Mental Health of Displaced and Refugee Children Resettled in Low-Income and Middle-Income Countries: Risk and Protective Factors

This systematic review draws on data around displacement to low- and middle-income countries, providing evidence for individual, family, community, and societal risk and protective factors that affect displaced children’s mental health. They highlight that exposure to violence is a well-established risk factor for poor mental health among children, and call attention to the challenges faced by children displaced to low- and middle-income countries as opposed to those experienced in high-income countries.

Systematic review of the evidence-base for individual, family, community, and social risk and protective factors for the mental health outcomes of children and adolescents. This review looks at data for displacement to low-income and middle-income settings. Final sample consisted of 27 studies from low-income and middle-income countries, with 5765 children and adolescents (two studies used identical samples). They included forcibly displaced children from Afghanistan, Bhutan, Bosnia, Cambodia, Democratic Republic of Congo, Kosovo, El Salvador, Eritrea, Guatemala, Iraq, Namibia, occupied Palestinian territory, Sudan, and Tibet, who were either internally displaced or resettled in Costa Rica, Honduras, India, Nepal, Nicaragua, Pakistan, Thailand, Turkey, and Uganda. The authors draw attention to exposure to violence as a well established risk factor for poor mental health. They note the paucity of research into predictor variables other than those in the individual domain and the neglect of other variables for the assessment of causal associations, including potential mediators and moderators identifiable in longitudinal work. They focus on risk and protective factors in relation to mental health outcomes in children to alert professionals to individuals and groups most likely to need intervention, and to clarify which modifiable factors can be targeted by policies in the health, social, and immigration sectors. Refugees resettled in low-income and middle-income settings often encounter quite different major challenges from those resettled in high-income settings: those in low-income and middle-income settings might be exposed to ongoing threats to their security and welfare, whereas those in high-income settings have to cope with a different social milieu and often complex asylum processes.

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