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Practitioner Review: Mental health problems of refugee children and adolescents and their management
Author(s) -
Hodes Matthew,
Vostanis Panos
Publication year - 2019
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.13002
Subject(s) - psychosocial , mental health , psychopathology , psychological intervention , psychiatry , refugee , population , psychology , socioeconomic status , service delivery framework , vulnerability (computing) , psychological resilience , clinical psychology , medicine , service (business) , environmental health , economy , archaeology , computer security , computer science , economics , psychotherapist , history
Background Since 2010, the numbers of refugees have increased and around half are under 18 years of age. It is known that experience of organised violence, displacement and resettlement increases the risk for psychiatric disorders and psychosocial impairment. This review integrates recent research into the risk and protective factors for psychopathology with service and treatment issues. Methods We draw on and critically evaluate key systematic reviews in the selected areas, innovative robust studies and relevant government reports. Results Many refugee children show resilience and function well, even in the face of substantial adversities. The most robust findings for psychopathology are that PTSD , and posttraumatic and depressive symptoms are found at higher prevalence in those who have been exposed to war experiences. Their severity may decrease over time with resettlement, but PTSD in the most exposed may show higher continuity. More severe psychiatric disorders including psychosis may also occur. Service delivery needs to take into account socioeconomic and cultural influences but, given the high level of unmet need even in high‐income countries, stepped care delivery is required. The evaluation of psychological interventions, often delivered in group settings, suggests that they can be effective for many distressed children; however, for the more impaired, a greater range of disorder‐specific therapies will be required. Conclusions Child and adolescent mental health clinicians and service providers need to be aware of the specific needs of this population and systems for service delivery. There are significant knowledge gaps in understanding risk and vulnerability, service delivery and treatment effectiveness.