This article is concerned with the small numbers of refugee children and
adolescents who, for psychiatric reasons, have significant social impairment,
with difficulties in functioning within their families and in school. Data from
recent studies carried out in London are presented regarding the characteristics
of this group. The studies show that the impaired refugee children are
psychiatrically heterogeneous, but had high exposure to past violence and
losses, and they experience high levels of isolation, compared with non-refugee
peers. These adversities are particularly likely to occur among those who are
psychiatrically admitted, including those who have psychoses. A high level of
cooperation between agencies, especially mental health and social services, is
frequently required to meet the complex needs of this group. Implications for
service provision and clinical management are discussed.
Almquist, K.
, &
Broberg, A.G.
(1999).
Mental health and social adjustment in young refugee children 31/2 years
after their arrival in Sweden
. Journal of the American Academy of Child and Adolescent
Psychiatry, 38,
723-730
.
2.
Bardsley, M.
, &
Storkey, M.
(2000).
Estimating the numbers of refugees in London
. Journal of Public Health Medicine, 22,
406-412
.
3.
Barwick, C.L.
,
Beiser, M.
, &
Edwards, G.
(2002). Refugee children and their families: Exploring
mental health risks and protective factors. In
F.J. Cramer Azima
&
N. Grizenko
(Eds.), Immigrant and refugee children and their families: Clinical,
research and training issues (pp. 65-94).
Madison, CT: International Universities Press
.
4.
Becker, D.F.
,
Weine, S.M.
,
Vojvoda, D.
, &
McGlashan, T.H.
(1999).
Case series: PTSD symptoms in adolescent survivors of ‘ethnic
cleansing’. Results from a 1-year follow-up study
. Journal of the American Academy of Child and Adolescent
Psychiatry, 38,
775-781
.
5.
Bird, H.R.
(1999). The assessment of functional impairment.
In
D. Shaffer
,
C. Lucas
, &
J. Richters
(Eds.), Diagnostic assessment in child and adolescent
psychopathology!(pp. 209-229).
New York: Guilford Press
.
6.
Bird, H.R.
, &
Gould, M.S.
(1995). The use of diagnostic instruments and global
measures of functioning in child psychiatry epidemiological studies. In
F.C. Verhulst
&
H.M. Koot
(Eds.), The epidemiology of child and adolescent psychopathology
(pp. 86-103).
Oxford: Oxford University Press
.
7.
Fazel, M.
, &
Stein, A.
(2003).
Mental health of refugee children: Comparative study
. British Medical Journal, 327,
134
.
8.
Fazel, M.
, &
Stein, A.
(2004).
UK immigration law disregards the best interests of children
. The Lancet, 363,
1749-1750
.
9.
Fraser, R. (2003). Psychiatric disorder and social adjustment among young
adults leaving local authority care. Unpublished MSc dissertation, Imperial
College, London, University of London.
10.
Health Advisory Service
. (1995). Child and adolescent mental health services.
Together we stand.
London: HMSO
.
11.
Hodes, M.
(2000).
Psychologically distressed refugee children in the United Kingdom
. Child Psychology and Psychiatry Review, 5,
57-68
.
12.
Hodes, M.
(2002).
Implications for psychiatric services of chronic civilian strife or war:
Young refugees in the UK
. Advances in Psychiatric Treatment, 8,
366-374
.
13.
Howard, M.R.
, &
Hodes, M.
(2000).
Psychopathology, adversity and service utilisation of young refugees
. Journal of the American Academy of Child and Adolescent
Psychiatry, 39,
368-377
.
14.
Kivling-Boden, G.
, &
Sundbom, E.
(2001).
Life situation and post-traumatic symptoms: A follow-up study of refugees
from the former Yugoslavia living in Sweden
. Nordic Journal of Psychiatry, 55,
401-408
.
15.
Kope, T.M.
, &
Sack, W.H.
(1987).
Anorexia nervosa in Southeast Asians: A report on three cases
. Journal of the American Academy of Child and Adolescent
Psychiatry, 26,
795-797
.
16.
Leavey, G.
,
Hollins, K.
,
King, M.
,
Barnes, J.
,
Papadopoulos, C.
, &
Grayson, K.
(2004).
