Abstract
BackgroundThis paper revisits the themes of an influential 1993 review regarding the factors shaping the mental health and psychosocial well‐being of refugees to take stock of developments in the evidence base and conceptualisation of issues for refugee children over the last 25 years.MethodsThe study deployed a systematic search strategy. This initially identified 784 papers, which was reduced to 65 studies following application of inclusion and exclusion criteria. We used a later iteration of Bronfenbrenner’s bioecological model of human development – the PPCT model – to consolidate evidence.ResultsWe identify a range of risk and protective factors operating at individual, familial, community and institutional and policy levels that influence outcomes for refugee children. The dynamics shaping the interaction of these influences are linked to the life course principles of socio‐historical time and developmental age, proximal processes and child agency.ConclusionsActions at individual, familial, community, school, institutional and policy levels all have potential traction on mental health and psychosocial well‐being of refugee children. However, evidence suggests that greatest impact will be secured by multilevel interventions addressing synergies between ecological systems, approaches engaging proximal processes (including parenting programmes) and interventions facilitating the agency of the developing refugee child.
Highlights
Of the estimated global refugee population of approaching 26 million refugees, over a half are under the age of eighteen (UNHCR, 2018)
519 titles and abstracts were screened for relevance resulting in 86 full-text articles retrieved for further eligibility assessment
The majority of studies were conducted in highincome contexts: Scandinavia (10), Australia (10), the United States (7), mainland Europe (9), Canada (2) and the United Kingdom (2)
Summary
Of the estimated global refugee population of approaching 26 million refugees, over a half are under the age of eighteen (UNHCR, 2018). The ‘global refugee crisis’ of the last decade has been marked by large-scale displacement of populations from conflict-affected and low-income settings and varieties of accommodation and resistance of these movements by other nations Factors such as displacement experience, familial separation and acculturative stress all have clear implications for children’s wellbeing and development outcomes in such circumstances. In 1993, the second author completed a review of mental health in refugee populations with a developmental focus on behalf of Harvard Centre for the Study of Culture and Medicine (Ager, 1993). This was part of the preparation for the production of World Mental Health: Problems and Priorities in LowIncome Settings (Desjarlais, Eisenberg, Good, & Kleinman, 1995), one of the foundational works in establishing the field of global mental health.
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