[On-line pornography and minors. Diagnosis, challenges and proposals]. / Pornografía on-line y menores. Diagnóstico, desafíos y propuestas.

The consumption of pornography over the Internet by minors has been increasing exponentially in recent years. The use of digital technologies and the ease of access to these contents are causes that explain this event. Simultaneously, there is concern about the increase in sexual violence, associated with discriminatory behavior, despite the efforts of laws and programs that promote sexual reproductive health (SRH) and the principle of equality. From a bioethical point of view, it is urgent to address this issue, which affects the physical and psychological health of minors and their affective-sexual education. The study addresses whether it is possible to relate the consumption of online pornography by minors and sexual violence. To do this, legal sources, reports from associations, audiovisual councils and scientific studies are consulted. In all of them, the relationship between the consumption of online pornography by adolescents and risky behavior in emotional-sexual matters and gender inequality is evident. In the legal and fiscal sphere, it is alerted to the damage that is occurring and points out the need to propose lines of action that reverse this situation. We propose measures to technically regulate access to content. These measures are based on the precautionary principle, a tool that has been applied in fields such as health and the environment. More studies and political actions are needed to make the Internet a safe place for minors.

[Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria]. / Beyond NICE: Aktualisierte systematische Übersicht zur Evidenzlage der Pubertätsblockade und Hormongabe bei Minderjährigen mit Geschlechtsdysphorie.

Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria Abstract: Objective: The suppression of physiological puberty using puberty-blocking pharmacological agents (PB) and prescribing cross-sex hormones (CSH) to minors with gender dysphoria (GD) is a current matter of discussion, and in some cases, PB and CSH are used in clinical practice for this particular population. Two systematic reviews (one on PB, one on CSH treatment) by the British National Institute for Clinical Excellence (NICE) from 2020 indicated no clear clinical benefit of such treatments regarding critical outcome variables. In particular, these two systematic NICE reviews on the use of PB and CSH in minors with GD detected no clear improvements of GD symptoms. Moreover, the overall scientific quality of the available evidence, as discussed within the above-mentioned two NICE reviews, was classified as "very low certainty" regarding modified GRADE criteria. Method: The present systematic review presents an updated literature search on this particular topic (use of PB and CSH in minors with GD) following NICE principles and PICO criteria for all relevant new original research studies published since the release of the two above-mentioned NICE reviews (updated literature search period was July 2020-August 2023). Results: The newly conducted literature search revealed no newly published original studies targeting NICE-defined critical and important outcomes and the related use of PB in minors with GD following PICO criteria. For CSH treatment, we found two new studies that met PICO criteria, but these particular two studies had low participant numbers, yielded no significant additional clear evidence for specific and clearly beneficial effects of CSH in minors with GD, and could be classified as "low certainty" tfollowing modified GRADE criteria. Conclusions: The currently available studies on the use of PB and CSH in minors with GD have significant conceptual and methodological flaws. The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn't suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD. Psychotherapeutic interventions to address and reduce the experienced burden can become relevant in children and adolescents with GD. If the decision to use PB and/or CSH is made on an individual case-by-case basis and after a complete and thorough mental health assessment, potential treatment of possibly co-occurring mental health problems as well as after a thoroughly conducted and carefully executed individual risk-benefit evaluation, doing so as part of clinical studies or research projects, as currently done in England, can be of value in terms of generation of new research data. The electronic supplement (ESM) 1 is an adapted and abreviated English version of this work.

Impact of COVID-19 on Unaccompanied Immigrant Minors and Families: Perspectives from Clinical Experts and Providers.

