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The Strengths and Difficulties Questionnaire as a Mental Health Screening Tool for Newly Arrived Pediatric Refugees
Andrea E Green1,2, Stanley J Weinberger3,4, Valerie S Harder3,5
1Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, VT, USA. andrea.green@uvmhealth.org.
Insights
Mental health screening for refugee children using the Strengths and Difficulties Questionnaire (SDQ) is crucial. Scores were highest on arrival, with referrals peaking at six months, indicating a need for early and ongoing primary care assessment.
Area of Science:
- Pediatric primary care
- Refugee health
- Mental health screening
Background:
- Refugee children often experience pre-migration trauma and face resettlement challenges.
- Early identification of mental health difficulties in this population is essential.
- Primary care settings offer a vital opportunity for screening.
Purpose of the Study:
- To evaluate the utility of the Strengths and Difficulties Questionnaire (SDQ) for screening refugee children in primary care.
- To assess changes in mental health scores over the first year of resettlement.
- To identify patterns of referral and differences based on geographic origin.
Main Methods:
- The Strengths and Difficulties Questionnaire (SDQ) was administered to refugee children aged 4-18 years.
- Screening occurred during the Domestic Medical Examination and at three subsequent primary care visits within the first year.
- Statistical analyses examined the association between time, SDQ scores, referrals, and geographic origin.
Main Results:
- SDQ scores were significantly higher upon arrival compared to later visits (P < .0005).
- Referrals for mental health support were most frequent at the six-month follow-up visit (P < .01).
- Iraqi children consistently exhibited higher SDQ scores across all assessment points (P < .03).
Conclusions:
- The SDQ is a viable tool for primary care mental health screening of newly arrived refugee children.
- Screening upon arrival is recommended to identify immediate difficulties.
- Children with persistent high scores at six months may require targeted interventions or referrals.
Abstract:
Many refugee children have exposure to trauma prior to arrival and during resettlement. Mental health screening in primary care among resettled refugee children is needed. The Strengths and Difficulties Questionnaire (SDQ) was used to screen refugee children age 4-18 years at their Domestic Medical Examination and three other primary care visits in their first year of resettlement. We tested the association between time and SDQ score or intervention/referral, and differences based on geographic origin. SDQ scores were highest upon arrival (Ps < .0005). Referrals were most common at the six-month visit compared to arrival and one month (Ps < .01). Iraqi children had higher SDQ scores at all visits (Ps < .03). The SDQ can be used in primary care to screen newly arrived refugee children. Practitioners should screen at arrival to identify difficulties. Those with difficulties continuing at six months may need an intervention or referral.
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