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Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children: a
Simone Goosen1, Karien Stronks, Anton E Kunst
1Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands and Netherlands Association for Community Health Services, Utrecht, The Netherlands.
Insights
Frequent relocations increase mental distress in asylum-seeking children. This risk is higher for vulnerable children, highlighting the need for stable housing policies.
Area of Science:
- Child and Adolescent Psychiatry
- Public Health
- Migration Studies
Background:
- Concerns exist regarding the mental health impact of relocations on asylum-seeking children.
- Previous evidence is limited to cross-sectional studies, necessitating longitudinal research.
- Asylum seeker center relocations may negatively affect children's psychological well-being.
Purpose of the Study:
- To determine if relocations during the asylum process correlate with new mental distress diagnoses in children.
- To investigate if this association is more pronounced in vulnerable asylum-seeking children.
- To provide empirical evidence for policy recommendations concerning asylum seeker housing.
Main Methods:
- Longitudinal study using electronic medical records from Dutch asylum seeker health services (2000-2008).
- Inclusion of 8047 children aged 4-17 years.
- Analysis of mental, behavioral, or psychosocial problems using International Classification of Primary Care codes and Cox regression models to assess the association between relocation rates and mental distress incidence.
Main Results:
- A high annual relocation rate (over 1 per year) was significantly associated with an increased incidence of mental distress (RR = 2.70).
- The risk of mental distress was amplified in children who had experienced violence (RR = 3.87).
- Children of mothers with PTSD or depression also showed a higher risk associated with frequent relocations (RR = 3.40).
Conclusions:
- Frequent relocations are linked to a greater risk of mental distress in asylum-seeking children.
- Vulnerable children, including those with a history of violence or with mothers diagnosed with PTSD/depression, face a disproportionately higher risk.
- Findings support policies aimed at minimizing relocations to protect the mental health of asylum-seeking children.
Background:
There are concerns about negative effects of relocations between asylum-seeker centres on the mental health of asylum-seeking children. However, empirical evidence comes from cross-sectional studies only. In this longitudinal medical record study, we aimed to assess: (i) whether relocations during the asylum process are associated with the incidence of newly recorded mental distress in asylum-seeking children; and (ii) whether this association is stronger among vulnerable children.
Methods:
Data were extracted from the electronic medical records database of the Community Health Services for Asylum Seekers in The Netherlands (study period: 1 January 2000-31 December 2008). Included were 8047 children aged 4 to 17 years. Case attribution was done using International Classification of Primary Care codes for mental, behavioural or psychosocial problems. The association between annual relocation rate and incidence of mental distress was measured using relative risks (RR) estimated with multivariate Cox regression models.
Results:
A high annual relocation rate (>1 relocation/year) was associated with increased incidence of mental distress [RR = 2.70; 95% confidence interval (CI) 2.30-3.17]. The relative risk associated with a high annual relocation rate was larger in children who had experienced violence (RR = 3.87; 95% CI 2.79-5.37) and in children whose mothers had been diagnosed with post-traumatic stress disorder or depression (RR = 3.40; 95% CI 2.50-4.63).
Conclusions:
The risk of mental distress was greater in asylum-seeking children who had undergone a high annual relocation rate. This risk increase was stronger in vulnerable children. These findings contribute to the appeal for policies that minimize the relocation of asylum seekers.
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