1-E8 ◽

Cited By ~ 9

Author(s):

William G. Fernandez ◽

Sandro Galea ◽

Jennifer Ahern ◽

Sarah Sisco ◽

Ronald J. Waldman ◽

...

Keyword(s):

Mental Health ◽

Emergency Department ◽

Health Status ◽

Medical Care ◽

Mental Health Status

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Sleep duration and health status self-assessment (SF-36) in the elderly: a population-based study (ISA-Camp 2008)

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2012000900007 ◽

2012 ◽

Vol 28 (9) ◽

pp. 1674-1684 ◽

Cited By ~ 8

Author(s):

Margareth Guimarães Lima ◽

Marilisa Berti de Azevedo Barros ◽

Maria Cecília Goi Porto Alves

Keyword(s):

Mental Health ◽

Health Status ◽

Sleep Duration ◽

Bodily Pain ◽

The Elderly ◽

Population Based ◽

Linear Regression Models ◽

Population Based Study ◽

Negatively Associated ◽

Sf 36

The aim of this study was to determine the association between sleep duration and health status among the elderly. A population-based study was carried out with 1,418 elderly individuals using data from the health survey of Campinas, São Paulo State, Brazil (ISA-Camp 2008). Linear regression models were used to determine associations between the physical and mental components and subscales of the SF-36 and sleep duration. Elderly male individuals who slept > 6 hours obtained lower mean SF-36 scores for the vitality and mental health scales and the mental component summary than those who slept for seven to eight hours. All scales were negatively associated with sleep duration < 10 hours, except bodily pain. Scores for the mental health, vitality and role-emotional subscales were lower among women who slept for less than five hours. Mental health was negatively associated with < 10 hours of sleep. Sleep deprivation and excessive sleep were associated with poorer health status, with differences between genders, principally in the long duration sleep categories.

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