Is the Refugee Health Screener a Useful Tool when Screening 14- to 18-Year-Old Refugee Adolescents for Emotional Distress?

Abstract

Abstract The high number of asylum seekers in Sweden has highlighted the need for structured assessment tools to screen for refugee mental health problems in clinical services. We examined the utility of the Refugee Health Screener (RHS) in refugee adolescents, aged 14–18, attending routine clinical examinations or staying in group homes/refugee centres (N = 29). Participants completed a survey, including the RHS, administered through iPads in their native language. The RHS showed excellent internal consistency (α = 0.96) and correlated moderately with symptoms of post-traumatic stress disorder (r = 0.41, p = 0.025). Mean scores and prevalence rates were comparable to a study of adult refugees in Sweden. Unaccompanied refugee minors (URMs) scored significantly higher (M = 32.0, SD = 12.9) compared to youth staying with their families (M = 7.5, SD = 8.2, p < 0.001, d = 2.27). Our findings confirm that the RHS can be used in the adolescent population in Sweden. These findings moreover suggest that URMs are a particularly vulnerable group with a large burden of mental health problems. In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs) and another 35,015 children in families (Swedish Migration Agency, 2017). Most URMs (86 per cent) are boys, mainly from Afghanistan, Syria, Somalia and Eritrea, whereas children in families (accompanied refugee minors) more often come from Syria and Iraq with an equal gender distribution. During the asylum process, lasting up to 30 months, children have access to free education and health care. URMs are under the care of the social services and are assigned a legal guardian until they turn 18. Adults are entitled to acute health care and housing but cannot work and have no access to studies. If granted asylum, the person/family is assigned to a municipality that assumes responsibility for them. Thus, on top of adverse events before and during migration, the asylum and resettlement process per se involves stressors and a lack of control for refugees, which increases the risk of developing mental health problems.