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Abstract Refugee young people have high rates of unmet mental health needs. Established barriers to accessing mental health care may be contextual to the host country and its support systems. The aim of this study was to establish the perspectives of refugee young people, parents, and service providers on service responses across one middle-income and one high-income country, Turkey and the UK, respectively. In Turkey, eight professionals (social work, psychology, and education), ten parents and ten young people took part. In the UK, stakeholders included four professionals (health, educational psychology, and non-statutory), seven parents and seven young people. Data were analyzed using a codebook thematic approach. Despite structural differences between the two systems, several commonalities were identified in responses. Conceptualization of mental health, stigma, shame, and parents’ language acquisition acted as barriers to help-seeking in both countries, whilst schools were viewed as central to the initiation of interventions. Contextual barriers in Turkey included child marriage and labor, whilst reliance on non-governmental organizations (NGOs) facilitated joint care pathways. In the UK, providers aimed to adapt and extend care pathways through primary health care. Recommendations included designated policy, joint working, schools acting as service hubs, awareness, and training professionals on contextual knowledge. [ABSTRACT FROM AUTHOR]

Despite the evidence on the role of parental factors, especially attachment relationships, in mediating complex trauma experienced by refugee children, there is limited evidence on the use of attachment‐based interventions. The aim of this study was to explore the feasibility of adapting such an intervention, group theraplay, for refugee children in Turkey. Fifteen child–parent dyads participated, and completed measures on attachment relationships, child mental health and parenting strategies. Children engaged with the intervention, whilst it proved more difficult to involve parents regularly. There was a significant improvement in children's post‐traumatic stress and other common mental health symptoms, as well as parent‐rated attachment relationship difficulties. Attachment‐based modalities using play, activities and games can be particularly useful for children and families with cultural and language challenges. Therapeutic interventions for refugee children and families should be integrated with other types of support within a multimodal service approach. [ABSTRACT FROM AUTHOR]

Although there has been increasing attention on the impact of risk and resilience factors on refugee children's mental health, there has been limited evidence on the role of parental factors to inform interventions, and this predominantly relies on adult reports. The aim was to investigate the relationship between perceived parenting styles and attachment relationships and child mental health, as reported by 322 Syrian refugee minors aged between 8 and 17 years in Turkey. Child-rated scales included the Children Revised Impact of Event Scale–8 (CRIES-8), Strengths and Difficulties Questionnaire (SDQ), Security Scale and Egna Minnen Betraffande Uppfostran for Children (EMBU-C), and were used as measures of post-traumatic stress disorder (PTSD), general mental health problems, attachment relationships and perceived parenting styles, respectively. Children with secure maternal and paternal attachment perceived their parents as less rejecting, while children with secure paternal attachment also reported their parents as emotionally warmer. Attachment relationships significantly contributed in predicting PTSD after controlling for age and gender, while conduct problems were predicted by lack of emotional warmth, rejection and over-protection by both parents, in addition to insecure attachment relationships. Refugee children's views are essential in establishing their needs and planning interventions. These should address both the impact of trauma and current family relationships. [ABSTRACT FROM AUTHOR]

Background: Child mental health services and related agencies are faced with an increasing challenge in responding to the influx of refugee children around the world. There is strong evidence on the prevalence and complexity of these children's mental health problems and broader needs. Aims: To review the research literature on risk and protective factors, and associated mental health interventions for refugee children. Methods: Peer‐reviewed studies were included for the period 2004–2017; if they included refugee, asylum‐seeking or internally displaced children under 18 years; and adopted a quantitative design. Vulnerability and protective factors for refugee children were considered in this context, followed by the respective types of interventions at pre‐, peri‐ and postmigration stage, and across high‐ and low‐/middle‐income countries. Eighty‐two peer‐reviewed studies fulfilled the selection criteria. Results: The existing body of literature is largely based on identifying risk factors among children with mental health problems and predominantly designing trauma‐focused interventions to reduce their symptomatic distress. Recent research and services have gradually shifted to a broader and dynamic resilience‐building approach based on ecological theory, that is at child, family, school, community and societal level. There is increasing evidence for the implementation and effectiveness of multimodal interventions targeting all these levels, despite the methodological constraints in their evaluation. Conclusions: In high‐income countries, child mental health services need to collaborate with all agencies in contact with refugee children, establish joint care pathways, and integrate trauma‐focused interventions with family and community approaches. In low‐ and middle‐income countries, where specialist resources are sparse, resilience‐building should aim at maximising and upskilling existing capacity. A six‐dimensional psychosocial model that applies to other children who experience complex trauma is proposed. [ABSTRACT FROM AUTHOR]