Although refugee children often show great resilience, the fact is undeniable that those affected by war, conflict, and treacherous journeys are at significant risks for having poor mental health, such as post-traumatic stress disorder (PTSD), anxiety disorders, or depression [3]. If untreated, refugee children with PTSD have greater risks for poor mental and physical health and quality of life later in their lives [1].

Despite the criticality of this issue, not all humanitarian programmes implement mental health and psychosocial support for refugee children largely due to the acute shortage of mental health professionals with special knowledge of children, including those affected by violence and war [5]. This shortage often results in the complex intersection of various factors that undermine the wellbeing of refugee children, such as (1) household, (2) individual, and (3) environmental/ societal factors to be overlooked.

(1) Household factors

The loss of primary caregivers or child abuse from caregivers — who are also under significant stress in precarious situations or affected by PTSD themselves — could add to the traumatisation of refugee children [1].

(2) Individual (child) factors

Through multiple encounters with traumatic events in their countries of origin, on their journeys to seek asylum, and in their host countries, refugee children are likely to develop complex forms of poor mental health [3]. “Secondary trauma” is considered to be the period during which refugee children adapt to their host country and navigate through linguistic, cultural, and socioeconomic barriers or challenges [3] . Exclusionary immigration laws in some host countries often prevent refugee populations from seeking appropriate mental health support [3] as well.

(3) Environmental/societal factors

Extended waiting periods for the outcomes of their asylum applications, staying in refugee camps, and cultural isolation can also undermine the mental health of refugee children [3]. More broadly, a lack of political attention and rights-based policies across host countries where human rights violations of refugees and asylum seekers often take place can also affect the mental health of refugees. An example is the death of several migrant children in detention centres at the U.S.-Mexico border due to their physical vulnerability and ill health [9].

Although these factors have been largely overlooked due to the complex nature of issues surrounding the mental health of refugee children [3], there is a shift to psychosocial interventions that reflect wider familial and structural as well as individualised, interpersonal support [4]. Mercy Corps, for example, has laid out the Profound Stress Attunement (PSA) framework to mitigate against the long-term psychological impacts of child suffering through measurable programmes that seek to increase children’s sense of normalcy, such as interactions with a support network and practical training to improve children’s resilience [4][5]. The PSA framework recognises the criticality of a comprehensive, evidence-based approach and the need to support refugee children to strengthen ties to their communities as well as their families [5]. These types of group-based activities have also been adopted by the United Nations High Commissioner for Refugees (UNHCR) in humanitarian settings. UNHCR has also started to integrate mental health and psychosocial assistance into existing interventions to cater to the diverse needs of refugees [6].

More research on the mental health of refugee children and a wider assessment of the scale and effectiveness of current interventions should be conducted to support refugee children with poor mental health. Every humanitarian intervention needs to consider not only children’s reactions to trauma, but also the diverse emotional, developmental, and behavioural impact of traumatic incidents to better attend to the needs of refugee children [7].

About the Author

Yume holds a BA in International Development with International Education from the University of Sussex. She has a passion for writing on issues related to human rights, law, and international development. She has been named the 2019 Global Winner in the Social Sciences: Anthropology and Cultural Studies category at The Global Undergraduate Awards, the world’s largest academic awards programme, for her research on the rights of Palestinian children in the Occupied Territories. She was also Highly Commended for two other pieces on the marginalisation of ethnic and racial minorities and women, emerging among the top 10% of global entries.

Includovate is a feminist research incubator that “walks the talk”. Includovate is an Australian social enterprise consisting of a consulting firm and research incubator that designs solutions for gender equality and social inclusion. Its mission is to incubate transformative and inclusive solutions for measuring, studying, and changing discriminatory norms that lead to poverty, inequality, and injustice. To know more about us at Includovate, follow our social media: @includovate, LinkedIn, Facebook, Instagram.

References

[1] Gadeberg, A.K., Montgomery, E., Frederiksen, H.W. and Norredam, M. (2017). Assessing trauma and mental health in refugee children and youth: a systematic review of validated screening and measurement tools. European Journal of Public Health. 27(3):439–446.

[2] UNHCR. (2021). Refugee Data Finder. Available at: https://www.unhcr.org/refugee-statistics/ [Accessed 29 November 2021].

[3] Fazel, M and Stein, A. (2002). The Mental Health of Refugee Children. Archives of Disease in Childhood. 87:366–370.

[4] Panter-Brick, C., Dajani, R., Eggerman, M., Hermosilla, S., Sancilio, A and Ager, A. (2018). Insecurity, distress and mental health: experimental and randomize controlled trials of a psychosocial intervention for youth affected by the Syrian crisis. The Journal of Child Psychology and Psychiatry. 59:5–523–541.

[5] Mercy Corps. (2016). Advancing Adolescents: Evidence on the Impact of Psychosocial Support for Syrian Refugee and Jordanian Adolescents. Portland, USA and Edinburgh, UK: Mercy Corps. Available at: https://www.mercycorps.org/sites/default/files/2019-11/Advancing_Adolescents%20Report_FINAL_ONLINE.pdf

[6] UNHCR. (2021). Mental Health and Psychosocial Support. Available at: https://www.unhcr.org/mental-health-psychosocial-support.html [Accessed 20 November 2021].

[7] Boyden J. and de Berry, J. (eds.). (2004). Children and Youth on the Frontline: Ethnography, Armed Conflict and Displacement, New York and Oxford: Berghahn Books. pp.xi-xxvii.

[8] Panter-Brick, C. and Eggerman, M., (2017). ‘Anthropology and global mental health: Depth, breadth, and relevance’. In White, R.G., Jain, S., Orr, D.M.R. and Read, U.M. (eds.). The Palgrave handbook of sociocultural perspectives on global mental health. London: Palgrave Macmillan, pp. 383–401.

[9] Acevedo, N. (2019). ‘Why are migrant children dying in U.S. custody?’. NBC News. 30 May. Available at: https://www.nbcnews.com/news/latino/why-are-migrant-children-dying-u-s-custody-n1010316 [Accessed 25 November 2021].