Abstract
Objectives
Asylum-seeking minors are known to be at increased risk of physical and mental diseases compared to both native children and adult asylum seekers. We present a nationwide register-based study based on the health assessment of 7210 newly arrived minors in Danish asylum centres from 1 January 2011 to 31 December 2015.
Methods
We describe socio-demographic characteristics, trauma history and symptoms of physical and mental health. To associate the reporting of traumatic events and signs of anxiety or depression, we performed logistic regression analysis.
Results
We found a high, albeit varying, prevalence of traumatic experiences, sleeping and eating problems, and head- and toothache. In the subgroup that was assessed for need of urgent support, more than two of every five minor scored above the threshold. In the subgroup examined by a doctor, one of every four had at least one abnormal finding.
Conclusions
The prevalence of trauma and mental health symptoms and the association of the two were striking. Our findings underline that timely recognition and appropriate treatment of childhood traumas should be given high priority in the receiving communities.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barton S, Karner C, Salih F et al (2014) Clinical effectiveness of interventions for treatment-resistant anxiety in older people: a systematic review, Appendix 1, Diagnostic criteria for anxiety disorders set out in DSM-IV and ICD-10 classification systems. Health Technol Assess Winch Engl 18:1–59. https://doi.org/10.3310/hta18500
Bendixen AMC Børn i asylsystemet. In: refugees.dk. http://refugees.dk/fakta/asylproceduren-i-danmark/boern-i-asylsystemet/. Accessed 10 Jan 2019
Betancourt TS, Newnham EA, Birman D et al (2017) Comparing trauma exposure, mental health needs, and service utilization across clinical samples of refugee, immigrant, and U.S.-origin children. J Trauma Stress 30:209–218. https://doi.org/10.1002/jts.22186
Bischoff A, Bovier PA, Rrustemi I et al (2003) Language barriers between nurses and asylum seekers: their impact on symptom reporting and referral. Soc Sci Med 57:503–512
Bischoff A, Schneider M, Denhaerynck K, Battegay E (2009) Health and ill health of asylum seekers in Switzerland: an epidemiological study. Eur J Public Health 19:59–64. https://doi.org/10.1093/eurpub/ckn113
Byllesby BM, Durham TA, Forbes D et al (2016) An investigation of PTSD’s core dimensions and relations with anxiety and depression. Psychol Trauma Theory Res Pract Policy 8:214–217. https://doi.org/10.1037/tra0000081
Di Meco E, Di Napoli A, Amato LM et al (2018) Infectious and dermatological diseases among arriving migrants on the Italian coasts. Eur J Public Health 28:910–916. https://doi.org/10.1093/eurpub/cky126
Drury J, Williams R (2012) Children and young people who are refugees, internally displaced persons or survivors or perpetrators of war, mass violence and terrorism. Curr Opin Psychiatry 25:277–284. https://doi.org/10.1097/yco.0b013e328353eea6
Eiset AH, Wejse C (2017) Review of infectious diseases in refugees and asylum seekers—current status and going forward. Public Health Rev 38:22. https://doi.org/10.1186/s40985-017-0065-4
Eiset AH, Aoun MP, Haddad RS et al (2020) Asylum seekers’ and Refugees’ Changing Health (ARCH) study protocol: an observational study in Lebanon and Denmark to assess health implications of long-distance migration on communicable and non-communicable diseases and mental health. BMJ Open 10:e034412. https://doi.org/10.1136/bmjopen-2019-034412
Eurostat (2018) Eurostat—asylum and managed migration. Eurostat, the statistical office of the European Union
Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet Lond Engl 365:1309–1314. https://doi.org/10.1016/s0140-6736(05)61027-6
Gadeberg AK, Montgomery E, Frederiksen HW, Norredam M (2017) Assessing trauma and mental health in refugee children and youth: a systematic review of validated screening and measurement tools. Eur J Public Health 27:439–446. https://doi.org/10.1093/eurpub/ckx034
Green JG, McLaughlin KA, Berglund PA et al (2010) Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry 67:113. https://doi.org/10.1001/archgenpsychiatry.2009.186
Hebebrand J, Anagnostopoulos D, Eliez S et al (2016) A first assessment of the needs of young refugees arriving in Europe: what mental health professionals need to know. Eur Child Adolesc Psychiatry 25:1–6. https://doi.org/10.1007/s00787-015-0807-0
Horlings A, Hein I (2018) Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools. Eur J Pediatr 177:163–169. https://doi.org/10.1007/s00431-017-3027-4
Jablonka A, Behrens GMN, Stange M et al (2017) Tetanus and diphtheria immunity in refugees in Europe in 2015. Infection 45:157–164. https://doi.org/10.1007/s15010-016-0934-7
Jacobson NC, Newman MG (2017) Anxiety and depression as bidirectional risk factors for one another: a meta-analysis of longitudinal studies. Psychol Bull 143:1155–1200. https://doi.org/10.1037/bul0000111
Kärki T, Napoli C, Riccardo F et al (2014) Screening for infectious diseases among newly arrived migrants in EU/EEA countries—varying practices but consensus on the utility of screening. Int J Environ Res Public Health 11:11004–11014. https://doi.org/10.3390/ijerph111011004
Kerbl R, Grois N, Popow C et al (2018) Pediatric healthcare for refugee minors in europe: steps for better insight and appropriate treatment. J Pediatr 197:323–324.e2. https://doi.org/10.1016/j.jpeds.2018.03.061
Kien C, Sommer I, Faustmann A et al (2018) Prevalence of mental disorders in young refugees and asylum seekers in European countries: a systematic review. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-018-1215-z