The number of unaccompanied immigrant minors (UIMs) and families from Central America seeking asylum in the U.S. continues to rise. This growth, combined with restrictive government policies, led to crowded and suboptimal conditions in Customs and Border Patrol and non-governmental organization facilities. COVID-19 further taxed facilities and exacerbated uncertainty surrounding length of detention, basic human rights, and family reunification. The current project features testimonies from the authors who work as clinical experts and providers in Texas - a top destination for Central American immigrants. In collaboration with a deputy director of a not-for-profit human rights organization, volunteer psychologists, and the director of a humanitarian respite center, we describe challenges faced by administrators and clinical staff in addressing the mental health needs of immigrant children and families during the COVID-19 pandemic. The primary themes identified were anti-immigrant policies that occurred concurrently with COVID-19; difficulty implementing COVID-19 protocols alongside scarcity of supplies and volunteers; increased mental health needs among UIMs and immigrant families; and challenges in UIM placement upon release from custody. Strategies for addressing clinical challenges in the near- and long-term and opportunities for improvement in care systems to immigrant youth, including correcting anti-immigrant policies, addressing ongoing COVID-19 protocols and challenges, meeting mental and physical health needs, facilitating release and reunification for unaccompanied immigrant minors, and maximizing youth resilience through trauma-informed interventions, are presented.

Coping strategies of unaccompanied refugee minors shortly after arrival in Belgium.

Unaccompanied refugee minors (URMs) are a group in an especially vulnerable situation with heightened psychological suffering due to both stressful life events and current daily stressors. Research has shown that certain coping strategies such as avoidance can be adaptive in the face of ongoing stress. We conceptualize social support as an essential coping resource that these strategies tap into. Since the interrelations between these factors are often not clear in the literature, this study strives to identify and link URMs' coping strategies, the respective coping resources and the various stressors they target, shortly after arrival in a high-income country. Seventy-nine URMs from various backgrounds were recruited in two first-phase reception centers in Belgium. In addition to self-report questionnaires to assess stressful life events and current daily stressors, we conducted semi-structured interviews, with cultural mediators if required. Thematic analysis was applied to the participants' accounts and resulted in the identification of four coping strategies: avoidance and distraction, continuity and coherence, selective reliance, and positive appraisal and acceptance. The relation between these coping strategies, the various coping resources used, and the specific stressors at which they aim are discussed. We conclude that avoidant coping and contact with the ethnic community, particularly the peer group, are fundamental strategies for successful coping. Practitioners need to support URMs in their coping efforts by providing and facilitating appropriate coping resources.

Attitudes of Employees in Unaccompanied Children's Shelters and Work-Related Stress During the COVID-19 Pandemic.

Data related to the stress of employees in shelters for unaccompanied minors are scarce, especially when considering the escalation of the refugee issue. This study analyzed aspects of this issue as it was carried out in child protection organizations in Greece, which is a country where a huge number of immigrants and refugees pass through and thousands of professionals are employed in this field.More specifically, the aim of this study was to examine the stress (general, perceived, work-related) and burnout symptoms of a specific group of employees exposed to the COVID-19 quarantine restrictions, employees at the 'front line' of care in shelters that host unaccompanied minors and teenagers.The study was carried out from March 2020 to December 2021, when social restrictions and other preventive measures were imposed. The study sample was recruited from non-governmental organizations and shelters for unaccompanied minors, in the urban area of the center of Athens, i.e. the International Organization for Migration, The Home Project, Arsis, Iliachtida, and Zeuxis. The sample consisted of employees at the 'front line' of care in shelters that hosted unaccompanied minors and teenagers. Participants were professionals whose duty was to deal with and respond to the needs of children and adolescents within the shelters they lived in. Participants completed the following questionaires before and after the pandemic restrictions: the Job Stress Measure (JSM), the Maslach Burnout Inventory (MBI), the Perceived Stress Scale (PSS), the Stress in General Scale (SiGS) and a questionnaire of 11-items regarding COVID-19, focusing on the professionals' perceived stress, working conditions, working demands and the impact of COVID-19 on all the aforementioned.The study sample consisted of 50 employees (40 females, 10 males; mean age ± SD 31.46 ± 7.91 years) in hostels for unaccompanied minors. A statistically significant difference was found only in SiGS, with increased stress after COVID-19 (p = 0.001). In terms of sex, significant differences were found at baseline in PSS and Emotional Exhaustion (p = 0.036 and p = 0.028, respectively) (females revealed higher levels than males). Age and educational level were factors that interacted with the increased levels in SiGS after COVID-19 (p = 0.015 and p = 0.006, respectively). Moreover, significant differences were found at baseline in PSS (p = 0.004), with higher levels observed in employees with higher education. Workers who did not work remotely had lower levels in Personal Accomplishment after COVID-19 compared to employees who worked remotely (p = 0.050). Interestingly, the JSM showed a tendency for decreased stress levels after the implementation of the quarantine, suggesting that the employees' work-related stress remained approximately at the same levels. On the other hand, perceived stress increased as the job demands remained the same, while social and personal outlet was in appeasement.The necessity for more research to be held among health professionals is evident and is also imperative to carry out interventional studies to manage stress and thus, provide better mental health services to unaccompanied minors. There is also need for further research in similar populations of professionals outside the urban context of Athens, i.e. in the Greek islands near the sea borders, where the refugees' entries are higher in number and more frequent.

