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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
Combining a guided self-help and brief alcohol intervention to improve mental health and reduce substance use among refugee men in Uganda: A cluster-randomized feasibility trialPositive impactSuggestive evidencePositive impact
Epidemiology of substance use among forced migrants: A global systematic reviewNo evidence about impactSystematic reviewNo evidence about impact
Drug use and criminality among unaccompanied refugee minors: A review of the literatureNo evidence about impactSuggestive evidenceNo evidence about impact
Cultural values and practices in alcohol and other drug use among immigrant youth: A systematic reviewNo evidence about impactSystematic reviewNo evidence about impact
A short review of acculturation and addiction among immigrant and refugee communities in the United States and abroadNo evidence about impactSuggestive evidenceNo evidence about impact
Changing Latino adolescent’s substance use norms and behaviors: The effects of synchronized youth and parent drug use prevention interventionsPositive impactSuggestive evidencePositive impact
Connecting refugees to substance use treatment: A qualitative studyNo evidence about impactSuggestive evidenceNo evidence about impact
Families preparing a new generation: Adaptation of an adolescent substance use intervention for Burmese refugee familiesNo evidence about impactSuggestive evidenceNo evidence about impact
The impact of a parent-based prevention intervention on Mexican-descent youths’ perceptions of harm associated to drug use: Differential intervention effects for male and female youthsPositive impactSuggestive evidencePositive impact
A systematic review of qualitative research on substance use among refugeesNo evidence about impactSystematic reviewNo evidence about impact
Primary substance use prevention programs for children and youth: A systematic reviewInconclusive or mixed impactSystematic reviewInconclusive or mixed impact
Mental health help seeking among traumatized individuals: A systematic review of studies assessing the role of substance use and abuseNo evidence about impactSystematic reviewNo evidence about impact
Interventions to improve health among refugees in the United States: A systematic reviewPositive impactSystematic reviewPositive impact
Substance use and treatment disparities among Asian Americans, Native Hawaiians, and Pacific Islanders: A systematic reviewNo evidence about impactSystematic reviewNo evidence about impact
Outcomes of a brief motivational intervention for heavy alcohol use in racial or ethnic minority compared to white emerging adultsPositive impactSuggestive evidencePositive impact
Alcohol use trajectories of adult Latinx immigrants during their first decade in the United StatesNo evidence about impactSuggestive evidenceNo evidence about impact
Evaluation of the integrated intervention for dual problems and early action among Latino immigrants with co-occurring mental health and substance misuse symptoms: A randomized clinical trialPositive impactImpact evaluationPositive impact
Culturally sensitive prevention programs for substance use among adolescents of color: A systematic review and meta-analysis of randomized controlled trialsPositive impactMeta-analysisPositive impact
Culturally sensitive treatment for underrepresented adolescents with substance use: A systematic reviewPositive impactSystematic reviewPositive impact
Family-based interventions of preventing substance use among immigrant youth: A scoping review.Positive impactSystematic reviewPositive impact
A systematic literature review of substance-use prevention programs amongst refugee youthNo evidence about impactSystematic reviewNo evidence about impact
Risk and protective factors for early substance use initiation: A longitudinal study of Mexican-origin youthNo evidence about impactSuggestive evidenceNo evidence about impact
Histories of violence among clients seeking substance use disorder treatment: A systematic mapping reviewNo evidence about impactSystematic reviewNo evidence about impact