Mental health among children seeking asylum in Denmark--the effect of length of stay and number of relocations: a cross-sectional study.
BACKGROUND
The process of seeking asylum and the related organisational conditions in the host country may adversely affect the children's mental health. The objective of this study was to examine the mental health of children seeking asylum in relation to organisational factors of the asylum system including length of stay and number of relocations.


METHODS
The population included all 260 parent-accompanied asylum-seeking children aged 4-16 years living in the asylum centres managed by the Danish Red Cross in October-December 2006. Mental health was evaluated using the Strengths and Difficulties Questionnaire. School teachers evaluated children aged 4-16; and the 11-16-year-olds completed the self-report version. To assess the association between organisational factors and mental health, binary logistic regression analyses were done using backwards elimination. We received responses for 246 children equivalent to 95% of the study population.


RESULTS
Using teachers' reports, we found that children who had been asylum-seeking for more than one year in Denmark had an increased risk of having mental difficulties (odds ratio 5.5, 95% CI 1.8-16.3); four or more relocations in the asylum system were also associated with a higher risk (3.0, 1.4-6.7). When the self-report data were included, the associations were even stronger.


CONCLUSIONS
Protracted stays at asylum centres and multiple relocations within the asylum system appear to have an adverse effect on asylum-seeking children's mental health. A limit to the duration of the children's stay in the asylum system should be ensured. Follow-up studies with inclusion of other conditions, such as parental mental health and the children's previous trauma, are needed to clarify the influence of the different factors and their interactions.
Nielsen
Signe S
SS
Department of Health Services Research, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5A, DK-1014 Copenhagen K, Denmark. s.smith.nielsen@pubhealth.ku.dk
Norredam
Marie
M
Christiansen
Karen L
KL
Obel
Carsten
C
Hilden
Jørgen
J
Krasnik
Allan
A
D000293:Adolescent; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003155:Community Mental Health Centers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000208:ethnology; D012011:Red Cross; D012036:Refugees / Q000523:psychology*; D012737:Sex Factors; D011795:Surveys and Questionnaires