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Review: How should child mental health services respond to the refugee crisis?
Author(s) -
Eruyar Seyda,
Huemer Julia,
Vostanis Panos
Publication year - 2018
Publication title -
child and adolescent mental health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.912
H-Index - 46
eISSN - 1475-3588
pISSN - 1475-357X
DOI - 10.1111/camh.12252
Subject(s) - mental health , psychological intervention , refugee , context (archaeology) , vulnerability (computing) , distress , medicine , mental distress , global mental health , psychological resilience , psychology , psychiatry , political science , clinical psychology , geography , social psychology , computer security , archaeology , computer science , law
Background Child mental health services and related agencies are faced with an increasing challenge in responding to the influx of refugee children around the world. There is strong evidence on the prevalence and complexity of these children's mental health problems and broader needs. Aims To review the research literature on risk and protective factors, and associated mental health interventions for refugee children. Methods Peer‐reviewed studies were included for the period 2004–2017; if they included refugee, asylum‐seeking or internally displaced children under 18 years; and adopted a quantitative design. Vulnerability and protective factors for refugee children were considered in this context, followed by the respective types of interventions at pre‐, peri‐ and postmigration stage, and across high‐ and low‐/middle‐income countries. Eighty‐two peer‐reviewed studies fulfilled the selection criteria. Results The existing body of literature is largely based on identifying risk factors among children with mental health problems and predominantly designing trauma‐focused interventions to reduce their symptomatic distress. Recent research and services have gradually shifted to a broader and dynamic resilience‐building approach based on ecological theory, that is at child, family, school, community and societal level. There is increasing evidence for the implementation and effectiveness of multimodal interventions targeting all these levels, despite the methodological constraints in their evaluation. Conclusions In high‐income countries, child mental health services need to collaborate with all agencies in contact with refugee children, establish joint care pathways, and integrate trauma‐focused interventions with family and community approaches. In low‐ and middle‐income countries, where specialist resources are sparse, resilience‐building should aim at maximising and upskilling existing capacity. A six‐dimensional psychosocial model that applies to other children who experience complex trauma is proposed.