Annual Research Review: A multilevel bioecological analysis of factors influencing the mental health and psychosocial well‐being of refugee children

Abstract

Background This 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. Methods The 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. Results We 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. Conclusions Actions 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.

Mental Health Outcomes of Unaccompanied Refugee Minors: a Rapid Review of Recent Research

“…Mental health of UMRs represents a complex task for receiving countries, as the needs are often disproportionately high in this group and thus quick access is desirable. However, access to necessary services has been seen to be delayed on both sides of the Atlantic in the Netherlands, Belgium and Canada, with lengthy asylum-seeking procedures, coupled with cultural differences, especially surrounding belief systems and language resulting in deterioration in mental health over time and further increasing the need for services among this group [47].…”

An interdisciplinary framework examining culture and adaptation in migrant children and adolescents

“…A bidirectional relationship exists between individual-level characteristics (e.g., behavioral dispositions, bioecological resources [skills], and demand [physical appearance]) and the nested systems. Prior research that has drawn on the bioecological model to study the experiences of migrant children and adolescents, demonstrates the unique positions along with migrant-specific factors that affect developmental outcomes (Arakelyan & Ager, 2020;Jensen, 2007;.…”

Syrian Refugee Youth Resettled in Norway: Mechanisms of Resilience Influencing Health-Related Quality of Life and Mental Distress

“…Family cohesion, perceived parental support, and parental mental health—particularly in mothers—are associated with fewer psychological difficulties in children ( 7 ). Friends and the subjective experience of peer relationships are also integral to healthy psychological development in children and youth ( 7 , 17 , 18 ). Friendships may prevent social isolation and loneliness and infer a sense of belonging, especially in school ( 19 ).…”

“…At an individual level, self-regulation, coping mechanisms, and self-efficacy have shown protective effects (13,14). Family and parental factors are of utmost importance for refugee children and youth; these emphasise how the family may function as a key emotional regulator, buffering, or exacerbating the impact of earlier PTEs from war and flight (10,(15)(16)(17). Family cohesion, perceived parental support, and parental mental health-particularly in mothers-are associated with fewer psychological difficulties in children (7).…”

“…However, the above resilience factors and processes are often investigated separately and scattered throughout several contexts, despite the acknowledgement of complex interactions (9). Evidence supports a multiple factor model where the total constellation of resilience factors promotes better functioning after adversity, not one specific driving factor (7,10,17,20). A composite measure was therefore included in this study.…”