Title: Community-based interventions for improving mental health in refugee children and adolescents in high- income countries
Funder: Department of Health and Social Care

Abstract: Children account for 42% of all forcibly displaced people worldwide (1). The experiences of refugee children in their country of origin, on their journey and post-migration are likely to increase the risk of developing mental health difficulties. In 2018, over 3000 children arrived in the UK unaccompanied. Many of them had experienced horrors including violence, human rights violations and loss of loved ones (2). Studies on prevalence rates of mental illness among refugees and asylum seekers, including children, report widely varying estimates. A recent study of 1000 young Syrian refugees found that 46% had developed post traumatic stress disorder (PTSD) (3). Our recent overview of reviews indicated a lack of evidence on mental health support for refugee children (4). Most of the evidence was focused on the treatment of PTSD, whilst refugee children encounter a range of mental health difficulties and may benefit from preventative interventions. A 2019 report from Amnesty International, the Refugee Council and Safe the Children points out the need for research on ways to support unaccompanied child refugees through therapy and practical help (2). This review can inform policy makers which community interventions are most likely to benefit the mental health of refugee children. Interventions which brings communities, schools, and families together, such as art therapy in schools or group cognitive-behavioural therapy in community centres, could provide accessible and acceptable support to young refugees (5). The Education Policy Institute found that in 2019, children and young people had to wait around two months on average to begin treatment (6). Community interventions may be more readily available and thus reduce pressure on UK Child and Adolescent Mental Health Services (CAMHS). The research team has considerable experience in the conduct of Cochrane reviews and other systematic reviews relating to mental health prevention and treatment. Based on literature searching and screening, we expect to include over thirty studies (10 to 15 RCTs). References/Other: 1. UNHCR. Asylum in the UK. Available from: https://www.unhcr.org/asylum-in-the-uk.html. Accessed 13 September 2021. 2. Amnesty International, the Refugee Council, Save the Children. Without my family. The impact of family separation on child refugees in the UK. 2019. 3. Khamis V. Posttraumatic stress disorder and emotion dysregulation among Syrian refugee children and adolescents resettled in Lebanon and Jordan. Child Abuse & Neglect 2019;89:29-39. 4. Uphoff E, Robertson L, Cabieses B, et al. An overview of systematic reviews on mental health promotion, prevention, and treatment of common mental disorders for refugees, asylum seekers, and internally displaced persons. Cochrane Database of Systematic Reviews 2020, Issue 9. Art. No.:CD013458. DOI: 10.1002/14651858.CD013458.pub2. 5. Herati H, Meyer SB. Mental health interventions for immigrant-refugee children and youth living in Canada: a scoping review and way forward. Journal of Mental Health 2020. DOI:10.1080/09638237.2020.1818710 6.Crenna-Jennings W, Hutchinson J. Access to Child and Adolescent Mental Health Services in 2019. January 2020. Available from: https://epi.org.uk/wp-content/uploads/2020/01/Access-to-CAMHSin-2019_EPI.pdf. Accessed 13 September 20201.

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Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH