Comparing Expectations of Social Workers in Norwegian Trauma-Informed Care Institutions: Perspectives from Social Work Leadership and Young Unaccompanied Refugees

BackgroundPsychological distress and lack of family support may explain the mental health problems that are consistently found in young unaccompanied refugees in Western countries. Given the strong relationship between poor mental health and alcohol misuse, this study investigated hospital admissions due to alcohol related disorders among accompanied and unaccompanied young refugees who settled in Sweden as teenagers.MethodsThe dataset used in this study was derived from a combination of different registers. Cox regression models were used to estimate the risks of hospital care due to alcohol related disorders in 15,834 accompanied and 4376 unaccompanied young refugees (2005–2012), aged 13 to 19 years old when settling in Sweden and 19 to 32 years old in December 2004. These young refugees were divided into regions with largely similar attitudes toward alcohol: the former Yugoslavian republics, Somalia, and the Middle East. The findings were compared with one million peers in the native Swedish population.ResultsCompared to native Swedes, hospital admissions due to alcohol related disorders were less common in young refugees, with a hazard ratio (HR) of 0.65 and 95% confidence interval (CI) between 0.56 and 0.77. These risks were particularly lower among young female refugees. However, there were some differences across the refugee population. For example, the risks were higher in unaccompanied (male) refugees than accompanied ones (HR = 1.49, 95% CI = 1.00–2.19), also when adjusted for age, domicile and income. While the risks were lower in young refugees from Former Yugoslavia and the Middle East relative to native Swedes, independent of their length of residence in Sweden, refugees from Somalia who had lived in Sweden for more than ten years showed increased risks (HR = 2.54, 95% CI = 1.71–3.76), after adjustments of age and domicile. These risks decreased considerably when income was adjusted for.ConclusionYoung refugees have lower risks of alcohol disorders compared with native Swedes. The risks were higher in unaccompanied young (male) refugees compared to the accompanied ones. Moreover, Somalian refugees who had lived in Sweden for more than ten years seems to be particularly vulnerable to alcohol related disorders.

Summary This study reviews two different types of frontline social services for unaccompanied young adult refugees participating in an intensive Social Support Programme implemented in 2016–2019 by a local municipality. More specifically, the study took a phenomenological research approach to review the impact of intensive case management and specialised educational/occupational orientation services on young refugees’ capabilities and agency to reach aspired life goals. The capability approach has been applied as a theoretical framework for identifying opportunities and challenges in this regard. The paper covers a mixed-method design that includes qualitative and quantitative data. The qualitative data are drawn from 42 in-depth interviews with 24 young refugees and one interview and three focus group discussions with 10 service providers. The article also includes a limited amount of longitudinal statistics on the aspirations of 31 young refugees upon entering and exiting the support programme. Findings This article shows theoretical and empirical evidence for utilising the capability approach to review social services for young refugees. Findings suggest that social workers and refugees face intersecting structural and interpersonal tensions that counteract with the expansion of young refugees’ capabilities and agency to reach their aspired life goals. Specific strategies are suggested to diminish described challenges. Applications Social work with unaccompanied young adult refugees should shift its attention from integrating these young individuals into the dominant social order, to prioritising their human development.

Mental health care for unaccompanied young refugees in Germany through a stepped care approach versus enhanced usual care: a cluster-randomised hybrid effectiveness-implementation trial.

Background: Young people who have travelled to another country, unaccompanied and with refugee status, are a both resilient and vulnerable group with specific needs. Supporting them is often challenging for social workers, and providing this support is mediated by the expectations that these young people have of social workers and social worker roles. Aim: In this study, we explore how young unaccompanied refugees (YURs) perceive the roles of social workers in the national context of Norway, where concerns about the quality of social work for this group have been highlighted. Method: Using the theoretical lens of role theory, semi-structured in-depth interviews were conducted with 11 Afghan boys between 16 and 23 years of age, living under the protection of the Child Welfare Services (CWS) in two municipalities in Norway. The interviews explored the boys’ positive and negative experiences of the social worker. A thematic analysis was conducted, in which the coding framework was informed by the premise that actual experience informs our expectations of other individuals’ behaviour and roles. Findings: YURs’ expectations are more than instrumental, and more than a task they expect the social worker to perform. They also expect the task to be performed in a person-centred, therapeutic alliance (e.g. with humour and trust), and that the social worker exhibits particular personal characteristics or competences, besides being culturally competent and sensitive. Conclusion: We find that YURs’ descriptions of the social worker’s roles of being a caregiver and practical helper are similar to what other young people in contact with the CWS expect. However, YURs expect an additional role, which is specific to this field of social work, namely that of an integration helper. However, the expectations that each individual young person has of social workers are individual, in flux and contextual, and not consistent over time. Therefore, we recommend prioritizing learning more about the young person’s individual expectations of the social worker roles, as well as a useful weighting of these roles for each individual young refugee.