Applying an Antiracist Approach to Promoting Health Equity and Psychological Well-Being in Unaccompanied Immigrant Minors.

Unaccompanied immigrant minors (UIMs) are a fast-growing demographic in the United States, doubling in population since 2014.1 According to the Office of Refugee Resettlement, a UIM is someone under the age of 18 years who enters the United States without lawful status and an accompanying guardian.2 Most UIMs in the United States originate from the Central American northern triangle (ie, El Salvador, Guatemala, Honduras), with violence, extreme poverty, and family re-unification as the top 3 reasons for migration.1,3 Repeated exposure to stressful and/or traumatic events at home, during migration, and upon arrival increases UIMs' risk for psychological distress and mental disorders.3 UIMs' repeated encounters with race-based trauma (eg, racism, discrimination) further heightens this risk.3 The repercussions of these events are compounded by the fact that UIMs lack the adversity buffering effect that is traditionally associated with the presence of a caregiver.3 Furthermore, UIMs' mental health risk is augmented by their interaction with US systems (eg, legal, immigration, child welfare, educational, healthcare) with policies and practices that are discriminatory, are exclusionary, propagate the view of UIMs as racialized threats to society, and fail to consider their developmental context.3,4 Considering these risks, it is imperative to the well-being and positive development of UIMs that they have access to quality mental health services (MHS).

[Refugee Minors from Ukraine and their Families - First Experiences from an Intercultural Practice for Child and Adolescents Psychiatry and an Outpatient Clinic for Refugees/Hamburg]. / Minderjährige Geflüchtete aus der Ukraine und ihre Familien ­ Erste Erfahrungen aus der interkulturellen Versorgungspraxis sowie der Flüchtlingsambulanz/Hamburg.

Due to the Russian invasion in Ukraine, many families were forced to flee to Germany, often having to leave relatives behind.The outpatient clinic for refugees at Universitätsklinikum Eppendorf coordinates the psychosocial and psychotherapeutic care for refugee minors from Ukraine in Hamburg. The intercultural practice for child and adolescents psychiatry offers on-site consultations for children and adolescents in camps in order to provide a low-threshold access to counseling and diagnostics. Diagnostic and therapeutic experiences to this point indicate the contribution of multifactorial stress to the development of symptoms in Ukrainian minors.The threat of war and displacement seems to be only one of many factors. Although there are some remarkable resilience factors for Ukrainian refugee children and adolescents in comparison to refugees from other countries of origin, the forced adaptation to living and studying conditions in Hamburg bears challenges for many. Additionally due to war experiences psychotherapeutic and psychiatric care is frequently needed. On Germany's side, there is a need for action to ameliorate the accessibility to the health care system for refugees and migrants. Support of therapists in this complex working field is thereby as important as advocacy for the needs of minor refugees in German society.

[Taking care of an unaccompanied minor's body at the Maison des adolescents]. / Prendre en charge le corps et son histoire, parcours d'une mineure non accompagnée à la Maison des adolescents.

The care of unaccompanied young exiles in public health care facilities for adolescents often requires teams to adapt their capacities for institutional containment. We describe the case of a 16 year old female migrant adolescent, whose follow-up occurred at the Maison des adolescents of the Cochin Hospital, with several healthcare workers involved. The healthcare team had to reflect on the meaning of her somatic symptoms and why the referring adults were so worried (such as fear of death). We describe how we articulated somatic and psychological care for this adolescent girl living in a precarious situation.

