title: Overrepresentation of unaccompanied refugee minors in inpatient psychiatric care.
abstract: BACKGROUND
  Unaccompanied refugee minors (URMs) have high levels of psychiatric symptoms, and concerns for their access to mental health services have been raised. From the mid-2000s, an increasing number of asylum-seeking URMs, mainly adolescent boys from Afghanistan, have been referred to the Child & Adolescent Psychiatry emergency unit in Malmö, Sweden. The aim of the study was to compare inpatient psychiatric care between URMs and non-URMs.
  
  
  RESULTS
  All admissions in 2011 at the emergency unit were identified and divided into URMs (n = 56) and non-URMs (n = 205). On the basis of unique patients' first treatment occasion, a group level analysis was performed on gender, age, treatment duration, additional treatment occasions/patient, involuntary care, involuntary care by gender, and ICD-10 principal diagnosis. To retrieve further sample characteristics, a questionnaire was administered to the physicians responsible for admitting patients in 2011. More URMs than non-URMs exhibited self-harm or suicidal behaviour in conjunction with referral. 86% of URMs were admitted with symptoms relating to stress in the asylum process. In the catchment area, 3.40% of the URM population received inpatient care and 0.67% inpatient involuntary care, compared to 0.26% and 0.02% respectively of the non-URM population, both comparisons p < 0.001. There were more boys in the URM group (95%) compared to the non-URM group (29%). A difference in use of involuntary care disappeared after adjusting for gender. No differences were found in diagnoses except for neurotic disorders (F40-48), which were more common in the URM group.
  
  
  CONCLUSIONS
  From an epidemiological perspective, URMs were overrepresented in inpatient psychiatric care.
authors.affiliation: Office for Healthcare "Sund", Child & Adolescent Psychiatry, SE-205 02 Malmö, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Ramel
authors.affiliation: Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, SE-221 85 Lund, Sweden ; Office for Healthcare "Sund", Child & Adolescent Psychiatry, SE-221 85 Lund, Sweden.
authors.forename: Jakob
authors.initials: J
authors.lastname: Täljemark
authors.affiliation: Department of Mathematical Statistics, Centre for Mathematical Sciences, Lund University, SE-223 62 Lund, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Lindgren
authors.affiliation: Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, SE-221 85 Lund, Sweden ; Department of Health Sciences, Clinical Health Promotion Centre, Lund University, SE-205 02 Malmö, Sweden ; Office for Healthcare "Sund", Child & Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, SE-205 02 Malmö, Sweden.
authors.forename: Björn Axel
authors.initials: BA
authors.lastname: Johansson
keywords: Child & Adolescent Psychiatry; Inpatient care; Involuntary care; Unaccompanied refugee minors
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