Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 8/2016

01-08-2016 | Original Paper

Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers

Authors: Amina Barghadouch, Maria Kristiansen, Signe Smith Jervelund, Anders Hjern, Edith Montgomery, Marie Norredam

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 8/2016

Login to get access

Abstract

Purpose

Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country.

Methods

This study compared 24,427 refugee children from Asia, The Middle East, Sub-Saharan Africa and former Yugoslavia, who obtained residency in Denmark between 1 January 1993 and 31 December 2010 with 146,562 Danish-born children, matched 1:6 on age and sex. The study looked at contacts with psychiatric hospitals as well as psychologists and psychiatrists in private practice.

Results

Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40–0.45) among refugee boys and 0.35 (95 % CI 0.33–0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services.

Conclusions

Refugee children used fewer psychiatric healthcare services than Danish-born children. This may indicate that refugee children experience barriers in accessing psychiatric healthcare systems and do not receive adequate assessment of their mental health and subsequent referral to specialist services.
Literature
1.
go back to reference United Nations High Commissioner for Refugees (2013) Displacement. The new 21st century challenge. UNHCR Global Trends 2012 United Nations High Commissioner for Refugees (2013) Displacement. The new 21st century challenge. UNHCR Global Trends 2012
2.
go back to reference Montgomery E (2011) Trauma, exile and mental health in young refugees. Acta Psychiatr Scand 124:1–46CrossRef Montgomery E (2011) Trauma, exile and mental health in young refugees. Acta Psychiatr Scand 124:1–46CrossRef
3.
go back to reference Montgomery E, Foldspang A (2005) Seeking asylum in Denmark: refugee children’s mental health and exposure to violence. Eur J Public Health 15:233–237CrossRefPubMed Montgomery E, Foldspang A (2005) Seeking asylum in Denmark: refugee children’s mental health and exposure to violence. Eur J Public Health 15:233–237CrossRefPubMed
4.
go back to reference Hjern A, Angel B (2000) Organized violence and mental health of refugee children in exile: a six-year follow-up. Acta Paediatr 89:722–727CrossRefPubMed Hjern A, Angel B (2000) Organized violence and mental health of refugee children in exile: a six-year follow-up. Acta Paediatr 89:722–727CrossRefPubMed
5.
go back to reference Hjern A, Angel B, Jeppson O (1998) Political violence, family stress and mental health of refugee children in exile. Scand J Soc Med 26:18–25PubMed Hjern A, Angel B, Jeppson O (1998) Political violence, family stress and mental health of refugee children in exile. Scand J Soc Med 26:18–25PubMed
6.
go back to reference Fazel M, Reed RV, Panter-Brick C, Stein A (2012) Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet 379:266–282CrossRefPubMed Fazel M, Reed RV, Panter-Brick C, Stein A (2012) Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet 379:266–282CrossRefPubMed
7.
go back to reference Goosen S, Stronks K, Kunst A (2013) Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children: a longitudinal medical record study. Int J Epidemiol 43(1):94–104CrossRefPubMed Goosen S, Stronks K, Kunst A (2013) Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children: a longitudinal medical record study. Int J Epidemiol 43(1):94–104CrossRefPubMed
8.
go back to reference Nielsen SS, Norredam M, Christiansen KL, Obel C, Hilden J, Krasnik A (2008) Mental health among children seeking asylum in Denmark—the effect of length of stay and number of relocations: a cross-sectional study. BMC Public Health 8:293–301CrossRefPubMedPubMedCentral Nielsen SS, Norredam M, Christiansen KL, Obel C, Hilden J, Krasnik A (2008) Mental health among children seeking asylum in Denmark—the effect of length of stay and number of relocations: a cross-sectional study. BMC Public Health 8:293–301CrossRefPubMedPubMedCentral
9.
go back to reference Ehtholt KA, Yule W (2006) Practitioner review: assessment and treatment of refugee children and adolescents who have experienced trauma. J Child Psychol Psychiatry 47:1197–1210CrossRef Ehtholt KA, Yule W (2006) Practitioner review: assessment and treatment of refugee children and adolescents who have experienced trauma. J Child Psychol Psychiatry 47:1197–1210CrossRef
