Promoting Resilience in Unaccompanied Asylum-Seeking and Refugee Minors
BACKGROUND: In 2018, the European Union received 20,000 applications from unaccompanied asylum-seeking minors (UAMs) applying for international protection, and 60,000 UAMs from Central America were apprehended at the US-Mexico border. These unaccompanied minors are vulnerable, and the traumas they face impact their mental health. As such, it is important to design mental health interventions that promote resilience and address the unique mental health needs of unaccompanied minors. OBJECTIVE: This literature review will summarize the existing literature to identify mental health interventions and other resilience factors that can promote the mental health of UAMs resettled in Europe and the United States. METHODS: Scopus was searched for articles published in Europe and the US. Titles and abstracts were screened based on the inclusion and exclusion criteria, which resulted in 41 qualitative and quantitative studies of interest. RESULTS: In addition to violence, poverty and war in their countries of origin and extreme physical hardships in their migration journeys, UAMs also faced adjustment and acculturation- specific stressors in the host country. All of these factors negatively impacted UAMs' mental health. The average number of traumatic experiences for each UAM ranged from 6-9. The prevalence of mental health pathology was 24-38% for anxiety, 15-43% for depression and 16- 73% for post-traumatic stress disorder. In addition, UAMs faced unique barriers to mental health service utilization, which included low perceived need of mental health services and distrust of both mental health services and providers. Group psychotherapeutic interventions promoted social interactions and trust-building in UAMs but showed no clinically significant decrease in PTSD symptoms. Individual trauma-based psychotherapeutic interventions clinically improved PTSD symptoms in 66-83.3% of participants. Lastly, strong social bonds, high-support housing, continued spiritual-practice and access to education were protective factors that promoted UAMs' resilience. CONCLUSION: Although UAMs have faced multiple adversities, both in their countries of origin and host countries, there are potential interventions to promote resilience and treat mental health pathologies. Culturally- adjusted, individual trauma-focused therapy has shown the best mental health outcomes for UAMs with clinical PTSD. Considerations and suggestions for future research are discussed.
Delivery of Health Care, Health Services Needs and Demand, Mental Health Services, Minors, Refugees, Stress Disorders, Post-Traumatic
University of Texas Southwestern Medical Center
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