There is general agreement in Australia and other Western resettlement countries that many refugee adolescents with social, behavioural, and mental health problems are not accessing mental health care. There is, however, a paucity of research on refugee adolescent mental health service utilisation and help-seeking. Most research to date has centred on adolescents in the general population, and even then is still very limited. This paper presents the findings of 13 focus groups held with 85 refugee adolescents aged 13-17 years from Afghanistan, Bosnia, Iran, Iraq, Liberia, Serbia, and Sudan. The study was part of a wider investigation of mental health service utilisation by refugee parents of children aged 4-17 years, and by adolescents aged 13-17 years. With respect to adolescents, the focus group findings indicate that most are very reluctant to venture beyond their close friendship networks for help with their psychosocial problems due to a range of individual, cultural, and service-related barriers. Implications for mental health policymakers, service planners, and service providers are discussed.

The large and diverse bodies of literature on refugee child and adolescent mental health have not been matched by a commensurate interest in help-seeking. Most help-seeking research has centred on Western and, to a lesser extent, non-refugee ethnic minority adult populations. An emerging child and adolescent help-seeking literature consistently reports widespread underutilization of mental health services by children in the general population. Current research and opinion suggest a similar trend for refugee and other ethnic minority children. While service underutilization appears to be an issue for all children, those from refugee backgrounds may be at increased risk of mental health problems and have greater difficulty accessing mental health care. From a policy and practice perspective, the most important explanation for low uptake of services by refugee families concerns an overall failure of Western mental health systems to accommodate the needs of ethnically diverse populations in general and refugees in particular. In order to effectively plan for the mental health needs of refugee children and adolescents, Western host country governments need a clear understanding of help-seeking behaviour.

Background. Despite the frequency of traumatic or stressful events experienced by refugee children and adolescents prior to migration and following resettlement, the majority do not experience mental health problems emphasising the critical nature of resilience. While a host of factors deemed to be protective of mental health in young refugees have been identified, there has been little research exploring the role of resilience as a distinct psychological construct. This study aimed to explore the nature of psychological resilience in refugee adolescents and the relationship between resilience and depression, other emotional and behavioural problems, and mental health service uptake. Method. One hundred and seventy multiethnic refugee adolescents aged 13–17 from South Australia were administered a survey comprising the Connor-Davidson Resilience Scale (CD-RISC), Children’s Depression Inventory (CDI), and Strengths and Difficulties Questionnaire (SDQ). Results. Females tended to have higher resilience, as did those adolescents who had been living in Australia longer. Adolescents suffering from depressive symptoms or other emotional or behavioural problems had lower resilience. There was little evidence of an association between resilience scores and exposure to trauma or service utilisation. Discussion. Fostering resilience may be critical to efforts to prevent or reduce mental health problems in refugee adolescents.

Background: Young refugees resettled in Western countries are at increased risk of mental health problems. However, most research has centred on post traumatic stress disorder (PTSD), with depression, other mental health disorders, and problems receiving comparatively less attention. Method: Depressive symptomatology was assessed using the Children's Depression Inventory (CDI) in a multiethnic community sample of 348 refugee children (n = 180) and adolescents (n = 168) aged 7-17 years living in South Australia. Results: According to parent reports, 7.1% of children and adolescents had depressive symptomatology for which services were available and yet only 21.5% of these accessed services. Conclusions: Young refugees need improved access to culturally appropriate mental health care. Key practitioner message:• Young refugees resettled in Western countries are at increased risk of mental health problems.• Most research has centred on Post Traumatic Stress Disorder (PTSD) with depression receiving comparatively less attention • Using a large sample of South Australian refugee children and adolescents, we found a prevalence rate of 7.1% of clinically relevant depressive symptomatology as reported by parents • Of the children and adolescents with parent-reported elevated depressive symptomatology, just 21.1% had accessed mental health services • Future research and policy development in this area would benefit from a focus on improving service utilisation in child and adolescent refugees

While there is a growing body of literature on the mental health status of adult refugees, children have been relatively neglected in research, particularly in Australia. This study investigated the prevalence of emotional and behavioural problems and patterns of service utilisation among 530 refugee children and adolescents aged 4-17 years living in South Australia. Parents and teachers of children aged 4-17 years and adolescents aged 13-17 years completed the appropriate versions of the Strengths and Difficulties Questionnaire. Of the 11.0% of children and adolescents found to have borderline or abnormal emotional and behavioural problems, only 13.0% accessed professional help. The study has practical implications for policy and practice.