Kloning T, Nowotny T, Alberer M et al (2018) Morbidity profile and sociodemographic characteristics of unaccompanied refugee minors seen by paediatric practices between October 2014 and February 2016 in Bavaria, Germany. BMC Public Health 18:983. https://doi.org/10.1186/s12889-018-5878-7
Kuh D, Ben-Shlomo Y, Lynch J et al (2003) Life course epidemiology. J Epidemiol Community Health 57:778–783. https://doi.org/10.1136/jech.57.10.778
Lindgren J, Ekblad S, Asplund M et al (2012) Mental ill health among asylum seekers and other immigrants in Sweden. Int J Migr Health Soc Care 8:167–179. https://doi.org/10.1108/17479891211287067
Lustig SL, Kia-Keating M, Knight WG et al (2004) Review of child and adolescent refugee mental health. J Am Acad Child Adolesc Psychiatry 43:24–36. https://doi.org/10.1097/00004583-200401000-00012
MacKenzie MJ, Bosk E, Zeanah CH (2017) Separating families at the border—consequences for children’s health and well-being. N Engl J Med 376:2314–2315. https://doi.org/10.1056/nejmp1703375
Marquardt L, Krämer A, Fischer F, Prüfer-Krämer L (2016) Health status and disease burden of unaccompanied asylum-seeking adolescents in Bielefeld, Germany: cross-sectional pilot study. Trop Med Int Health 21:210–218. https://doi.org/10.1111/tmi.12649
Masmas TN, Møller E, Buhmannr C et al (2008) Asylum seekers in Denmark—a study of health status and grade of traumatization of newly arrived asylum seekers. Torture Q J Rehabil Torture Vict Prev Torture 18:77–86
Montgomery E (2011) Trauma, exile and mental health in young refugees. Acta Psychiatr Scand 124:1–46. https://doi.org/10.1111/j.1600-0447.2011.01740.x
Nakken CS, Skovdal M, Nellums LB et al (2018) Vaccination status and needs of asylum-seeking children in Denmark: a retrospective data analysis. Public Health 158:110–116. https://doi.org/10.1016/j.puhe.2018.02.018
O’Donnell CA (2018) Health care access for migrants in Europe. Oxf Res Encycl Glob Public Health. https://doi.org/10.1093/acrefore/9780190632366.013.6
Padovese V, Egidi AM, Fenech TM et al (2014) Migration and determinants of health: clinical epidemiological characteristics of migrants in Malta (2010–11). J Public Health 36:368–374. https://doi.org/10.1093/pubmed/fdt111
Panter-Brick C, Hadfield K, Dajani R et al (2018) Resilience in context: a brief and culturally grounded measure for Syrian refugee and jordanian host-community adolescents. Child Dev 89:1803–1820. https://doi.org/10.1111/cdev.12868
Polcher K, Calloway S (2016) Addressing the need for mental health screening of newly resettled refugees. J Prim Care Community Health 7:199–203. https://doi.org/10.1177/2150131916636630
R Core Team (2016) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna
Reed RV, Fazel M, Jones L et al (2012) Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet Lond Engl 379:250–265. https://doi.org/10.1016/s0140-6736(11)60050-0
Reza M, Amin MS, Sgro A et al (2016) Oral health status of immigrant and refugee children in north america: a scoping review. J Can Dent Assoc 82:g3
Seedat F, Hargreaves S, Nellums LB et al (2018) How effective are approaches to migrant screening for infectious diseases in Europe? A systematic review. Lancet Infect Dis 18:e259–e271. https://doi.org/10.1016/s1473-3099(18)30117-8
Spallek J, Zeeb H, Razum O (2011) What do we have to know from migrants’ past exposures to understand their health status? A life course approach. Emerg Themes Epidemiol 8:6. https://doi.org/10.1186/1742-7622-8-6
Stubbe Østergaard L, Norredam M, Mock-Munoz de Luna C et al (2017) Restricted health care entitlements for child migrants in Europe and Australia. Eur J Public Health 27:869–873. https://doi.org/10.1093/eurpub/ckx083
Teicher MH (2018) Childhood trauma and the enduring consequences of forcibly separating children from parents at the United States border. BMC Med. https://doi.org/10.1186/s12916-018-1147-y
Udlændingestyrelsen, Styrelsen for International Rekruttering og Integration (2016) Tal og fakta på udlændingeområdet 2015. Udlændingestyrelsen (Danish Immigration Service)
Udlændingestyrelsen, Styrelsen for International Rekruttering og Integration Tal og fakta på udlændingeområdet 2012–2016 [Figurs & facts about immigration 2012–2016]. Udlændingestyrelsen [Danish Immigration Service]
Villanueva O’Driscoll J, Serneels G, Imeraj L (2017) A file study of refugee children referred to specialized mental health care: from an individual diagnostic to an ecological perspective. Eur Child Adolesc Psychiatry 26:1331–1341. https://doi.org/10.1007/s00787-017-0981-3
Wangdahl J, Lytsy P, Martensson L, Westerling R (2014) Health literacy among refugees in Sweden—a cross-sectional study. BMC Public Health 14:1030. https://doi.org/10.1186/1471-2458-14-1030
Acknowledgements
The authors would like to thank The Asylum Department of The Danish Red Cross for their collaboration on this study. A special thanks to doctor Ebbe Munk Andersen, nurse Dorte Mogensen, and lead health visitor nurse Jytte B. Jensen at Center Sandholm for their kind assistance, without whom, this research project would not have been possible.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
The study was approved by The Danish Data Protection Agency (3-3013-1042/1). Further ethical approval or informed consent is not required for the type of study in Denmark.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Eiset, A.H., Loua, A.S., Kruse, A. et al. The health status of newly arrived asylum-seeking minors in Denmark: a nationwide register-based study. Int J Public Health 65, 1763–1772 (2020). https://doi.org/10.1007/s00038-020-01501-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-020-01501-4