10.
go back to reference Ardbo C (2005) Folkhälsorapport 2005 [Public health report 2005]. Socialstyrelsen, Stockholm Ardbo C (2005) Folkhälsorapport 2005 [Public health report 2005]. Socialstyrelsen, Stockholm
11.
go back to reference Vaage AB, Garløv A, Hauff E, Thomsen PH (2007) Psychiatric symptoms and service utilization among refugee children referred to a Child Psychiatry Department: a retrospective comparative case note study. Transcult Psychiatry 44:440–458CrossRefPubMed Vaage AB, Garløv A, Hauff E, Thomsen PH (2007) Psychiatric symptoms and service utilization among refugee children referred to a Child Psychiatry Department: a retrospective comparative case note study. Transcult Psychiatry 44:440–458CrossRefPubMed
12.
go back to reference Mors O, Perto GP, Mortensen PB (2011) The Danish psychiatric central research register. Scand J Public Health 39:54–57CrossRefPubMed Mors O, Perto GP, Mortensen PB (2011) The Danish psychiatric central research register. Scand J Public Health 39:54–57CrossRefPubMed
13.
go back to reference Andersen JS, de Fine Olicarius N, Krasnik A (2011) The Danish national health service register. Scand J Public Health 39:34–37CrossRefPubMed Andersen JS, de Fine Olicarius N, Krasnik A (2011) The Danish national health service register. Scand J Public Health 39:34–37CrossRefPubMed
14.
go back to reference United Nations Statistics Division (2013) Standard country and area codes classifications (M49) United Nations Statistics Division (2013) Standard country and area codes classifications (M49)
15.
go back to reference Norredam M, Hansen OH, Pedersen JH, Kunst A, Kristiansen M, Krasnik A, Agyemang C (2015) Remigration of severely ill migrants to their countries of origin: myth or reality?–a register-based cohort study. Eur J Public Health 25(1):84–89CrossRefPubMed Norredam M, Hansen OH, Pedersen JH, Kunst A, Kristiansen M, Krasnik A, Agyemang C (2015) Remigration of severely ill migrants to their countries of origin: myth or reality?–a register-based cohort study. Eur J Public Health 25(1):84–89CrossRefPubMed
16.
go back to reference Weitoft GR, Gullberg A, Hjern A, Rosén M (1999) Mortality statistics in immigrant research: method for adjusting underestimation of mortality. Int J Epidemiol 28:756–763CrossRefPubMed Weitoft GR, Gullberg A, Hjern A, Rosén M (1999) Mortality statistics in immigrant research: method for adjusting underestimation of mortality. Int J Epidemiol 28:756–763CrossRefPubMed
17.
go back to reference Lier L, Jansson P, Rich B (2011) Asylbørns psykiske lidelser. In: Vitus K, Nielsen SS (eds) Asylbørn i Danmark. Hans Reitzels Forlag, København, pp 108–124 Lier L, Jansson P, Rich B (2011) Asylbørns psykiske lidelser. In: Vitus K, Nielsen SS (eds) Asylbørn i Danmark. Hans Reitzels Forlag, København, pp 108–124
18.
go back to reference Bodegård G (2005) Pervasive loss of function in asylum-seeking children in Sweden. Acta Paediatr 94:1706–1707CrossRefPubMed Bodegård G (2005) Pervasive loss of function in asylum-seeking children in Sweden. Acta Paediatr 94:1706–1707CrossRefPubMed
19.
go back to reference Ivert A, Merlo J, Svensson R, Levander MT (2013) How are immigrant background and gender associated with the utilisation of psychiatric care among adolescents? Soc Psychiatry Psychiatr Epidemiol 48:693–699CrossRefPubMed Ivert A, Merlo J, Svensson R, Levander MT (2013) How are immigrant background and gender associated with the utilisation of psychiatric care among adolescents? Soc Psychiatry Psychiatr Epidemiol 48:693–699CrossRefPubMed
20.
go back to reference Bean T, Eurelings-Bontekoe E, Mooijaart A, Spinhoven P (2006) Factors associated with mental health service need and utilization among unaccompanied refugee adolescents. Adm Policy Ment Health Ment Health Serv Res 33:342–355CrossRef Bean T, Eurelings-Bontekoe E, Mooijaart A, Spinhoven P (2006) Factors associated with mental health service need and utilization among unaccompanied refugee adolescents. Adm Policy Ment Health Ment Health Serv Res 33:342–355CrossRef
21.
