Abstract
In 2018, nearly 75 million people were displaced from their place of origin of which 20.4 million are considered as refugees. Children constitute over half of this population. A review of the currently available literature regarding the psychological impact of forced displacement on children was performed with the concept examined under three stages of flight: pre-migration, intra-migration and post-migration. The resilience of children despite adversities is explored. Post-traumatic stress disorder (PTSD), depression and anxiety are the most commonly studied effects of forced migration on children. Rates range from 20 to 52.7%, 23 to 44.1% and 38.3 to 69% respectively. PTSD is associated with pre-migration disturbances such as witnessing death or torture of relatives, assaults and separation from family. Intra-migration difficulties relate to the hazardous journey, length of detention, type of facility and failed asylum application. Post-migration difficulties highlighted are insecure asylum status, housing worries, multiple relocations and poor acculturation technique and are more related to depression and anxiety. Despite these challenges and the tremendous horror witnessed, the majority of children report good functionality in their host countries in the long-term. The purpose of this report is to provide an overview of the factors contributing to the manifestation of mental health issues in child refugees as well as to examine mechanisms which enhance successful resettling in the host society. Health and social care providers must understand the complex interplay between the damaging effects of displacement, and the innate protective factors that persecuted children possess. Management should involve a holistic approach that considers children, families and native communities.
Similar content being viewed by others
References
UNHCR (No Date) The UN Refugee Agency, Convention and protocol relating to the status of refugees: Switzerland
UNICEF (2019) Latest statistics and graphics on refugee and migrant children. Available from: https://www.unicef.org/eca/emergencies/latest-statistics-and-graphics-refugee-and-migrant-children. Accessed 22 July 2019
Reception and Integration Agency (2018) Monthly report october 2018. Department of Justice and Equality
Hopkins PE, Hill M (2008) Pre-flight experiences and migration stories: the accounts of unaccompanied asylum-seeking children. Child Geogr 6(3):257–268
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
Fazel M, Stein A (2003) Mental health of refugee children: comparative study. BMJ (Clinical research ed) 327(7407):134–134
Montgomery E, Foldspang A (2005) Seeking asylum in Denmark: refugee children’s mental health and exposure to violence. Eur J Pub Health 15(3):233–237
Thabet AA, Abed Y, Vostanis P (2001) Effect of trauma on the mental health of Palestinian children and mothers in the Gaza Strip. East Mediterr Health J 7(3):413–421
Gormez V, Kılıç HN, Orengul AC, Demir MN, Demirlikan Ş, Demirbaş S, Babacan B, Kınık K, Semerci B (2018) Psychopathology and associated risk factors among forcibly displaced Syrian children and adolescents. J Immigr Minor Health 20(3):529–535
Jakobsen M, Meyer DeMott M, Wentzel-Larsen T, Heir T (2017) The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway. BMJ Open 7(6):e015157
Zwi K, Mares S, Nathanson D, Tay AK, Silove D (2018) The impact of detention on the social–emotional wellbeing of children seeking asylum: a comparison with community-based children. Eur Child Adolesc Psychiatry 27(4):411–422
Fazel M, Stein A (2002) The mental health of refugee children. Arch Dis Child 87(5):366–370
Ellis BH, MacDonald H, Klunk-Gillis J, Lincoln A, Strunin L, Cabral HJ (2010) Discrimination and mental health among Somali refugee adolescents: the role of acculturation and gender. Am J Orthopsychiatry 80(4):564–575
Vervliet M, Lammertyn J, Broekaert E, Derluyn I (2014a) Longitudinal follow-up of the mental health of unaccompanied refugee minors. Eur Child Adolesc Psychiatry 23(5):337–346
Geltman PL et al (2005) The “lost boys of Sudan”: functional and behavioral health of unaccompanied refugee minors resettled in the United States. JAMA Pediatr 159(6):585–591
Goodman JH (2004) Coping with trauma and hardship among unaccompanied refugee youths from Sudan. Qual Health Res 14(9):1177–1196
Sack WH, Clarke GN, Seeley J (1996) Multiple forms of stress in Cambodian adolescent refugees. Child Dev 67(1):107–116
Thabet AAM, Vostanis P (1999) Post-traumatic stress reactions in children of war. J Child Psychol Psychiatry 40(3):385–391
Heptinstall E, Sethna V, Taylor E (2004) PTSD and depression in refugee children. Eur Child Adolesc Psychiatry 13(6):373–380
Kim YJ (2016) Posttraumatic stress disorder as a mediator between trauma exposure and comorbid mental health conditions in North Korean refugee youth resettled in South Korea. J Interpers Violence 31(3):425–443
Vervliet M, Meyer Demott MA, Jakobsen M, Broekaert E, Heir T, Derluyn I (2014b) The mental health of unaccompanied refugee minors on arrival in the host country. Scand J Psychol 55(1):33–37
