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Public health
Research
The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway
  1. Marianne Jakobsen1,
  2. Melinda Ashley Meyer DeMott1,
  3. Tore Wentzel-Larsen1,2,
  4. Trond Heir1,3
  1. 1 Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
  2. 2 Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
  3. 3 Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  1. Correspondence to Dr Marianne Jakobsen; marianne.jakobsen{at}nkvts.no

Abstract

Objectives To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications.

Design This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival.

Setting Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway.

Participants Male UM from Afghanistan, Somalia, Algeria and Iran.

Main outcome measures Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire.

Results At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress.

Conclusion Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum.

  • Refugee
  • Adolescent
  • Unaccompanied minor
  • Follow-up study
  • Norway

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-015157

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    Footnotes

    • Contributors MJ has had the main responsibility for the drafting and writing of the article. TH was, in collaboration with MAMD and MJ, responsible for the literature review and the conception and design of the article. MAMD and MJ have been responsible for all phases of the data collection. Data analysis and interpretation of data were done in cooperation among MJ, TH and TW-L. All authors have contributed to the scientific writing and proof-reading of the article. The paper has been read and approved by all authors before submission.

    • Funding This work was supported by the Norwegian Directorate of Immigration.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The Regional Medical Ethics Committee, South-East Norway approved this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected theseerrors and the correct publishers have been inserted into the references.