Abstract
To assess whether mental health counseling and other health services were associated with functional health outcomes of unaccompanied Sudanese refugee minors in the U.S., this study was a descriptive survey of 304 Sudanese refugee minors in foster care through the U.S. Unaccompanied Refugee Minors Program (URMP). Functional health outcomes included scores of Child Health Questionnaire (CHQ) scales and questions regarding care for symptoms or problems associated with behavioral disorders, i.e. somatization. Posttraumatic stress disorder (PTSD) was assessed using the Harvard Trauma Questionnaire (HTQ). Health services questions derived from the National Health Interview Survey. Minors reported high rates of counseling (45%); however no differences were noted in counseling use by those with PTSD compared with others. Counseling was not associated with health outcomes. The majority (76%) reported seeking medical care for symptoms or problems often associated with behavioral and emotional problems; however such care-seeking was more common among those with PTSD (OR = 2.5, 95% CI = 1.004–6.26). Through the efforts of the URMP, the Sudanese unaccompanied minors received high levels of psychosocial support despite the absence of their biological parents. Those with worse functional health were no more likely than others to have received mental health counseling while being more likely to seek care from any health professional. This was also the case for those with PTSD compared to those without it. In linear regression analyses, reported receipt of mental health counseling did not impact either positively or negatively on the score of any CHQ scale.
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Acknowledgements
This study was funded by the Joel and Barbara Alpert Endowment for the Children of the City, Department of Pediatrics, Boston Medical Center. This paper was presented in part at the annual meetings of the Pediatric Academic Societies on May 5, 2003, Seattle, WA and April 30, 2006, San Francisco, CA.
The authors wish to thank the following current and former staff of the Migration and Refugee Services of the U.S. Conference of Catholic Bishops, the Lutheran Immigration and Refugee Service, and the local affiliates of the U.S. Unaccompanied Refugee Minors Program, without whose support and assistance the study could not have been done: Julianne Duncan, Susan Schmidt, Marla Schmidt, Bethany Christian Services (Grand Rapids, MI), Catholic Community Services (Tacoma, WA), Catholic Family Center (Rochester, NY), Catholic Social Service (Phoenix, AZ), Commonwealth Catholic Charities (Richmond, VA), Lutheran Children and Family Services of Easter PA (Roslyn, PA), Lutheran Family Services Northwest (Seattle, WA), Lutheran Social Services of Michigan (Lansing, MI), Lutheran Social Services of New England (Newton, MA), Lutheran Social Services of North Dakota (Fargo, ND).
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Drs. Geltman, Grant Knight, and Ellis report no conflicts of interest. Ms Landgraf has a commercial interest in the business, HealthAct CHQ, Inc., which licenses the use of the Child Health Questionnaire and conducts its scoring for investigators. We do not believe that this presents any conflict of interest, however. The study was funded by the Joel and Barbara Alpert Endowment at Boston Medical Center. Faculty reviewers critiqued the original study proposal. The Endowment had no further input in the study or manuscript preparation. A previous paper was published in 2005 in Archives of Pediatrics and Adolescent Medicine.
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Geltman, P.L., Grant-Knight, W., Ellis, H. et al. The “Lost Boys” of Sudan: Use of Health Services and Functional Health Outcomes of Unaccompanied Refugee Minors Resettled in the U.S.. J Immigrant Minority Health 10, 389–396 (2008). https://doi.org/10.1007/s10903-007-9110-6
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DOI: https://doi.org/10.1007/s10903-007-9110-6