Caregiver and Adolescent Mental Health in Ethiopian Kunama Refugees Participating in an Emergency Education Program

Betancourt, Theresa S.; Yudron, Monica; Wheaton, Wendy; Smith-Fawzi, Mary C.

doi:10.1016/j.jadohealth.2012.01.001

Cited by 31 publications

(24 citation statements)

References 31 publications

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“…Of the 643 potentially relevant publications screened in full text, 125 were identified as eligible for this review. The grey literature search identified another 25 eligible publications, and a further seven were identified through reference list of previous reviews, with a total of 157 publications finally included in the review 24–154Table 1. summarises the characteristics of all included publications.…”

Section: Resultsmentioning

confidence: 99%

Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review

et al. 2020

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BackgroundOver 240 million children live in countries affected by conflict or fragility, and such settings are known to be linked to increased psychological distress and risk of mental disorders. While guidelines are in place, high-quality evidence to inform mental health and psychosocial support (MHPSS) interventions in conflict settings is lacking. This systematic review aimed to synthesise existing information on the delivery, coverage and effectiveness of MHPSS for conflict-affected women and children in low-income and middle-income countries (LMICs).MethodsWe searched Medline, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO)databases for indexed literature published from January 1990 to March 2018. Grey literature was searched on the websites of 10 major humanitarian organisations. Eligible publications reported on an MHPSS intervention delivered to conflict-affected women or children in LMICs. We extracted and synthesised information on intervention delivery characteristics, including delivery site and personnel involved, as well as delivery barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data.ResultsThe search yielded 37 854 unique records, of which 157 were included in the review. Most publications were situated in Sub-Saharan Africa (n=65) and Middle East and North Africa (n=36), and many reported on observational research studies (n=57) or were non-research reports (n=53). Almost half described MHPSS interventions targeted at children and adolescents (n=68). Psychosocial support was the most frequently reported intervention delivered, followed by training interventions and screening for referral or treatment. Only 19 publications reported on MHPSS intervention coverage or effectiveness.DiscussionDespite the growing literature, more efforts are needed to further establish and better document MHPSS intervention research and practice in conflict settings. Multisectoral collaboration and better use of existing social support networks are encouraged to increase reach and sustainability of MHPSS interventions.PROSPERO registration numberCRD42019125221.

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Section: Resultsmentioning

confidence: 99%

Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review

et al. 2020

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“…This possibly reflects the initial therapeutic underpinnings of interventions and the methodological designs of their evaluation. As parental engagement is often a key barrier, some programmes have either combined psychoeducation for children with their caregivers (Betancourt, Yudron, Wheaton, & Smith‐Fawzi, ; Jordans et al., ), or have integrated psychoeducation with basic needs interventions such as infant emergency feeding (Morris et al., ). There is less knowledge on how community strengths can be maximised, although factors such as peer support have been found to contribute positively (Morley & Kohrt, ).…”

Section: Introductionmentioning

confidence: 99%

Practitioner Review: Mental health problems of refugee children and adolescents and their management

Hodes

Vostanis

2018

Child Psychology Psychiatry

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Background: Since 2010, the numbers of refugees have increased and around half are under 18 years of age. It is known that experience of organised violence, displacement and resettlement increases the risk for psychiatric disorders and psychosocial impairment. This review integrates recent research into the risk and protective factors for psychopathology with service and treatment issues. Methods: We draw on and critically evaluate key systematic reviews in the selected areas, innovative robust studies and relevant government reports. Results: Many refugee children show resilience and function well, even in the face of substantial adversities. The most robust findings for psychopathology are that PTSD, and posttraumatic and depressive symptoms are found at higher prevalence in those who have been exposed to war experiences. Their severity may decrease over time with resettlement, but PTSD in the most exposed may show higher continuity. More severe psychiatric disorders including psychosis may also occur. Service delivery needs to take into account socioeconomic and cultural influences but, given the high level of unmet need even in high-income countries, stepped care delivery is required. The evaluation of psychological interventions, often delivered in group settings, suggests that they can be effective for many distressed children; however, for the more impaired, a greater range of disorder-specific therapies will be required. Conclusions: Child and adolescent mental health clinicians and service providers need to be aware of the specific needs of this population and systems for service delivery. There are significant knowledge gaps in understanding risk and vulnerability, service delivery and treatment effectiveness.

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“…For example, parents’ ill mental health was a risk factor for children's emotional and behavioural problems at asylum seekers’ centres in Germany, (Wiegersma, Stellinga‐Boelen, & Reijneveld, ). Kunama refugee adolescents’ internalising and externalising symptoms were predicted by their caregivers’ levels of distress (Betancourt, Yudron, Wheaton, & Smith‐Fawzi, ).…”

Section: Resultsmentioning

confidence: 99%

“…In a study with refugee adolescents from the Middle East, experience of discrimination was significantly associated with internalising symptoms, whereas externalising symptoms were related to school exclusion (Montgomery, ). A study with Ethiopian refugee youth revealed that difficulties in adaptation to the community and aggressive behaviours were strongly correlated (Betancourt et al., ). A number of community factors such as safety, criminality and stigma were associated with persistence of mental health problems among former child soldiers in Sierra Leone (Betancourt, Mc Bain, Newnham, & Brennan, ).…”

Section: Resultsmentioning

confidence: 99%

Review: How should child mental health services respond to the refugee crisis?

Eruyar

Huemer

Vostanis

2017

Child Adoles Ment Health

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Background Child mental health services and related agencies are faced with an increasing challenge in responding to the influx of refugee children around the world. There is strong evidence on the prevalence and complexity of these children's mental health problems and broader needs. Aims To review the research literature on risk and protective factors, and associated mental health interventions for refugee children. Methods Peer‐reviewed studies were included for the period 2004–2017; if they included refugee, asylum‐seeking or internally displaced children under 18 years; and adopted a quantitative design. Vulnerability and protective factors for refugee children were considered in this context, followed by the respective types of interventions at pre‐, peri‐ and postmigration stage, and across high‐ and low‐/middle‐income countries. Eighty‐two peer‐reviewed studies fulfilled the selection criteria. Results The existing body of literature is largely based on identifying risk factors among children with mental health problems and predominantly designing trauma‐focused interventions to reduce their symptomatic distress. Recent research and services have gradually shifted to a broader and dynamic resilience‐building approach based on ecological theory, that is at child, family, school, community and societal level. There is increasing evidence for the implementation and effectiveness of multimodal interventions targeting all these levels, despite the methodological constraints in their evaluation. Conclusions In high‐income countries, child mental health services need to collaborate with all agencies in contact with refugee children, establish joint care pathways, and integrate trauma‐focused interventions with family and community approaches. In low‐ and middle‐income countries, where specialist resources are sparse, resilience‐building should aim at maximising and upskilling existing capacity. A six‐dimensional psychosocial model that applies to other children who experience complex trauma is proposed.

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Caregiver and Adolescent Mental Health in Ethiopian Kunama Refugees Participating in an Emergency Education Program

Cited by 31 publications

References 31 publications

Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review

Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review

Practitioner Review: Mental health problems of refugee children and adolescents and their management

Review: How should child mental health services respond to the refugee crisis?

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