Finding Keys: A Systematic Review of Barriers and Facilitators for Refugee Children’s Disclosure of Their Life Stories

Abstract

The systematic review presented in this article aims to reveal what supports and hampers refugee children in telling their, often traumatic, life stories. This is important to ensure that migration decisions are based on reliable information about the children's needs for protection. A systematic review was conducted in academic journals, collecting all available scientific knowledge about the disclosure of life stories by refugee minors in the context of social work, guardianship, foster care, asylum procedures, mental health assessment, and therapeutic settings. The resulting 39 studies were thoroughly reviewed with reference to what factors aided or hampered the refugee children's disclosure of their life stories. The main barriers to disclosure were feelings of mistrust and self-protection from the side of the child and disrespect from the side of the host community. The facilitators for disclosing life stories were a positive and respectful attitude of the interviewer, taking time to build trust, using nonverbal methods, providing agency to the children, and involving trained interpreters. Social workers, mentors, and guardians should have time to build trust and to help a young refugee in revealing the life story before the minor is heard by the migration authorities. The lack of knowledge on how refugee children can be helped to disclose their experiences is a great concern because the decision in the migration procedure is based on the story the child is able to disclose.

Evaluation of the teaching recovery techniques community-based intervention for accompanied refugee children experiencing post-traumatic stress symptoms (Accompanied refugeeS In Sweden Trial; ASsIST): study protocol for a cluster randomised controlled trial

“…The challenges anticipated include recruitment, a high level of attrition, poor literacy among participants and assessment across the wide age range of the study. Recruitment is a particular concern as refugee children and adolescents report feelings of mistrust and self-protection when in a setting that requires self-disclosure, 55 such as mental health interventions like TRT, which is likely to affect intervention and trial participation. However, the trial has been designed to mitigate these challenges where possible (eg, over-recruitment; retention strategies; in-person data collection) and will be instrumental in building the Swedish evidence base for refugee child mental health interventions.…”

Disclosure in Undocumented Families and School Mental Health Clinics

“…Nondisclosure of psychosocial stressors and traumatic experiences in undocumented immigrant families is a real and major concern. 1,2 The genesis of nondisclosure of trauma in this population is multifactorial. Undocumented immigrants are less likely to engage with health care and other services for their children.…”

“…5,6 Fear of being treated in a substandard manner because of the presence of mental illness along with preexisting fears of discriminations because of their immigrant status have been identified as some of the factors impacting trust in treatment relationships. 2,4,5 Sandhu et al 5 further identified additional deterrents, including fear of increased vulnerability resulting from divulging sensitive information to clinicians and the possibility that translators may share this information with their community. The risks of legal ramifications and safety are also strong deterrents for trauma disclosure, and some undocumented immigrants fear disclosure of their status to legal authorities by mental health professionals.…”

‘There is No Mother to Take Care of You’. Views of Unaccompanied Children on Healthcare, Their Mental Health and Rearing Environment

“…In addition, it can be difficult for professionals to assess these emotional symptoms with the children (Bean et al, 2007;Vervliet et al, 2014). Professionalssuch as guardians, caregivers and social workersneed to take time to build trust and establish a bond (Van Os, Zijlstra, Post, Knorth, & Kalverboer, 2018). Without that, they cannot be expected to see or hear, let alone understand, all the mental health problems that unaccompanied refugee children may experience (Adams, 2009;Chase, 2010;Katsounari, 2014;Kohli, 2006).…”