The utilisation of mental health services by children and young people from a refugee background: a systematic literature review

Abstract

People from refugee background are known to be vulnerable to the development of mental health problems and to suicide because of the pre-migration events they have experienced and the difficulties associated with moving from their homeland to a usually different society. Concerns have been expressed that, in spite of this, young refugees' rates of contact with mental-health services are substantially lower than expected. This systematic literature review aimed to summarize what is known about the use of mental-health services by children and young people of refugee background and to identify factors that may constitute impediments to service use as well as factors that may facilitate access to and engagement with services. This article presents the main findings in relation to mental-health services utilization by children and young people of refugee background. An overview of literature on the general (i.e. adults or not-youth specific) refugee population has also been included to provide, where possible, a comparison between the former and the latter. A key finding of this review is that while countries of resettlement have introduced several policies and programs for refugee children and young people, these are based on very little evidence, thus more research is urged.

Keywords:

• refugee
• young
• youth
• mental health service use
• utilization
• access
• review

Notes on contributors

Erminia Colucci is a registered Psychologist (Italy) and holds a PhD in Cultural Psychiatry (Australia). She is currently completing an MPhil in Ethnographic Documentary/Visual Anthropology (UK) while still affiliated with the Centre for International Mental Health (The University of Melbourne, Australia).

Josef Szwarc is the Manager of Research and Policy at the Victorian Foundation for Survivors of Torture (Melbourne). He has worked on range of social policy and human rights issues for government and non-goverment agencies in Australia and UK.

Harry Minas is Director of the Centre for International Mental Health at the University of Melbourne, Director of the Victorian Transcultural Psychiatry Unit and a member of the Council for Immigration Services and Status Resolution, which advises the Immigration Minister.

Carmel Guerra is the founder and Chief Executive Officer of the Centre for Multicultural Youth (CMY) based in Melbourne, Australia. CMY is a community based organisation that provides services to and advocates for the needs of young people from refugee and migrant backgrounds.

Notes

1. For brevity, the terms ‘people of refugee background’ and ‘refugees’ will be used interchangeably throughout the article.

2. Because of the scarcity of relevant literature, we included manuscripts that were not looking specifically at the topic of mental health service utilization but reported some data on this topic.

3. An exception was made for Vaage et al. (2007) where the authors indicated that all or the great part of the sample consisted of refugees.

4. Countries of resettlement consider for permanent residence individuals and families living in countries where they have sought protection, after selection and referral by UNHCR. The status they provide ensures protection against refoulement and provides a resettled refugee and his/her family or dependents with access to civil, political, economic, social and cultural rights similar to those enjoyed by nationals (UNHCR, 2011).