Physical and mental health needs of unaccompanied children seeking asylum: a descriptive analysis in Kent, UK

Author(s): Rachel COYLE ; Sue BOWEN ; Sue MULLIN ; Nancy SAYER ; Georgie SIGGERS ; Samantha BENNETT

http://dx.doi.org/10.1016/S0140-6736(16)32276-0

Abstract

Background

A humanitarian crisis associated with the mass movement of refugees across Europe has been occurring since 2014. The county of Kent, located in the south east of England and containing the port Dover, has seen large increases in arrivals of unaccompanied children. We aimed to carry out a structured assessment of their health needs.

Methods

In accordance with the Children’s Act 1989 and 2004, looked-after children, including unaccompanied children, should be offered an initial health assessment to identify their needs. We analysed the results of 154 initial health assessments of unaccompanied children arriving in Kent in 2015. Although selection of the assessments was opportunistic, the sample was broadly representative of the wider cohort of unaccompanied children in Kent. The need for interventions such as immunisation and screening was reviewed.

Findings

989 unaccompanied young people entered Kent in 2015. Median age of the 154 children given an initial health assessment was 16 years (IQR 15·9–17·2); 145 (94%) were boys. The most common country of origin was Eritrea (62 children, 41%), followed by Afghanistan (24, 16%) and Syria (20, 13%). Psychological symptoms were reported in 63 children (41%), including symptoms of post-traumatic stress disorder (24, 16%). Dental disease (eg, decay and caries) was reported in 60 (46%) of 130 children examined. Dermatology signs, including fungal infection, scabies, and scars, were seen in 26 children (17%). Most symptoms reported were easily treatable, although symptoms of acute infection were recorded in a small number of children. Almost all the 989 unaccompanied young people needed catch-up immunisation. All of them came from countries with a moderate to high prevalence of chronic hepatitis B infection, and 700 children (71%) met WHO criteria for tuberculosis screening.

Interpretation

The key health needs identified were psychological symptoms (particularly of post-traumatic stress disorder), dental health, and dermatology complaints. Although physical complaints were common, most were non-acute and could be managed in the community. Infectious disease is an important issue in this cohort, which can be managed through simple, preventive measures such as immunisation and screening.

Tags: Unaccompanied minors, Children, Adolescents, Asylum seekers, Assessment, PTSD, United Kingdom

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