European Child & Adolescent Psychiatry

, Volume 23, Issue 5, pp 337–346 | Cite as

Longitudinal follow-up of the mental health of unaccompanied refugee minors

  • Marianne Vervliet
  • Jan Lammertyn
  • Eric Broekaert
  • Ilse Derluyn
Original Contribution


Despite growing numbers of unaccompanied refugee minors (UMs) in Europe, and evidence that this group is at risk of developing mental health problems, there still remain important knowledge gaps regarding the development of UMs’ mental health during their trajectories in the host country and, in particular, the possible influencing role of traumatic experiences and daily stressors therein. This study therefore followed 103 UMs from the moment they arrived in Belgium until 18 months later. Traumatic experiences (SLE), mental health symptoms (HSCL-37A, RATS) and daily stressors (DSSYR) were measured at arrival in Belgium, after 6 and 18 months. UMs reported generally high scores on anxiety, depression and post-traumatic stress disorder (PTSD). Linear mixed model analysis showed no significant differences in mental health scores over time, pointing towards the possible long-term persistence of mental health problems in this population. The number of traumatic experiences and the number of daily stressors leaded to a significant higher symptom level of depression (daily stressors), anxiety and PTSD (traumatic experiences and daily stressors). European migration policies need to reduce the impact of daily stressors on UMs’ mental health by ameliorating the reception and care facilities for this group. Moreover, regular mental health screenings are needed, in combination with, if needed, adapted psychosocial and therapeutic care.


Unaccompanied refugee minors Mental health Daily stressors Traumatic experiences Longitudinal study 



We would like to thank all participants, as also the staff of the centres of Steenokkerzeel and Neder-Over-Heembeek, the minors’ guardians, and all other involved staff. Thanks to the research assistants for their support with the data collection. This study could not have been carried out without the support of the European Refugee Fund and the Special Research Fund of Ghent University.

Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.


