Adversity and resilience amongst resettling Western Australian paediatric refugees

Background: Refugee children are exposed to multiple negative experiences. Cumulative adverse childhood experiences have long-term consequences and may manifest within and influence health, educational and psychosocial... [ view full abstract ]

Background: Refugee children are exposed to multiple negative experiences. Cumulative adverse childhood experiences have long-term consequences and may manifest within and influence health, educational and psychosocial domains. The Princess Margaret Hospital Refugee Health Service (RHS) undertakes multidisciplinary screening of refugee children 5 years), family separation/death, interrupted schooling, detention experience.
Results: Initial SDQ data were obtained from 204 patients (mean age 9.2 ± SD 4.4 years) with follow-up SDQs available in 143. One third (37.3%) had at least one psychological symptom identified based on initial screening proforma. Multiple R-ACE were disclosed with 126/201 (62.7%) experiencing ≥3. African ethnicity, age >10 years, separation anxiety on initial proforma, and nil formal parental education were associated with higher R-ACE. Initial SDQ results varied with age/ethnicity, however peer problem scores were consistently elevated. Total difficulty SDQ scores did not capture psychopathology at expected frequencies. Improvement in follow-up SDQ results were appreciated for children aged 4-10 years. Most patients (80.2%) disclosed improvement in health status following RHS involvement.
Conclusion: Refugee children have complex backgrounds with exposure to multiple traumatic events. Comprehensive standardised health and psychological screening is recommended to target intervention. Further validation of culturally age-appropriate mental health screening tools in this population is required.