G285(P) Evaluation of the health needs of unaccompanied asylum seeking children

Abstract

Aims Following the mass migration of children to Europe in 2015–2016, services faced the challenge of managing the needs of unaccompanied asylum seeking children (UASC). This multi-centre quality improvement project (QIP) aimed to identify common physical and emotional health issues, to aid development of optimal services for this particularly vulnerable group. Methods Initial Health Assessments (IHA) reports of the UASCs in four Community Paediatric Looked After Children services across London were assessed. Data was collected on demographics, personal history and health issues, and stored and analysed in a secure online database; ‘Redcap’. Results Data was gathered from 165 UASCs aged 12–17 years. 81% were male. There was significant variety between centres regarding country of origin; most common were Eritrea, Albania, Sudan and Vietnam. Political (including safety concerns) was the most common reason for leaving their home country (n=98, 59%). Most used multiple transport modes on their journey, and a significant proportion (32%, n=40) travelled over 12 months. The majority (57%, n=94) had experienced abuse; 82 disclosed physical abuse, and 18 disclosed sexual abuse. 55% (n=90) reported symptoms of mental health problems. 76% (n=127) had specific health issues, commonly skin conditions, sleep issues or non-specific pain. 35% (n=57) were assessed high-risk of TB contact; 12 had TB symptoms. Referrals for TB screening were made in 103 cases. 44 UASCs were referred to sexual health services; 25% of those required specialist sexual abuse centres. Over a third (n=60) of UASCs were referred to mental health services. 47 UASCs had health needs identified requiring GP follow-up. Average days in UK before IHA was 85; most UASCs had already registered with a GP, dentist and optician. Conclusion Multiple needs identified, including infectious disease risks, mental health and sexual health needs; yet despite meeting criteria for specialist services, many referrals were not made. This QIP found issues with length of time in accessing IHA appointments; assessments within 28 days are a statutory requirement. We are now working to develop guidance and pathways to address the needs of this uniquely vulnerable cohort.