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

Eur J Pediatr. 2018 Dec;177(12):1767-1774. doi: 10.1007/s00431-018-3249-0. Epub 2018 Sep 17.

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.

Keywords: Exile; Minors; Psychosocial; URM; Well-being; Youth perspective.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Denmark
  • Health Promotion / methods*
  • Health Services Needs and Demand*
  • Humans
  • Male
  • Mental Health Services*
  • Mental Health*
  • Minors
  • Refugees / psychology*
  • Social Support
  • Stress, Psychological / psychology