Refugee, asylum-seeking and internally displaced children and adolescents
Fazel M., Reed R., Stein A.
© 2015 by JohnWiley & Sons, Ltd. All rights reserved. Refugee, asylum-seeking and internally displaced children commonly experience potentially traumatic events, not only during organised violence before migration, but also during migration journeys, in refugee camps, or after resettlement. Although displaced children and families often show considerable resilience, children are nonetheless at elevated risk of post-traumatic stress disorder, depression and anxiety disorders. The significant majority of forcibly displaced children reside in low-and middle-income countries, yet research has focused on those resettled in high-income contexts. Children's recovery is adversely impacted by a range of additional adversities, including socioeconomic hardship, residential instability, and discrimination. Displaced parents often suffer psychological difficulties themselves, and may struggle to support children's changing developmental needs. Despite this, young people arriving with a parent are at substantially lower risk than unaccompanied minors, who have typically experienced more adverse events during their journeys, and commonly face multiple changes of carer, residence, or school. Unaccompanied minors often show worse psychological functioning as they near the point of their final asylum decision when they approach adulthood, whereas for accompanied children there are no clear age effects on mental health. In most contexts, girls are at increased risk of psychological difficulty. For all children, further exposure to violence after migration appears to be particularly detrimental. Recent research has sought to develop interventions, which may be specialist-delivered trauma-focused therapies, or multimodal psychosocial interventions focused on improving present life circumstances. Key challenges include ensuring interventions are systematically evaluated for effectiveness, culturally-appropriate and that they can be successfully delivered by non-specialists.