Child refugees
As part of our ‘supporting vulnerable learners’ podcast series, funded by Health Education England in 2018, we spoke with child psychiatrist and Charlie Waller trustee Dr Mina Fazel about the practical and emotional support that can be provided to child refugees and their families.
Listen to it now or read the interview below.
The global crisis and forced migration of refugees is a vast issue in today’s world. It’s affecting approximately 60 million people across the globe, at least half of whom are children.
Large numbers of young people are being forced to leave their homelands as a result of famine, organised violence and other highly challenging circumstances. This sizeable disruption can have a significant mental health impact if not addressed.
What are the most important mental health issues to consider for refugee children?
The two biggest issues to take into account are the child’s background and the environment they find themselves in. These young people’s backgrounds are widely reported in the press; many of us will be aware of the very difficult environments these children will have come from and why they have left: their home may have been significantly disrupted and they may have had little experience of formal education. They may also have experienced a whole range of losses, either personally or within their community.
We then have to consider the journey that these children and their families will have had to make to a place of safety. So many child refugees undergo truly treacherous journeys - either with or without their families - which can of course have a very big impact.
The final area to consider is the post-migration environment, living in a country of refuge. When working with young refugee children, we always need to always remember that, while we can’t change anything about what they may have experienced before coming to a country like England, we can take steps to improve their situation now. Even if we can’t address the past, or feel scared or unequipped to do so, we can dramatically change the future for these young people by altering the environment they now find themselves in.
Can you give us some examples of how it’s possible to improve the environment for refugee children?
Absolutely: let’s begin with schools. In the UK, refugee children are typically placed into schools within an age-appropriate class. This can have advantages from a social and peer perspective, but if you are a child who has never had the benefit of a formal education, there can also be big challenges, such as linguistic difficulties. Facilitating ‘settling in’ is so important, and this means understanding an individual’s learning needs.
At heart, children just want to hang out with other children; they just want to be normal kids with a normal peer network. We carried out research where we asked refugee children about the most important thing that happened that helped them to adjust, and what we discovered was surprising: they referred to incidents and moments in time when they became accepted by their peer group. It wasn't accessing counselling services or gaining status that was the biggest difference-maker: it was actually feeling accepted by their peers.
What these children need, and how we can help them, is much more accessible within schools than it is within clinical environments. For those working with vulnerable young children in schools, it’s important to recognise that the most positive and profound impact can actually take place in schools.
If you’re working in a school, think: what are we doing to prepare the children in our school to make sure that it’s a welcoming environment for refugee children? Are we taking time to understand where these kids come from, and what it might feel like to come to a new school environment, often in the middle of a term when no other kids are arriving and there are no familiar faces? Schools need to think creatively about ways for these children to meet and bond, creating natural opportunities for refugee children to build their social networks in ways that make them feel proud, valued and welcomed.
We need to change our perspective on how we perceive refugee children, recognising how much richness these young people bring with their incredible experiences.
What might be the signs that a refugee child could be experiencing anxiety or depression?
Firstly, we should recognise that it’s quite normal to take a while to adjust: don’t expect too much, too soon. These young people will primarily want to make friends and learn the language, so facilitating this first might be the most powerful intervention that we can make.
It’s so vital to create opportunities for peer interaction and help overcome feelings of social isolation: it’s not uncommon for refugee children who have been in the UK for as long as four or five years never to have been invited into the home of a native family. Therapeutic assistance is obviously available and plays an essential role, but let’s cover the basics first: providing linguistic support and helping children to establish a supportive peer network.
Of course, many refugee children will experience post-traumatic stress on some level; this can manifest itself in low mood and feelings of anxiety and depression, as a result of things they have seen or experienced. What’s most important to note is whether the child arrives in this state, or if their behaviour shifts after a period of time in the UK: every child is going to be withdrawn when they move into a new environment, but it’s vital for teachers and family to ask themselves if they’ve noticed a change.
If a child is having problems, what support and intervention might be needed?
One of the biggest problems affecting refugee and asylum-seeking children, as well as many other vulnerable young people, is that services can be very difficult to access for these groups. If you come from abroad, your mental health support systems may be completely different from ours; many refugee families may live in fear that, if they raise a problem that their child is experiencing with authorities, they may be at risk of deportation.