Berthold SM (1999) The effects of exposure to community violence on Khmer refugee adolescents. J Trauma Stress 12(3):455–471
Gadeberg AK, Montgomery E, Frederiksen HW, Norredam M (2017) Assessing trauma and mental health in refugee children and youth: a systematic review of validated screening and measurement tools. Eur J Pub Health 27(3):439–446
Bronstein I, Montgomery P, Dobrowolski S (2012) PTSD in asylum-seeking male adolescents from Afghanistan. J Trauma Stress 25(5):551–557
Jensen TK et al (2019) Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors. Eur Child Adolesc Psychiatry
Sack WH, Seeley JR, Clarke GN (1997) Does PTSD transcend cultural barriers? A study from the Khmer Adolescent Refugee Project. J Am Acad Child Adolesc Psychiatry 36(1):49–54
Halcón LL, Robertson CL, Savik K, Johnson DR, Spring MA, Butcher JN, Westermeyer JJ, Jaranson JM (2004) Trauma and coping in Somali and Oromo refugee youth. J Adolesc Health 35(1):17–25
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
Mangrio E, Zdravkovic S, Carlson E (2018) A qualitative study of refugee families’ experiences of the escape and travel from Syria to Sweden. BMC Res Notes 11(1):594–594
Ehntholt KA, Trickey D, Harris Hendriks J, Chambers H, Scott M, Yule W (2018) Mental health of unaccompanied asylum-seeking adolescents previously held in British detention centres. Clin Child Psychol Psychiatry 23(2):238–257
Lincoln AK, Lazarevic V, White MT, Ellis BH (2016) The impact of acculturation style and acculturative hassles on the mental health of Somali adolescent refugees. J Immigr Minor Health 18(4):771–778
Jensen TK, Skårdalsmo EMB, Fjermestad K (2014) Development of mental health problems – a follow-up study of unaccompanied refugee minors. 8(1)
Ellis BH, MacDonald H, Lincoln AK, Cabral HJ (2008) Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol 76(2):184–193
Keles S et al (2015) Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles. Ethn Health 21(3):1–18
Oppedal B, Idsoe T (2015) The role of social support in the acculturation and mental health of unaccompanied minor asylum seekers. Scand J Psychol 56(2):203–211
Fanning B, Veale A, O’Connor D (2001) Beyond the pale: asylum-seeking children and social exclusion in Ireland. University College Dublin, University College Cork
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
Goosen S, Stronks K, Kunst AE (2013) Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children: a longitudinal medical record study. Int J Epidemiol 43(1):94–104
Grgic M, et al. (2005) The mental health of children upon their return home after a long displacement period. Vol. 29. Collegium Antropologicum
Durà-Vilà G, Klasen H, Makatini Z, Rahimi Z, Hodes M (2012) Mental health problems of young refugees: duration of settlement, risk factors and community-based interventions. Clin Child Psychol Psychiatry 18(4):604–623
Meyer S, Murray LK, Puffer ES, Larsen J, Bolton P (2013) The nature and impact of chronic stressors on refugee children in Ban Mai Nai Soi camp, Thailand. Glob Public Health 8(9):1027–1047
Panter-Brick C, Grimon M-P, Eggerman M (2014) Caregiver—child mental health: a prospective study in conflict and refugee settings. J Child Psychol Psychiatry 55(4):313–327
Meyer SR, Steinhaus M, Bangirana C, Onyango-Mangen P, Stark L (2017) The influence of caregiver depression on adolescent mental health outcomes: findings from refugee settlements in Uganda. BMC psychiatry 17(1):405–405
Eruyar S, Maltby J, Vostanis P (2018) Mental health problems of Syrian refugee children: the role of parental factors. Eur Child Adolesc Psychiatry 27(4):401–409
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
Correa-Velez I, Gifford SM, Barnett AG (2010) Longing to belong: social inclusion and wellbeing among youth with refugee backgrounds in the first three years in Melbourne, Australia. Soc Sci Med 71(8):1399–1408
Fernando C, Ferrari M (2011) Spirituality and resilience in children of war in Sri Lanka. J Spiritual Ment Health 13(1):52–77
Aguilar P, Retamal G (1998) Rapid educational response in complex emergencies: a discussion document. International Bureau of Education: Geneva, Switzerland
Betancourt TS (2005) Stressors, supports and the social ecology of displacement: psychosocial dimensions of an emergency education program for Chechen adolescents displaced in Ingushetia, Russia. Cult Med Psychiatry 29(3):309
Faculty of Paediatrics (O’Brien, N., Crushell, E.) (2019) Children in direct provision. Royal College of Physicians of Ireland
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
This article does not contain any studies with human participants or animals performed by any of the authors.
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Cayabyab, C.R., O’Reilly, P., Murphy, AM. et al. Psychological morbidity among forcibly displaced children—a literature review. Ir J Med Sci 189, 991–997 (2020). https://doi.org/10.1007/s11845-020-02186-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-020-02186-7