Psychological disorder amongst refugee and migrant schoolchildren in London
. Social Psychiatry and Psychiatric Epidemiology,
39,
191-195
.
17.
Lie, B.
(2001).
A 3-year follow-up study of psychosocial functioning and general symptoms
in settled refugees
. Acta Psychiatrica Scandinavica, 106,
415-425
.
18.
Lustig, S.L.
,
Kia-Keating, K.
,
Knight, W.G.
,
Geltman. P.
,
Ellis, H.
,
Kinzie, D.
,
Keane, T.
, &
Saxe, G.N.
(2004).
Review of child and adolescent refugee mental health
. Journal of the American Academy of Child and Adolescent
Psychiatry, 43,
24-36
.
19.
McKelvey, R.S.
, &
Webb, J.A.
(1995).
Unaccompanied status as a risk factor in Vietnamese Amerasians
. Social Science & Medicine, 41,
261-266
.
20.
Mezzich, J.
,
Kleinman, A.
,
Fabrega, H.
, &
Parron, D.L.
(Eds.). (1996). Culture and psychiatric diagnosis. A DSM-IV
perspective (pp. 15-25).
Washington, DC: American Psychiatric Press
.
21.
Patel, N.
, &
Hodes, M.
(2005). Violent deliberate self harm amongst adolescent
refugees. Manuscript submitted for publication.
22.
Raval, H.
(2005).
Being heard and understood in the context of seeking asylum and refuge:
Communicating with the help of bilingual co-workers
. Clinical Child Psychology and Psychiatry, 10,
197-216
.
23.
Roy, P.
,
Rutter, M.
, &
Pickles, A.
(2004).
Institutional care: Associations between overactivity and lack of
selectivity in social relationships
. Journal of Child Psychology and Psychiatry, 45,
866-873
.
24.
Rutter, J.
, &
Jones, C.
(1998). Refugee education.
Stoke on Trent, UK: Trentham Books
.
25.
Sack, W.
(1998).
Multiple forms of stress in refugee and immigrant children
. Child and Adolescent Psychiatric Clinics of North America,
7,
153-167
.
26.
Sack, W.H.
,
Him, C.
, &
Dickason, D.
(1999).
Twelve-year follow-up study of Khmer youths who suffered massive war trauma
as children
. Journal of the American Academy of Child and Adolescent
Psychiatry, 38,
1173-1179
.
27.
Shaffer, D.
,
Gould, M.S.
,
Brasic, J.
,
Ambrosini, P.
,
Fischer, P.
,
Bird, H.
, &
Aluwahlia, S.
(1983).
A children’s global assessment scale
. Archives of General Psychiatry, 40,
1228-1231
.
28.
Stein, S.
,
Chalhoub, N.
, &
Hodes, M.
(1998).
Very early-onset bulimia nervosa: Report of two cases
. International Journal of Eating Disorders, 24,
323-327
.
29.
Tolmac, J.
, &
Hodes, M.
(2004).
Ethnicity and adolescent psychiatric admission for psychotic disorders
. British Journal of Psychiatry, 184,
428-431
.
30.
Tousignant, M.
,
Habimana, E.
,
Biron, C.
,
Malo, C.
,
Sidoli-LeBlanc, E.
, &
Bendris, N.
(1999).
The Quebec adolescent refugee project: Psychopathology and family variables
in a sample from 35 nations
. Journal of the American Academy of Child and Adolescent
Psychiatry, 38,
1426-1432
.
31.
Tufnell, G.
(2003).
Refugee children, trauma and the law
. Clinical Child Psychology and Psychiatry, 8,
431-443
.
32.
Weine, S.
,
Becker, D.
,
McGlashan, T.
,
Vojvoda, D.
,
Hartman, S.
, &
Robbins, J.
(1995).
Adolescent survivors of ‘ethnic cleansing’:
Observations on the first year in America
. Journal of the American Academy of Child and Adolescent
Psychiatry, 34,
1153-1159
.
33.
Westermeyer, J.
(1991). Psychiatric services for refugee
children. In
F. Ahearn
&
J.L. Athey
(Eds.), Refugee children. Theory, research and services (pp.
127-162).
Baltimore: Johns Hopkins University Press
.
