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What can we learn from unaccompanied refugee adolescents’ perspectives on mental health care in exile?

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Abstract

Unaccompanied refugee adolescents who have fled war and persecution often have poor mental health. Yet, little is known about their own perspectives on what can relieve their mental health problems. The aim was to explore unaccompanied refugee adolescents’ perspectives on healing and the mental healthcare offered to them when resettled. The study was based on methodical triangulation of participant observation in a Danish municipal institution for unaccompanied refugee minors, semi-structured individual interviews with experts, social workers and male refugee minors and a focus group interview with refugee minors. Results show that the refugee adolescents associated traditional conversational therapy with discussing negative and stigmatising aspects of their past and carrying risks of re-traumatisation. Instead, alternative activities were proposed, through which resources could be accumulated and they could be met without stereotype.

Conclusion: To enhance the complex mental health needs of unaccompanied minors’ mental healthcare, the perspective of the refugee adolescents should be taken into account. This calls for a holistic approach to mental healthcare in their daily lives, where they are met in a non-stigmatising manner in which their unique capabilities are the main focus. Moreover, a trusting relationship constitutes the fundament to support good mental health among refugee adolescents.

What is Known:

• Unaccompanied refugee adolescents are at risk of poor mental health outcomes, e.g., depression, anxiety, PTSD and psychosocial stress.

• Stigma, lack of social support, stressful life events and lack of intercultural competency among mental health professionals are barriers to good mental health.

What is New:

• There is a need for informal and tailored health promotion initiatives in the refugee adolescents’ everyday lives.

• To treat the refugee adolescents as equal human beings through curiosity and receptiveness to their resources is important in order to build trust and address stigma.

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Notes

  1. The World Health Organization (WHO) defines mental health as “[A] state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community” [34].

  2. FJ has received training in advanced qualitative research methods at University of Copenhagen from 2013 to 2016.

Abbreviations

CRC:

Convention of the Rights of the Child

PTSD:

Post-traumatic stress syndrome

WHO:

The World Health Organization

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Author information

Authors and Affiliations

  1. Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health, Copenhagen University, Øster Farimagsgade 5, 1014, Copenhagen, Denmark

    Frederikke Jarlby & Signe Smith Jervelund

  2. Netherlands Association for Community Health Services, Zwarte Woud 2, 3524 SJ, Utrecht, Netherlands

    Simone Goosen

  3. Department of Social Work and Social Pedagogy, Ghent University, Henri Dunantlaan 2, 9000, Gent, Belgium

    Ilse Derluyn

  4. Department of Sociology and Social Work, Aalborg University, Frederikskaj 10B, 2450, Copenhagen, Denmark

    Kathrine Vitus

Authors
  1. Frederikke Jarlby
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  2. Simone Goosen
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  3. Ilse Derluyn
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  4. Kathrine Vitus
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  5. Signe Smith Jervelund
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Contributions

FJ and SSJ conceived the study. FJ conducted the fieldwork, performed the data analysis, wrote the first draft of the manuscript and finalised the manuscript. SSJ supervised the study design and the analysis. SG, ID, KV and SSJ contributed to critically reviewing and revising the manuscript. The final manuscript as submitted is approved by all authors.

Corresponding author

Correspondence to Frederikke Jarlby.

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Conflict of interest

The authors declare that they have no conflict of interests.

Informed consent

Before the fieldwork, a detailed information sheet about the researcher and the aim of the study was provided to all participants. Informed consent was given by all participants in the study. For participants younger than 18 years of age, informed consent was also given by legally authorised representatives. All details which might lead to identification of the participants were changed in the presentation of the results.

Additional information

Communicated by Nicole Ritz

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Jarlby, F., Goosen, S., Derluyn, I. et al. What can we learn from unaccompanied refugee adolescents’ perspectives on mental health care in exile?. Eur J Pediatr 177, 1767–1774 (2018). https://doi.org/10.1007/s00431-018-3249-0

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  • DOI: https://doi.org/10.1007/s00431-018-3249-0

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