title: The "lost boys" of Sudan: use of health services and functional health outcomes of unaccompanied refugee minors resettled in the U.S.
abstract: To assess whether mental health counseling and other health services were associated with functional health outcomes of unaccompanied Sudanese refugee minors in the U.S., this study was a descriptive survey of 304 Sudanese refugee minors in foster care through the U.S. Unaccompanied Refugee Minors Program (URMP). Functional health outcomes included scores of Child Health Questionnaire (CHQ) scales and questions regarding care for symptoms or problems associated with behavioral disorders, i.e. somatization. Posttraumatic stress disorder (PTSD) was assessed using the Harvard Trauma Questionnaire (HTQ). Health services questions derived from the National Health Interview Survey. Minors reported high rates of counseling (45%); however no differences were noted in counseling use by those with PTSD compared with others. Counseling was not associated with health outcomes. The majority (76%) reported seeking medical care for symptoms or problems often associated with behavioral and emotional problems; however such care-seeking was more common among those with PTSD (OR = 2.5, 95% CI = 1.004-6.26). Through the efforts of the URMP, the Sudanese unaccompanied minors received high levels of psychosocial support despite the absence of their biological parents. Those with worse functional health were no more likely than others to have received mental health counseling while being more likely to seek care from any health professional. This was also the case for those with PTSD compared to those without it. In linear regression analyses, reported receipt of mental health counseling did not impact either positively or negatively on the score of any CHQ scale.
authors: Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA, pgeltman@bu.edu
authors: Paul L
authors: PL
authors: Geltman
authors: Wanda
authors: W
authors: Grant-Knight
authors: Heidi
authors: H
authors: Ellis
authors: Jeanne M
authors: JM
authors: Landgraf
mesh_terms: D000293:Adolescent; D002648:Child; D054540:Child, Orphaned / Q000523:psychology*; D003376:Counseling / Q000706:statistics & numerical data*; D005190:Family / Q000208:ethnology; D005581:Foster Home Care; D020793:Gatekeeping; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D033242:Minors / Q000523:psychology*; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy; D013397:Sudan / Q000208:ethnology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology