title: Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers.
abstract: Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country.
  
  
  
  This study compared 24,427 refugee children from Asia, The Middle East, Sub-Saharan Africa and former Yugoslavia, who obtained residency in Denmark between 1 January 1993 and 31 December 2010 with 146,562 Danish-born children, matched 1:6 on age and sex. The study looked at contacts with psychiatric hospitals as well as psychologists and psychiatrists in private practice.
  
  
  
  Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40-0.45) among refugee boys and 0.35 (95 % CI 0.33-0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services.
  
  
  
  Refugee children used fewer psychiatric healthcare services than Danish-born children. This may indicate that refugee children experience barriers in accessing psychiatric healthcare systems and do not receive adequate assessment of their mental health and subsequent referral to specialist services.
authors.affiliation: Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark. ambar@sund.ku.dk.
authors.forename: Amina
authors.initials: A
authors.lastname: Barghadouch
authors.affiliation: Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark.
authors.forename: Maria
authors.initials: M
authors.lastname: Kristiansen
authors.affiliation: Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark.
authors.forename: Signe Smith
authors.initials: SS
authors.lastname: Jervelund
authors.affiliation: Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, Stockholm, Sweden.|Clinical Epidemiology, Department of Medicine, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Hjern
authors.affiliation: DIGNITY-Danish Institute Against Torture, Copenhagen, Denmark.
authors.forename: Edith
authors.initials: E
authors.lastname: Montgomery
authors.affiliation: Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark.|Section of Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Marie
authors.initials: M
authors.lastname: Norredam
mesh_terms: D017954:Africa South of the Sahara / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003718:Denmark; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008877:Middle East / Q000208:ethnology; D012036:Refugees / Q000523:psychology*; D015022:Yugoslavia / Q000208:ethnology
keywords: Healthcare utilization; Migrant; Psychiatric contacts; Refugee children; Registry-based