This article explores unaccompanied young refugees’ participation in various learning contexts beyond school. Drawing from a qualitative study based on interviews with unaccompanied young refugees, educators and social workers in Norway, the findings emphasise the need for a holistic approach to refugee education in and across contexts of learning. The refugees originate from countries where access to formal schooling was difficult or disrupted. Many of them have been exposed to traumatic events prior to arrival. As the educational and psychosocial needs of resettled refugees are diverse and complex, it is unlikely that schools are able to meet them all. Participation in diverse settings, activities and practices beyond school may expand young refugees’ opportunities for meaningful learning as well as promote their social inclusion. Facilitating access to adequate learning contexts, along with supporting their own commitment to succeed, is decisive for young refugees’ educational achievement, psychosocial adjustment and inclusion in society. The paper emphasises the need for reconceptualising refugee education as inclusive of diverse learning contexts in and outside of school. Enhanced collaboration between schools, local community organisations and wider society will facilitate and support resettling young refugees’ opportunities to achieve their fullest potential.

Creating Trauma-Informed Long-Term Care Organizations

BackgroundYoung unaccompanied refugees who settle in a new country are at substantial risk of developing health problems while striving to uphold a meaningful, new life. We lack knowledge about how they use their personal agency to self-care in the context of their local communities. This article examines how young unaccompanied refugees create healthy identities and looks into the social structures that promote health in their everyday life. MethodsNineteen in-depth interviews were conducted with young unaccompanied refugees settled in Norway, originating from Afghanistan, Eritrea, and Syria. Interpretive phenomenological analysis was used. Our theoretical framework combined Antonovsky's (1987) theory of health, Honneth's (2005) philosophy of recognition, and Prilleltensky's (2020) social psychological concept of mattering. ResultsYoung unaccompanied refugees create healthy identities through “doings”, i.e. meaningful activities that provide recognition and the feeling of adding value. They confirm health as a relational phenomenon, including horizontal relations at, for example, school, work, gym, and other leisure activities in the local community. Vertical relations involving legal status, residence permits, and community values, were also highly important. The participants’ relation to parents/families in their country of origin was often complex, associated both with burdensome obligations to provide and a potential to care and matter. ConclusionYoung unaccompanied refugees are dependent on inclusive, supportive policies and structures which enable them to develop healthy identities. These findings should encourage policymakers and society to strengthen and expand arenas for “doings” and meaning for young unaccompanied refugees.

BackgroundUnaccompanied young refugees constitute an especially vulnerable population, reporting high rates of trauma and mental health problems. There is a significant gap in the literature on trauma and posttraumatic stress symptoms (PTSS) in unaccompanied young refugees who are still on the move and live in precarious circumstances such as refugee camps. This study therefore aimed to contribute to this gap by investigating pre- and peri-migration (potentially) traumatic experiences of unaccompanied young refugees; longitudinal trajectories of trauma, daily stressors and PTSS; and the impact of gender, trauma, and daily stressors on PTSS over time.MethodsThis longitudinal, mixed-method, and multi-country study was conducted in various settings (e.g. refugee camps, reception centers) across nine European countries. A heterogeneous sample of N = 187 unaccompanied young refugees (78.4% male) from 29 different countries was assessed via interviews at 3 time-points during a period of 27 months. Data was analyzed via growth curve modelling.ResultsPrevalence rates of (potentially) traumatic experiences ranged from 29.5 to 91.9%. Peri-migration traumatization remained stable over time (b = − 0.02; p = 0.371), but the number of reported daily stressors (b = − 0.24; p = 0.001) and PTSS scores significantly decreased over time (b = − 0.98; p = 0.004). Females reported higher PTSS compared with males at baseline (p = 0.002), but gender did not influence the longitudinal trajectory of PTSS. The pre-migration trauma load and daily stressors at baseline did not have a significant effect on PTSS at baseline or on the longitudinal trajectory.ConclusionsThis is the first study to document not only the high numbers of traumatic events for unaccompanied young refugees pre- and peri- migration, but also the continued traumatization during flight, as well as high rates of daily stressors and PTSS. Humanitarian and political assistance is urgently needed to curb the often life-threatening conditions unaccompanied young refugees face during migration.

ObjectivesSexual health needs of young refugees and asylum-seeking men are seldom explored or addressed, adversely affecting their mental and physical well-being. By interviewing young male former unaccompanied minors, refugees and...