  1. 1.
    EMN (2010) Policies on reception, return and integration arrangements for, and numbers of, unaccompanied minors—an EU Comparative Study. Accessed 18 March 2013
  2. 2.
    UNHCR (2012) UNHCR Global Trends 2011. United Nations High Commissioner for Refugees. Accessed 11 June 2013
  3. 3.
    Derluyn I, Mels C, Broekaert E (2009) Mental health problems in separated refugee adolescents. J Adolesc Health 44(3):291–297. doi: 10.1016/j.jadohealth.2008.07.016 PubMedCrossRefGoogle Scholar
  4. 4.
    Bronstein I, Montgomery P, Dobrowolski S (2012) PTSD in asylum-seeking male adolescents from Afghanistan. J Trauma Stress 25:551–557PubMedCrossRefGoogle Scholar
  5. 5.
    Fazel M, Reed RV, Panter-Brick C, Stein A (2012) Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet 379(9812):266–282. doi: 10.1016/s0140-6736(11)60051-2 PubMedCrossRefGoogle Scholar
  6. 6.
    Hodes M, Jagdev D, Chandra N, Cunniff A (2008) Risk and resilience for psychological distress amongst unaccompanied asylum seeking adolescents. J Child Psychol Psychiatry 49(7):723–732. doi: 10.1111/j.1469-7610.2008.01912.x PubMedCrossRefGoogle Scholar
  7. 7.
    Huemer J, Karnik N, Voelkl-Kernstock S, Granditsch E, Dervic K, Friedrich M, Steiner H (2009) Mental health issues in unaccompanied refugee minors. Child Adolesc Psychiatry Ment Health 3(1):13PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Lustig SL, Kia-Keating M, Knight WG, Geltman P, Ellis H, Kinzie JD, Keane T, Saxe GN (2004) Review of child and adolescent refugee mental health. J Am Acad Child Adolesc Psychiatr 43(1):24–36. doi: 10.1097/00004583-200401000-00012 CrossRefGoogle Scholar
  9. 9.
    Bean TM, Eurelings-Bontekoe E, Spinhoven P (2007) Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: one year follow-up. Soc Sci Med 64(6):1204–1215. doi: 10.1016/j.socscimed.2006.11.010 PubMedCrossRefGoogle Scholar
  10. 10.
    Smid GE, Lensvelt-Mulders G, Knipscheer JW, Gersons BPR, Kleber RJ (2011) Late-onset PTSD in unaccompanied refugee minors: exploring the predictive utility of depression and anxiety symptoms. J Clin Child Adolesc Psychol 40(5):742–755. doi: 10.1080/15374416.2011.597083 PubMedCrossRefGoogle Scholar
  11. 11.
    Crivello G (2011) ‘Becoming somebody’: youth transitions through education and migration in Peru. J Youth Stud 14(4):395–411. doi: 10.1080/13676261.2010.538043 CrossRefGoogle Scholar
  12. 12.
    O’Connor M, Sanson A, Hawkins MT, Olsson C, Frydenberg E, Toumbourou JW, Letcher P (2011) The relationship between positive development and psychopathology during the transition to adulthood: a person-centred approach. J Adolesc 35(3):701–712. doi: 10.1016/j.adolescence.2011.10.006 PubMedGoogle Scholar
  13. 13.
    Rousseau C, Said TM, Gagne MJ, Bibeau G (1998) Between myth and madness: the premigration dream of leaving among young Somali refugees. Cult Med Psychiatr 22(4):385–411CrossRefGoogle Scholar
  14. 14.
    Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P (2007) Comparing psychological distress, traumatic stress reactions, and experiences of unaccompanied refugee minors with experiences of adolescents accompanied by parents. J Nerv Ment Dis 195(4):288–297. doi: 10.1097/01.nmd.0000243751.49499.93 PubMedCrossRefGoogle Scholar
  15. 15.
    Mels C, Derluyn I, Broekaert E, Rosseel Y (2010) The psychological impact of forced displacement and related risk factors on Eastern Congolese adolescents affected by war. J Child Psychol Psychiatry 51(10):1096–1104. doi: 10.1111/j.1469-7610.2010.02241.x PubMedCrossRefGoogle Scholar
  16. 16.
    Miller KE, Rasmussen A (2010) War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med 70(1):7–16. doi: 10.1016/j.socscimed.2009.09.029 PubMedCrossRefGoogle Scholar
  17. 17.
    Montgomery E (2011) Trauma, exile and mental health in young refugees. Acta Psychiatr Scand 124:1–46. doi: 10.1111/j.1600-0447.2011.01740.x CrossRefGoogle Scholar
  18. 18.