go back to reference Garland AF, Lau AS, Yeh M, McCabe KM, Hough RL, Landsverk JA (2005) Racial and ethnic differences in utilization of mental health services among high-risk youths. Am J Psychiatry 162:1336–1343CrossRefPubMed Garland AF, Lau AS, Yeh M, McCabe KM, Hough RL, Landsverk JA (2005) Racial and ethnic differences in utilization of mental health services among high-risk youths. Am J Psychiatry 162:1336–1343CrossRefPubMed
22.
go back to reference Howard M, Hodes M (2000) Psychopathology, adversity, and service utilization of young refugees. J Am Acad Child Adolesc Psychiatry 18:368–377CrossRef Howard M, Hodes M (2000) Psychopathology, adversity, and service utilization of young refugees. J Am Acad Child Adolesc Psychiatry 18:368–377CrossRef
23.
go back to reference de Anstiss H, Ziaian T, Procter N, Warland J, Baghurst P (2009) Help-seeking for mental health problems in young refugees: a review of the literature with implications for policy, practice, and research. Transcult Psychiatry 46:584–607CrossRefPubMed de Anstiss H, Ziaian T, Procter N, Warland J, Baghurst P (2009) Help-seeking for mental health problems in young refugees: a review of the literature with implications for policy, practice, and research. Transcult Psychiatry 46:584–607CrossRefPubMed
24.
go back to reference Cauce AM, Domenech-Rodríguez M, Paradise M, Cochran BN, Shea JM, Srebnik D, Baydar N (2002) Cultural and contextual influences in mental health help seeking: a focus on ethnic minority youth. J Consult Clin Psych 70:44–55CrossRef Cauce AM, Domenech-Rodríguez M, Paradise M, Cochran BN, Shea JM, Srebnik D, Baydar N (2002) Cultural and contextual influences in mental health help seeking: a focus on ethnic minority youth. J Consult Clin Psych 70:44–55CrossRef
25.
go back to reference Zwaanswijk M, van der Ende J, Verhaak PFM, Bensing JM, Verhulst FC (2005) Help-seeking for child psychopathology: pathways to informal and professional services in The Netherlands. J Am Acad Child Adolesc Psychiatry 44:1292–1300CrossRefPubMed Zwaanswijk M, van der Ende J, Verhaak PFM, Bensing JM, Verhulst FC (2005) Help-seeking for child psychopathology: pathways to informal and professional services in The Netherlands. J Am Acad Child Adolesc Psychiatry 44:1292–1300CrossRefPubMed
26.
go back to reference Nørredam M (2008) Migrants’ access to healthcare. Department of Health Services Research, Institute of Public Health, University of Copenhagen, Copenhagen Nørredam M (2008) Migrants’ access to healthcare. Department of Health Services Research, Institute of Public Health, University of Copenhagen, Copenhagen
27.
go back to reference Norredam M, Garcia-Lopez A, Keiding N, Krasnik A (2009) Risk of mental disorders in refugees and native Danes: a register-based retrospective cohort study. Soc Psychiat Epidemiol 44:1023–1029CrossRef Norredam M, Garcia-Lopez A, Keiding N, Krasnik A (2009) Risk of mental disorders in refugees and native Danes: a register-based retrospective cohort study. Soc Psychiat Epidemiol 44:1023–1029CrossRef
28.
go back to reference Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365:1309–1314CrossRefPubMed Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365:1309–1314CrossRefPubMed
29.
go back to reference Sayal K (2006) Annotation: pathways to care for children with mental health problems. J Child Psychol Psychiatry 47:649–659CrossRefPubMed Sayal K (2006) Annotation: pathways to care for children with mental health problems. J Child Psychol Psychiatry 47:649–659CrossRefPubMed
30.
go back to reference Pacione L, Measham T, Rousseau C (2013) Refugee children: mental health and effective interventions. Curr Psychiatry Rep 15:341–349CrossRefPubMed Pacione L, Measham T, Rousseau C (2013) Refugee children: mental health and effective interventions. Curr Psychiatry Rep 15:341–349CrossRefPubMed
31.
go back to reference May S, Rapee RN, Coello M, Momartin S, Aroche J (2013) Mental health literacy among refugee communities: differences between the Australian lay public and the Iraqi and Sudanese refugee communities. Soc Psychiatry Psychiatr Epidemiol 49(5):757–769CrossRefPubMed May S, Rapee RN, Coello M, Momartin S, Aroche J (2013) Mental health literacy among refugee communities: differences between the Australian lay public and the Iraqi and Sudanese refugee communities. Soc Psychiatry Psychiatr Epidemiol 49(5):757–769CrossRefPubMed
32.