Abstract. Background: Social support is an important resource and source of self-esteem and belongingness for all children and youths. Yet, for unaccompanied asylum-seeking and refugee minors, who leave their home countries without a caretaking adult, extra-familial social, supportive networks in exile may be crucial for their well-being. We propose that their origin in collectivist cultures involves resources for re-establishing social networks in countries of resettlement. Aim: The overall aim of this study is to examine if cultural factors such as values and self-construals are associated with variations in perceived social support from friends among unaccompanied young refugees. We propose a model in which related self-construals mediate the association between collectivist values and perceived friend support. Method: We collected cross-sectional self-report questionnaire data from 611 unaccompanied young refugees (84.5% male; Mage = 18.49 years, SD = 2.57 years) who had been granted residence in Norway. Results: Structural equation analyses revealed that higher levels of collectivist values were associated with stronger related self-construals, which, in turn, were positively associated with stronger perceived support from friends. However, related self-construals only acted as a partial mediator. Limitations: The generalizability of our findings to other groups of immigrant children and youth and/or to unaccompanied refugees in other countries is unknown and should be examined in future studies. Conclusion: Our results contribute new theoretical knowledge about how the development of social supportive relationships in the diaspora is embedded in cross-cultural contexts. Maintaining aspects of one’s heritage culture can promote resilient outcomes among unaccompanied young refugees.

Background Unaccompanied minor refugees are a high risk group for trauma-related disorders. Although these disorders pose a risk for unhealthy substance use, research of substance use among young refugees is lacking. Methods This study investigated substance use in a total of 102 refugees between 16 and 21 years of age who arrived as unaccompanied minors in Germany. Participants were asked about their religious beliefs and substance use within the last three months and prior to leaving their countries of origin. Unhealthy substance use was assessed by drug-specific questionnaires. Results Overall, 38% of the study participants met the criteria for unhealthy substance use (12% solely for unhealthy tobacco use). According to self-ratings, 21% of the refugees met the criteria for unhealthy alcohol use, 25% for unhealthy tobacco use and 12% for unhealthy cannabis use. Young refugees who had already used drugs in their country of origin were more susceptible to developing unhealthy substance use. Identifying as religious seems to reduce the risk for unhealthy substance use. Conclusion The results reveal that unaccompanied refugees are highly vulnerable for unhealthy substance use. Special programs for unhealthy substance use prevention are needed for this group.

The article examines how unaccompanied young refugees in Sweden relate to and talk about their everyday lives and life plans during a time of transition from childhood to adulthood. We regard them as navigators and emotional beings embodying social situations, relationships and sentiments in their habitus throughout their lives affecting their life plans and acting to build capital in social fields. Their narratives show that they all have a life plan. However, disruptions and adjustments of life plans occur, often related to their birth families, deeply embodied in their habitus, to their everyday life, but also to socio-economic and political contexts both globally and locally. Their position as young ‘unaccompanied minors’ is fragile when it comes to realizing future goals. A stable social and economic structure, stability capital, appears to contribute to possibilities of adapting to or maintaining sustainable life plans.

Improving mental health services for young refugees: The role of organisational readiness in residential care facilities

Receiving the right to stay in Norway might seem a critical factor for refugees’ well-being and belonging. Yet, this research shows that young unaccompanied refugees experience ambivalent feelings towards Norwegian society after their resettlement. The study is based on a qualitative research design with 14 young unaccompanied refugees residing in Norway. Drawing on recognition theory, we focus on how participants’ psychosocial well-being is constituted through their encounters with social workers and helpers, restrictive asylum policies, and anti-immigration discourses in Norwegian society. Our findings suggest that, while social workers are central to the well-being of these young people, their interaction is sometimes perceived by the young people as emotional misrecognition. Further, while they have the right to residency, their right to family life is not fully recognised, and this poses a threat to their well-being. Anti-immigration discourses contribute further to feelings of ambivalent recognition. Participants strived to manage through active involvement in relationships, everyday coping, sensemaking, critical reflection and social engagement, insisting on their own and other refugees’ worth. We argue that youth-focused social services must explicitly engage with these young people’s broader legal, emotional and social (mis)recognition and with their ways of managing challenges when assisting them in achieving well-being.

The experiences of unaccompanied young migrants and refugees challenge the idea of a common European asylum policy but also show that traditional welfare typologies used to account for differences in welfare across states fail to account for the lived experiences of this group. They do not consider the shifting categorizations of young migrants in institutional terms, nor how the stratification of their social rights plays out over place and time. Moreover, current welfare typologies give inadequate attention to the increasing intersection of the labour market and opportunities for regularization, the relative importance and role of the state in the welfare mix, and the nexus of access to welfare and immigration enforcement. This article draws on qualitative longitudinal research in England and Italy to argue that rather than experiencing welfare through the lens of Liberal (England) versus Conservative or Mediterranean (Italy) regimes, unaccompanied young migrants and refugees in these countries are better understood as navigating different systems of ‘iron rod welfare’ and ‘colander welfare’. In England, the nexus between welfare and legal status is policed by an iron rod on one side of which exists a plethora of social rights, but on the other the risk of a proactive detention and deportation regime. In Italy, meanwhile, the holes of the colander denote gaps in protection but also possibilities to navigate alternative welfare strategies independently of the state. The ability to act independently of the state is an important but under-theorized capability for this population, for whom the state is a more ambiguous actor than is traditionally considered in European social policy.