The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway

OBJECTIVES To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications. DESIGN This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival. SETTING Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway. PARTICIPANTS Male UM from Afghanistan, Somalia, Algeria and Iran. MAIN OUTCOME MEASURES Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire. RESULTS At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress. CONCLUSION Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum.