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      Psychological First Aid–Informed Guidelines for Mental Health Professionals Working With Central American Unaccompanied Minors in Transitional Settings

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          Abstract

          Abstract: News of unaccompanied minors (UMs) from Central America entering the United States–Mexico border have inundated political and social platforms as policies are discussed to address this crisis. The hope for a future away from violence, poverty, and fear drives these minors into embarking on an uncertain journey to the United States. The dangers these children encounter on their long travels along with previous distressing experiences from their home country put a devastating toll on their psychological and overall well-being. Their anguish continues as these youth are placed in transitional settings (i.e., shelters) while awaiting to be released into their new communities. While psychological care is often available at these settings, the complex realities of these children call for culturally and trauma-responsive guidelines to address their unique psychosocial needs. This conceptual paper reviews existent literature on the mental health needs of Central American youth in the United States–Mexico border as well as relevant theories and principles, such as the evidence-informed psychological first aid (PFA), which has shown to help Central American youth in the immediate aftermath of disasters and other crises. The aim of this manuscript was to adapt and expand on the core elements of PFA and utilize its theoretical basis to (1) enhance the psychological health of Central American UMs in transitional settings and (2) equip mental health professionals working in the United States–Mexican border or other US mental health professionals to address the immediate psychological needs of UMs from a culturally sensitive and trauma-informed approach.

          Abstract

          Impact and Implications:

          The importance of working in partnership and striving to work together is emphasized in the 2015–2030 United Nations Sustainable Development Goals. These goals highlight the importance of international collaboration and training among any staff or professionals working with Central American unaccompanied minors (UMs) in transitional settings. These guidelines will serve as a tool to support mental health professionals working across borders through education and training, with the aim to successfully identifying and addressing the needs of these youth. These guidelines could contribute to effective and useful interventions when working with Latinx youth from a culturally and linguistically sensitive lens.

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          Most cited references52

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          Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies

          Background In recent years there has been a progressive rise in the number of asylum seekers and refugees displaced from their country of origin, with significant social, economic, humanitarian and public health implications. In this population, up-to-date information on the rate and characteristics of mental health conditions, and on interventions that can be implemented once mental disorders have been identified, are needed. This umbrella review aims at systematically reviewing existing evidence on the prevalence of common mental disorders and on the efficacy of psychosocial and pharmacological interventions in adult and children asylum seekers and refugees resettled in low, middle and high income countries. Methods We conducted an umbrella review of systematic reviews summarizing data on the prevalence of common mental disorders and on the efficacy of psychosocial and pharmacological interventions in asylum seekers and/or refugees. Methodological quality of the included studies was assessed with the AMSTAR checklist. Results Thirteen reviews reported data on the prevalence of common mental disorders while fourteen reviews reported data on the efficacy of psychological or pharmacological interventions. Although there was substantial variability in prevalence rates, we found that depression and anxiety were at least as frequent as post-traumatic stress disorder, accounting for up to 40% of asylum seekers and refugees. In terms of psychosocial interventions, cognitive behavioral interventions, in particular narrative exposure therapy, were the most studied interventions with positive outcomes against inactive but not active comparators. Conclusions Current epidemiological data needs to be expanded with more rigorous studies focusing not only on post-traumatic stress disorder but also on depression, anxiety and other mental health conditions. In addition, new studies are urgently needed to assess the efficacy of psychosocial interventions when compared not only with no treatment but also each other. Despite current limitations, existing epidemiological and experimental data should be used to develop specific evidence-based guidelines, possibly by international independent organizations, such as the World Health Organization or the United Nations High Commission for Refugees. Guidelines should be applicable to different organizations of mental health care, including low and middle income countries as well as high income countries. Electronic supplementary material The online version of this article (doi:10.1186/s13033-017-0156-0) contains supplementary material, which is available to authorized users.
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            Mental Health Service Use Among Immigrants in the United States: A Systematic Review.

            Immigrants face stressors unique to the experience of migration that may exacerbate or cause mental health problems but access care at rates far below the general population, leaving them at risk of untreated mental health conditions. This review synthesizes current findings on mental health service utilization among immigrants to inform future research efforts addressing disparities in access to care.
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              Review of child and adolescent refugee mental health.

              To review stressful experiences and stress reactions among child and adolescent refugees, as well as interventions and ethical considerations in research and clinical work, within the framework of the chronological experiences of child refugees; namely, the phases of preflight, flight, and resettlement. Highlighted are special refugee populations such as unaccompanied minors, asylum seekers, and former child soldiers. Pertinent medical findings are summarized. The authors reviewed articles from 1990 to 2003 addressing the topics above. Literature was gathered from databases including PsycINFO, Medline, and SocioFile. Pertinent earlier papers and those from other disciplines cited in database-identified articles were also included. Child and adolescent refugees suffer from significant conflict-related exposures. Reactions to stress may be mediated by coping strategies, belief systems, and social relations. More research is needed on interventions, specifically on efficacy and cultural relevance. Interventions that have an impact on multiple ecological levels need further development and evaluation.
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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                International Perspectives in Psychology
                International Perspectives in Psychology
                Hogrefe Publishing Group
                2157-3883
                2157-3891
                April 19 2023
                Affiliations
                [1 ]USC University Center for Excellence in Developmental Disabilities, Children’s Hospital Los Angeles, Los Angeles, CA, USA
                [2 ]Department of Pediatrics, University of Southern California, Los Angeles, CA, USA
                Article
                10.1027/2157-3891/a000074
                15c9b967-22e9-4d8d-ba2b-1ffbd3aeca73
                © 2023
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