War trauma experience and behavioral screening of Bosnian refugee children resettled in Massachusetts
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Published on: November 30, 2015
P L Geltman1, M Augustyn, E D Barnett
1Division of Community Pediatrics, Boston University School of Medicine, Massachusetts, USA. paul.geltman@state.ma.us
Insights
Bosnian refugee children exposed to war violence showed high rates of behavioral symptoms. The Refugee Health Assessment (RHA) can identify these issues but lacks intervention capabilities.
Area of Science:
- Public Health
- Child Psychology
- Trauma Studies
Background:
- Bosnian refugees resettled in Massachusetts experienced significant war-related trauma.
- High prevalence of behavioral symptoms observed in this vulnerable population.
Purpose of the Study:
- To assess war violence exposure and behavioral symptoms in Bosnian refugee children.
- To evaluate the utility of behavioral screening during the Refugee Health Assessment (RHA).
Main Methods:
- Survey of 31 Bosnian refugee children in 1996.
- Data collection on war exposure, separation, loss, and economic deprivation.
- Assessment of reported behavioral symptoms and interest in mental health services.
Main Results:
- 81% exposed to armed combat, 71% experienced death of a loved one, 52% economic deprivation.
- 77% of children exhibited behavioral symptoms; only one family sought psychosocial services.
- The RHA identified at-risk children but did not facilitate intervention.
Conclusions:
- Bosnian refugee children face substantial risks for behavioral symptoms due to war trauma.
- The RHA is a critical opportunity for early identification of mental health needs.
- Primary care providers must recognize and manage potential long-term behavioral issues in refugee children.
Abstract:
The authors assessed war violence exposure and behavioral symptoms in Bosnian refugee children in Massachusetts and the utility of behavioral screening of refugees during the Refugee Health Assessment (RHA), required of newly arrived refugees. The study was a survey of 31 Bosnian refugee children in 1996 at the International Clinic of Boston Medical Center, the state's largest contracted provider of the RHA. Subjects were also offered referrals to appropriate mental health services. Sixty-eight percent experienced long-term separation from a parent. Eighty-one percent were directly exposed to armed combat. Seventy-one percent experienced the death of a close friend or relative. Fifty-two percent experienced economic deprivation. Families reported behavioral symptoms for 77% of children. Only one family expressed interest in psychosocial services of any kind. Large numbers of Bosnian refugees are likely to have experienced traumatic war violence and are at risk of behavioral symptoms. The RHA affords opportunities to screen for behavioral problems but not to intervene. Primary care providers and other clinicians should be aware of likely recurrences of symptoms in high-risk children such as these.