    Montgomery E, Foldspang A (2008) Discrimination, mental problems and social adaptation in young refugees. Eur J Pub Health 18(2):156–161. doi: 10.1093/eurpub/ckm073 CrossRefGoogle Scholar
  19. 19.
    Goodman JH (2004) Coping with trauma and hardship among unaccompanied refugee youths from Sudan. Qual Health Res 14(9):1177–1196. doi: 10.1177/1049732304265923 PubMedCrossRefGoogle Scholar
  20. 20.
    Reijneveld SA, de Boer JB, Bean T, Korfker DG (2005) Unaccompanied adolescents seeking asylum: poorer mental health under a restrictive reception. J Nerv Ment Dis 193(11):759–761. doi: 10.1097/01.nmd.0000185870.55678.82 PubMedCrossRefGoogle Scholar
  21. 21.
    Vervliet M, De Mol J , Broekaert E, Derluyn I (2013) ‘That I live, that’s because of her.’ Intersectionality as a framework for unaccompanied refugee mothers. Br J Soc Work. doi: 10.1093/bjsw/bct060
  22. 22.
    Wallin AMM, Ahlstrom GI (2005) Unaccompanied young adult refugees in Sweden, experiences of their life situation and well-being: a qualitative follow-up study. Ethn Health 10(2):129–144. doi: 10.1080/13557850500071145 PubMedCrossRefGoogle Scholar
  23. 23.
    Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P (2006) Validation of the multiple language versions of the Reactions of Adolescents to Traumatic Stress questionnaire. J Trauma Stress 19(2):241–255. doi: 10.1002/jts.20093 PubMedCrossRefGoogle Scholar
  24. 24.
    Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P (2007) Validation of the multiple language versions of the Hopkins Symptom Checklist-37 for refugee adolescents. Adolescence 42(165):51–71PubMedGoogle Scholar
  25. 25.
    Bentler PM, Woodward JA (1980) Inequalities among lower bounds to reliability—with applications to test-construction and factor-analysis. Psychometrika 45(2):249–267. doi: 10.1007/bf02294079 CrossRefGoogle Scholar
  26. 26.
    Bird HR, Shaffer D, Fisher P (1993) The Columbia Impairment Scale (CIS): pilot findings on a measure of global impairment for children and adolescents. Int J Methods Psychiatric Res 3:167–176Google Scholar
  27. 27.
    Derluyn I, Broekaert E, Schuyten G (2008) Emotional and behavioural problems in migrant adolescents in Belgium. Eur Child Adolesc Psych 17(1):54–62. doi: 10.1007/s00787-007-0636-x CrossRefGoogle Scholar
  28. 28.
    Derluyn I, Broekaert E (2007) Different perspectives on emotional and behavioural problems in unaccompanied refugee children and adolescents. Ethn Health 12(2):141–162. doi: 10.1080/13557850601002296 PubMedCrossRefGoogle Scholar
  29. 29.
    Derluyn I, Broekaert E (2008) Unaccompanied refugee children and adolescents: the glaring contrast between a legal and a psychological perspective. Int J Law Psychiatry 31(4):319–330. doi: 10.1016/j.ijlp.2003.06.006 PubMedCrossRefGoogle Scholar
  30. 30.
    West BT, Welch KB, Galecki AT (2007) Linear mixed models: a practical guide using Statistical Software. Taylor & Francis Group, LLC., New YorkGoogle Scholar
  31. 31.
    Bates D, Maechler M, Bolker B (2012) lme4: linear mixed-effects models using S4 classes. R package version 0.999999-0. Accessed 18 March 2013
  32. 32.
    R Core Team (2012) R: a language and environment for statistical computing. R Foundation for Statistical Computing, ISBN 3-900051-07-0. Accessed 18 March 2013
  33. 33.
    Beiser M, Hou F (2001) Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10-year study. Soc Sci Med 53(10):1321–1334. doi: 10.1016/s0277-9536(00)00412-3 PubMedCrossRefGoogle Scholar
  34. 34.
    Kinzie JD, Sack W, Angell R, Clarke G, Ben R (1989) A 3-year follow-up of Cambodian young people traumatized as children. J Am Acad Child Adolesc Psychiatr 28(4):501–504. doi: 10.1097/00004583-198907000-00006 CrossRefGoogle Scholar
  35. 35.
    Rumbaut RG, Komaie G (2010) Immigration and adult transitions. Future Child 20(1):43–66PubMedCrossRefGoogle Scholar
  36. 36.
