What do we know about mental health support for young refugees?

Posted on 31 August 2022

A recently published Cochrane review led by CRD Research Fellow Noortje Uphoff, looked at the evidence on mental health support for young refugees in high-income countries.

Latest reports estimate around 4 million Ukrainian people have fled their homes to find refuge in Europe and the United Kingdom. This has highlighted the need for robust evidence on how best to support the mental health needs of refugees, including children and adolescents.

This systematic review found limited evidence with only three randomised controlled trials that had teenage participants. The interventions evaluated in these trials were music therapy, Stabilization Training to help young people stabilise and cope with their symptoms, and a trauma-based psychological therapy called Teaching Recovery Techniques.

There was no evidence that these interventions could improve mental health symptoms when compared to a waiting list group. There was no difference between the interventions and a waiting list for symptoms of post-traumatic stress, depression, psychological distress, or behavioural problems. For all outcomes, the review authors had low to very low confidence in the results being accurate and trustworthy.

The authors suggest that the quality of research in this field should be improved. This is not an easy task. Researchers will need to consider carefully how to make participation in a trial possible for young people who may be traumatised, not in long-term housing, reluctant to take part in a mental health study, and who may not speak the language of the host country. The review authors also mention issues with the evidence which could be resolved more easily, such as clear reporting of participant characteristics and the aim and target of interventions. This would make it easier to interpret evidence and to combine results from different studies together in a systematic review. Until evidence from more robust randomised controlled trials is available, people commissioning and delivering mental health services may need to borrow from other sources. The review identified 35 non-randomised studies, and these may shed a light on working mechanisms of mental health support services and barriers and facilitators of successful implementation.

Efforts towards building the evidence base for mental health support for this vulnerable group of people are needed.

Soltan F, Cristofalo D, Marshall D, Purgato M, Taddese H, Vanderbloemen L, Barbui C, Uphoff E. Community‐based interventions for improving mental health in refugee children and adolescents in high‐income countries. Cochrane Database of Systematic Reviews 2022, Issue 5, Art. No.: CD013657

This review is part of the Cochrane Common Mental Disorders Group programme of work. Noortje received an NIHR Evidence Synthesis Incentive Award to complete this priority review.