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Evidence Summary

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What Strategies Support the Mental Health of Unaccompanied Refugee Minors?

There is strong evidence that therapeutic strategies grounded in cognitive behavioral therapy (CBT) reduce mental health symptoms among unaccompanied refugee minors (URMs).

▪ Three systematic reviews, three scoping reviews, and five suggestive studies highlight the reduction of post-traumatic stress disorder (PTSD) and trauma-related symptoms and other forms of mental health distress when interventions are grounded in CBT.

Substantial evidence supports group therapy as a strategy to reduce barriers and improve mental health outcomes.

▪ A systematic review noted that group therapy, where multiple URMs simultaneously participate in an intervention, improved overall engagement and outcomes, regardless of the setting and its combination with other interventions. Group therapy also reduces barriers to continued engagement with interventions, such as stigma and language, while increasing trust and community building.

There is strong evidence of the positive impact of culturally sensitive social support systems, such as care arrangements, in improving outcomes for URMs.

▪ Two systematic reviews indicate that URMs had better mental health outcomes when placed in an ethnically matched care placement setting (i.e., a URM living with at least one other person who identifies with the same ethnicity). Furthermore, the mental health outcomes of URMs are poorer if they have experienced trauma; reside in independent, lone, or large detention institutions; or if they are female.

Growing evidence encourages adapting treatment approaches and implementation delivery according to the unique needs of URMs.

▪  A suggestive study underscored the importance of incorporating religion and spirituality into interventions to enable the involvement of URMs in therapy and its role in helping them cope with trauma.

▪  Two suggestive studies and one systematic review promote the implementation of trauma-informed, culturally adapted interventions within school-based settings.

▪  A suggestive study highlighted the potential of multimodal co-therapy, which encompasses cultural, biological, narrative, and institutional approaches to improving URM mental health outcomes.

Post TitleStrength of EvidenceType of StudyDirection of Evidence
Defining effective care coordination for mental health referrals of refugee populations in the United StatesSuggestiveSuggestive evidenceN/A
Meeting complex needs through community collaboration: A case studyInconclusive or mixed impactSuggestive evidenceInconclusive or mixed impact
Supporting human trafficking survivor resiliency through comprehensive case managementSuggestiveSuggestive evidenceN/A
Bringing refugees from crisis to flourishing: The role of resettlement agencies and the church in facilitating integration and stabilitySuggestiveSuggestive evidenceN/A
Integrated behavioral health care for Karen refugees: a qualitative exploration of active ingredientsSuggestiveSuggestive evidencePositive impact
Outcomes for Youth Served by the Unaccompanied Refugee Minor Foster Care Program: A Pilot StudySuggestiveSuggestive evidenceInconclusive or mixed impact
Culturally congruent intensive case management service for three refugee communitiesSuggestiveSuggestive evidenceInconclusive or mixed impact
Connecting refugees to substance use treatment: a qualitative studySuggestiveSuggestive evidencePositive impact
Intensive psychotherapy and case management for Karen refugees with major depression in primary care: a pragmatic randomized control trialModerateImpact evaluationPositive impact
Defining effective care coordination for mental health referrals of refugee populations in the united statesSuggestiveSuggestive evidencePositive impact
A systematic review of social service programs serving refugeesStrongSystematic reviewInconclusive or mixed impact
Findings from an extended case management US refugee resettlement programSuggestiveSuggestive evidencePositive impact
Healthcare access for Iraqi refugee children in Texas: persistent barriers, potential solutions, and policy implicationsSuggestiveSuggestive evidencePositive impact

Studies included in the database focused on high-income or upper middle-income countries, including but not limited to the United States. Studies included must have been published since 2012. To identify evidence related to case management with refugees, we searched the following websites and databases using the following population, methodology, and target intervention terms:

Websites and Databases Population Terms Methodology Terms Target Problem Terms
Campbell Collaboration
Cochrane Collaboration
Mathematica Policy Research
Urban Institute
Migration Policy Institute
CINAHL
ASSIA
Social Services Abstracts
Social Work Abstracts
PsycInfo
ERIC
refugee
OR
immigrant
OR
“unaccompanied minor”
OR
asylee
OR
“temporary protected status”
OR
“victims of traffick*”
OR
“traffick* victims”
OR
T-Visa
OR
U-Visa
OR
Cuban
OR
Haitian
OR
Amerasian
evaluation
OR
impact
OR
program
OR
intervention
OR
policy
OR
project
OR
train*
OR
therapy
OR
treatment
OR
counseling
OR
workshop
OR
review
OR
meta-analysis
OR
synthesis
“case manage*”