    Sack WH, Him C, Dickason D (1999) Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children. J Am Acad Child Adolesc Psychiatr 38(9):1173–1179. doi: 10.1097/00004583-199909000-00023 CrossRefGoogle Scholar
  37. 37.
    Almqvist K, BrandellForsberg M (1997) Refugee children in Sweden: posttraumatic stress disorder in Iranian preschool children exposed to organized violence. Child Abuse Negl 21:351–366PubMedCrossRefGoogle Scholar
  38. 38.
    Hjern A, Angel B (2000) Organized violence and mental health of refugee children in exile: a six-year follow-up. Acta Paediatr 89(6):722–727. doi: 10.1080/080352500750044089 PubMedCrossRefGoogle Scholar
  39. 39.
    Montgomery E (2010) Trauma and resilience in young refugees: a 9-year follow-up study. Dev Psychopathol 22(2):477–489. doi: 10.1017/s0954579410000180 PubMedCrossRefGoogle Scholar
  40. 40.
    Rousseau C, Drapeau A, Rahimi S (2003) The complexity of trauma response: a 4-year follow-up of adolescent Cambodian refugees. Child Abuse Negl 27(11):1277–1290. doi: 10.1016/j.chiabu.2003.07.001 PubMedCrossRefGoogle Scholar
  41. 41.
    Almqvist K, Broberg AG (1999) Mental health and social adjustment in young refugee children 31/2 years after their arrival in Sweden. J Am Acad Child Adolesc Psychiatry 38:723–730PubMedCrossRefGoogle Scholar
  42. 42.
    Spinhoven P, Bean T, Eurelings-Bontekoe L (2006) Inconsistencies in the self-report of traumatic experiences by unaccompanied refugee minors. J Trauma Stress 19(5):663–673. doi: 10.1002/jts.20152 PubMedCrossRefGoogle Scholar
  43. 43.
    Henley J, Robinson J (2011) Mental health issues among refugee children and adolescents. Clin Psycholog 15(2):51–62. doi: 10.1111/j.1742-9552.2011.00024.x CrossRefGoogle Scholar
  44. 44.
    Hodes M (2000) Psychologically distressed refugee children in the United Kingdom. Child Psychol Psychiatry Rev 5:57–68. doi: 10.1017/S136064170000215X CrossRefGoogle Scholar
  45. 45.
    Ehntholt KA, Yule W (2006) Practitioner review: assessment and treatment of refugee children and adolescents who have experienced war-related trauma. J Child Psychol Psychiatry 47(12):1197–1210. doi: 10.1111/j.1469-7610.2006.01638.x PubMedCrossRefGoogle Scholar
  46. 46.
    EMN (2009) Unaccompanied refugee minors in Belgium: reception, return and integration arrangements. Accessed 11 June 2013
  47. 47.
    Ruiz-Casares M, Rousseau C, Derluyn I, Watters C, Crepeau F (2010) Right and access to healthcare for undocumented children: addressing the gap between international conventions and disparate implementations in North America and Europe. Soc Sci Med 70(2):329–336. doi: 10.1016/j.socscimed.2009.10.013 PubMedCrossRefGoogle Scholar
  48. 48.
    Watters C, Ingleby D (2004) Locations of care: meeting the mental health and social care needs of refugees in Europe. Int J Law Psychiatry 27(6):549–570. doi: 10.1016/j.ijlp.2004.08.004 PubMedCrossRefGoogle Scholar
  49. 49.
    Vitus K, Liden H (2010) The status of the asylum-seeking child in Norway and Denmark: comparing discourses, politics and practices. J Refug Stud 23(1):62–81. doi: 10.1093/jrs/feq003 CrossRefGoogle Scholar
  50. 50.
    Kohli RK (2006) The comfort of strangers: social work practice with unaccompanied asylum-seeking children and young people in the UK. Child Fam Soc Work 11(1):1–10CrossRefGoogle Scholar
  51. 51.
    Ahearn FL (2000) Psychosocial wellness. Methodological approaches to the study of refugees. In: Ahearn FL (ed) Psychosocial wellness of refugees, vol 7. Studies in forced migration. Berghahn Books, New York, pp 4–23Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Marianne Vervliet
    • 1
  • Jan Lammertyn
    • 2
  • Eric Broekaert
    • 3
  • Ilse Derluyn
    • 1
  1. 1.Department of Social Welfare Studies, Faculty of Psychology and Educational SciencesGhent UniversityGhentBelgium
  2. 2.Faculty of Psychology and Educational SciencesGhent UniversityGhentBelgium
  3. 3.Department of OrthopedagogicsGhent UniversityGhentBelgium

Personalised recommendations