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Review of Child and Adolescent Refugee Mental Health

NCJ Number
Journal of the American Academy of Child & Adolescent Psychiatry Volume: 43 Issue: 1 Dated: January 2004 Pages: 24-36
Stuart L. Lustig M.D.; Maryam Kia-Keating Ed.M.; Wanda Grant Knight Ph.D.; Paul Geltman M.D.; Heidi Ellis Ph.D.; J. David Kinzie M.D.; Terence Keane Ph.D.; Glenn N. Saxe M.D.
Date Published
January 2004
13 pages
This article discusses stressful experiences and stress reactions among child and adolescent refugees, as well as interventions and ethical considerations in research and clinical work.
Approximately half of the world’s 20 million refugees are children. Between 1988 and 2001, the United States admitted over 1.3 million refugees, for whom health professionals are increasingly called upon to help. This review details the phases of refugee experiences -- preflight, flight, and resettlement. Four broad responses to the stressful experiences are described: anticipation, devastating events, survival, and adjustment. These reactions fit within the three phases of the refugee experience. The impact of war among young refugees manifests as psychopathology defined by Western models of illness. Despite multiple traumas and the challenges of acculturation, child and adolescent refugees are resilient, although studies of resilience, as well as of the longitudinal course of symptoms, are few. Parental well-being appears to affect child functioning, and adjustment during resettlement is facilitated by appropriate contact with the native culture. Clinical research and implementation of clinical services must account for cultural variations in symptom expression, diagnosis, and treatment-seeking. The range of desirable services at various social/ecological levels merits further attention, especially among the most vulnerable groups, such as children in detention and unaccompanied minors. 54 references