The psychological needs of Syrian Refugee Children

The UK is committed to offering refuge to a number of Syrian child refugees. Some children are already being placed in foster care. This is the start of a process.  To be effective refuge must also include an ability to provide clinically appropriate treatment to these children.

Many will arrive having complex psychological needs.   These needs will not be assuaged simply by a warm and secure foster placement.  To think this is the case is naive. It is a daily source of frustration to try to provide and source services for the mental health needs of UK children. We will struggle to find treatment resources to meet the increased need. Difficulty is no excuse not to rise to a challenge. It is critical that we do develop resources. It is also critical that every country accepting child refugees does the same.

Demographics

Children under 18 account for over 50% of the displaced Syrian refugees with approximately 40% under 12 years old. Many will find themselves alone in a strange country.  It is crucial to understand the impact of these children’s experiences on their mental health. It is also important to grasp that the impact of these experiences if left untreated or treated wrongly will have on them.  These will be long term consequences on the children themselves and on wider society.

Many of the fleeing children have been caught in the crossfire of war.   Most have seen death at close range. Some have seen a parent killed. Others have become permanently separated from parents usually  in the chaos of fleeing conflict. In the UK it is hard to conceptualise this type of psychological trauma.

Research undertaken with refugee children identifies Post-Traumatic Stress Disorder as by far the most prevalent condition that these children are coping with. PTSD requires timely diagnosis and specialist treatment. This is not merely a call for play therapy which in some cases may be extremely dangerous; cause escalating triggers and leave unaddressed the very nature of the trauma.  Depression and behavioural problems, including aggression and other social affective disorders are the next most common consequences of the conflict seen in children.  Responding to the psychological needs of refugee children calls for a necessary new and specialised paradigm in treatment.

There must be an emphasis placed on the early psychological assessment of children. This early screening is crucial to their immediate and ongoing needs.  Professionals having a duty of care must be trained in identifying PTSD symptoms in children of a different culture. Recognising trauma in displaced child refugees is more difficult than the identification of PTSD in the indigenous UK population. There is an absolute requirement for clinically robust PTSD treatment which is provided in a culturally congruent narrative.

It is a genuine challenge to provide effective treatment and to deliver such interventions using the skills of an interpreter. Effective treatment incorporates the childrens existing cultural experiences while subtly introducing UK culture.   It must be remembered that being suddenly immersed into another culture always causes difficulty for a child. Arriving traumatised and alone is another matter .

Treatment needs

It is of paramount that psychologists skilled in treating child post-traumatic stress are involved at an early stage following a child’s arrival in the UK. Treating PTSD is a specialised intervention. It is imperative that  there is a clear distinction made between psychological trauma and other emotional problems.

Summary

In addition to an emergency safe placement, child refugees require access to early specialised psychological screening and assessment protocols. They require an individualised statement of emotional needs.

 This process should be followed by the provision of skilled PTSD and/or other relevant treatment tailored to the individual child. There should also be ongoing monitoring and review.

Anything less and the warm notion of ‘refuge’ is reduced to a hollow word.

 

Dr Chrissie Tizzard is a Chartered Consultant Adult, Adolescent and Child Psychologist who specialises in the assessment and treatment of Post -Traumatic Stress Disorder and vicarious traumatisation across the lifespan. She has developed and ran training workshops throughout Europe since 2000 and continues to be a speaker at trauma conferences throughout the world. She also acts as a consultant to several Local Authorities.