go back to reference Nørredam M, Krasnik A (2011) Migrants’ access to health services. In: Rechel B, Mladovsky B, Devillé W, Rijks B, Petrova-Benedict R, McKee M (eds) Migration and health in the European Union. Open University Press, McGraw-Hill, Berkshire, pp 67–78 Nørredam M, Krasnik A (2011) Migrants’ access to health services. In: Rechel B, Mladovsky B, Devillé W, Rijks B, Petrova-Benedict R, McKee M (eds) Migration and health in the European Union. Open University Press, McGraw-Hill, Berkshire, pp 67–78
33.
go back to reference Bischoff A, Bovier PA, Isah R, Francoise G, Ariel E, Louis L (2003) Language barriers between nurses and asylum seekers: their impact on symptom reporting and referral. Soc Sci Med 57:503–512CrossRefPubMed Bischoff A, Bovier PA, Isah R, Francoise G, Ariel E, Louis L (2003) Language barriers between nurses and asylum seekers: their impact on symptom reporting and referral. Soc Sci Med 57:503–512CrossRefPubMed
34.
go back to reference Norredam M, Mygind A, Nielsen AS, Bagger J, Krasnik A (2007) Motivation and relevance of emergency room visits among immigrants and patients of Danish origin. Eur J Public Health 17:497–502CrossRefPubMed Norredam M, Mygind A, Nielsen AS, Bagger J, Krasnik A (2007) Motivation and relevance of emergency room visits among immigrants and patients of Danish origin. Eur J Public Health 17:497–502CrossRefPubMed
35.
go back to reference Crone MR, Bekkema N, Wiefferink CH, Reijneveld SA (2010) Professional identification of psychological problems among children from ethnic minority groups: room for improvement. J Pediatr 156:277–284CrossRefPubMed Crone MR, Bekkema N, Wiefferink CH, Reijneveld SA (2010) Professional identification of psychological problems among children from ethnic minority groups: room for improvement. J Pediatr 156:277–284CrossRefPubMed
36.
go back to reference Kleinman A, Bonson P (2006) Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS Med 3:1673–1676CrossRef Kleinman A, Bonson P (2006) Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS Med 3:1673–1676CrossRef
37.
go back to reference Durà-Vilà G, Klasen H, Makatini Z, Rahimi Z, Hodes M (2013) Mental health problems of young refugees: duration of settlement, risk factors and community-based interventions. Clin Child Psychol Psychiatry 18:604–623CrossRefPubMed Durà-Vilà G, Klasen H, Makatini Z, Rahimi Z, Hodes M (2013) Mental health problems of young refugees: duration of settlement, risk factors and community-based interventions. Clin Child Psychol Psychiatry 18:604–623CrossRefPubMed
38.
go back to reference Lægeforeningen (2011) Undersøgelse. Ventetid skader psykiatriske patienter. Lægeforeningen Lægeforeningen (2011) Undersøgelse. Ventetid skader psykiatriske patienter. Lægeforeningen
39.
go back to reference Nørredam M, Mygind A, Krasnik A (2005) Access to health care for asylum seekers in the European Union—a comparative study of country policies. Eur J Public Health 16:285–289CrossRef Nørredam M, Mygind A, Krasnik A (2005) Access to health care for asylum seekers in the European Union—a comparative study of country policies. Eur J Public Health 16:285–289CrossRef
40.
go back to reference Sandahl H, Norredam M, Hjern A, Asher H, Nielsen SS (2013) Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries. Scand J Public Health 41:630–636CrossRefPubMed Sandahl H, Norredam M, Hjern A, Asher H, Nielsen SS (2013) Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries. Scand J Public Health 41:630–636CrossRefPubMed
41.
go back to reference Gadeberg AK, Norredam M (2016) Urgent need for validated trauma and mental health screening tools for refugee children and youth. Eur Child Adolesc Psychiatry. doi:10.1007/s00787-016-0837-2 Gadeberg AK, Norredam M (2016) Urgent need for validated trauma and mental health screening tools for refugee children and youth. Eur Child Adolesc Psychiatry. doi:10.​1007/​s00787-016-0837-2
Metadata
Title
Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers
Authors
Amina Barghadouch
Maria Kristiansen
Signe Smith Jervelund
Anders Hjern
Edith Montgomery
Marie Norredam
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 8/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-016-1260-1

Other articles of this Issue 8/2016

Social Psychiatry and Psychiatric Epidemiology 8/2016 Go to the issue