It’s important to explain how we work in the UK, and to signpost to individuals and organisations working within school environments who can provide pastoral support and make referrals to increasingly accessible mental health services. More and more of these services are now working in close collaboration with schools; these third sector organisations and charities are building important bridges with children and their families.
For a child who is traumatised, a core part of their symptoms will likely be to avoid any reminder of the trauma itself. The child may understand that if they get referred on to mental health services, they will be asked to explore the very subject matter they have been trying so hard to avoid. So we have to remember that this is the last thing that many families will want to do, and be sensitive to this.
So as a non-specialist member of staff, is it better not to address the original trauma that the children have experienced?
What often happens is that everyone surrounding the child avoids the traumatic issue, out of concern for making the situation worse. But then the subliminal message that these children receive is that nobody wants to talk to them about it, or that it’s dangerous to speak about the trauma. So, when there is an opening to talk about it, many will run away from it.
The reality, for most of these children, is that the circumstances they will have gone through will be incredibly complicated, and will take a long time to work through. That’s why it’s important to acknowledge: “I don’t personally know how I can help you, but I will come with you to help you get the right help”. Some schools will invite professional mental health services into the school environment itself, breaking down the barriers.
Asking a child how they are feeling is unlikely to make the situation worse, and you may ultimately be the only person who takes the time to ask the child. Speaking, and being there for them, even if you don’t have the answers yourself, can make all the difference. Don’t perpetuate a cycle of avoidance.
What good and bad lived experiences can you share, from your time spent working with refugee children?
Refugee children primarily just want to be normal kids with normal friends and feel accepted. They don’t want to be isolated. While in the first few weeks and months of arriving in a new country it can be helpful to make friends and be with others who have gone through similar experiences, after a while children will want to make friends naturally. Schools can facilitate this better than anyone else and make sure kids are included.
A lot of community projects exist for refugee children, and these serve an essential role. Yet what children sorely crave is to be involved with a community and part of a peer network of their choosing; this could be anything from a cricket club to a dance or sewing class. Schools need to consider how to make lunchtime and recreational activities inclusive to all.
Are there any practical strategies that a teacher or member of support staff might put in place to aid learning or settling in?
If a refugee child has come over with their family, it must be noted that everyone within the family unit will likely have complex needs themselves as a result of what they have experienced. They will need strong support and communication.
Schools need to find ways to facilitate communication and aid the children in their new school setting, going the little extra step to help these children, who will probably be carrying a lot of burdens and responsibilities on their young shoulders. Google Translate is a great resource and we should use online translation services to help to keep parents informed and build relationships. Anything that can be done, both to support the parental role and encourage self-sufficiency within an unfamiliar system, should be done.
What would be the one thing that you would change to support a young refugee child’s mental health, if you could?
I would like all schools to be fully prepared for refugee children before they arrive, considering what they could do to prepare their environments in the most exciting and creative ways, so that when these kids arrive, everyone is at least somewhat prepared. A lot of thought is put into what we should do for the refugee children themselves, and that’s very positive, but we also need to think more about the preparedness of the host population too.
There are ways to creatively commemorate events - for example, some schools celebrate international food, inviting families to bring beloved dishes from their culture which, in turn, brings people together. We should talk openly and proudly about the positive aspects of every culture and consider how we can facilitate pride, while also recognising as a community how difficult it must be to be displaced.
But arguably the most important role that schools can play is to help native children to understand the challenges without burdening the refugee child to have to be the educator of others. Children need to have the opportunity to consider what it would feel like to arrive in a school in a non-traditional way. If work is carried out to prepare children in advance of a refugee child’s arrival into the classroom, who knows what the positive difference could be in the long run?
Above all else, we should recognise that the refugee children and their families who manage to come to a high-income country like England are often highly resilient and resourceful. We need to give these children and their families enormous respect: they are likely to be the most capable people in their own individual societies. We should celebrate their arrival while also recognising the responsibility that we have, as a nation, to support those who remain displaced, stuck in refugee camps with little or no resources.
Our attitude to those who arrive in the UK should be to recognise how lucky we are to welcome these people into our country. We should think carefully about what we can do to support these young people and their families, who have the potential to become either incredible resources for our nation, or for their native countries, if or when they choose to return in the future.
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