Mental health among unaccompanied refugee minors after settling in Norway: A matched cross-sectional study.

Aims: To describe the mental health of unaccompanied refugee minors (URMs) settled in Norway and compare their responses to an age- and sex-matched sample of Norwegian young people. Methods: The data were from the Pathways to Independence study of URMs aged 15-20 years (n = 81; 82.7% male; response rate 80%) conducted in 2018-2019 in the Bergen municipality, Norway. The data from the URMs were linked to an age- and sex-matched group of young people from the Norwegian youth@hordaland study conducted in 2012 (n = 324). Mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Results: URMs were more likely to agree with most items pertaining to emotional problems, peer problems and prosocial subscales than Norwegian young people. Few differences were found for items on the conduct problems and hyperactivity-inattention problems scales. Poor psychometric properties, including weak factor loadings and low internal consistency, were detected for the SDQ subscales among URMs, except for the emotional problems subscale, indicating that the originally proposed five-factor model fitted the data poorly. Conclusions: URMs appear to have moderately more emotional problems than Norwegian young people. They are more likely to report being alone, getting along better with adults than with their peers and being bullied, but also report being more helpful and sharing with others. Studies with larger samples of URMs should determine the most appropriate factor structure of the SDQ when administered to URM samples.

Post-traumatic stress disorder in refugee minors in an outpatient care center: prevalence and associated factors.

Due to their likelihood for experiencing a number of traumatic events, refugee minors have an increased risk of developing post-traumatic stress disorder (PTSD). However, the prevalence of PTSD in refugee children varies widely between studies, and it remains somewhat unclear what factors increase children's risk of PTSD. This study aimed to assess the prevalence of PTSD in a clinical outpatient sample of refugee minors, and to evaluate the association of different risk factors with a PTSD diagnosis. N = 417 refugee minors were recruited from an outpatient clinical center in Hamburg, Germany. The median age was 15.4 years and 74.6% of the minors were male. As part of the standard diagnostic process, their social history and a potential PTSD diagnosis using the Module K of the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) was assessed. The predictive value of age, gender, number of interpersonal traumatic events, un-/accompanied status, presence of family member in the host country, flight duration, residence status, and time since arrival in the host country were investigated using logistic regression analysis. The prevalence of PTSD among the young refugee patients was 61.6%. Significant predictors of a PTSD diagnosis were number of interpersonal traumatic life events, age, residence status, and time since arrival in the host country. The prediction model explained 33.8% of variance of the outcome with the number of interpersonal traumatic events having the largest contribution (20.8%). The high prevalence of PTSD among refugee minors in outpatient care emphasizes the need to establish appropriate care structures and train specialists in the treatment of PTSD.

[The health of trans minors in France]. / La santé des mineurs trans en France.

In France, the health of trans minors remains a sensitive and too often invisible subject, leaving a population marked by great vulnerability on the margins of health services. It is therefore particularly interesting to highlight the medical issues related to this population, the psychological risks related to transphobia and the questions related to hormonal treatments at the heart of current controversies.

Mental health of unaccompanied refugee minors in Europe: A systematic review.

BACKGROUND: Nearly half of the refugee and asylum seeking population in Europe is under the age of 18, and many of these individuals are unaccompanied children and adolescents. OBJECTIVE: The aim of this systematic review is both to summarize findings regarding the prevalence of mental health disorders among unaccompanied refugee minors (URM) in European countries since the last available systematic review (October 2017), and to describe associated risk factors. METHODS: Five databases were systematically searched for articles published between October 1, 2017 and May 1, 2022. RESULTS: The findings from 23 studies conducted in 9 countries which examined 80,651 child and adolescent URM are explained. Afghanistan was the most common country of origin in the majority of studies and >75 % of the subjects were boys. Most of the studies (N = 13, 56.5 %) assessed posttraumatic stress disorder (PTSD) prevalence. We found a high prevalence of mental health disorders among URM children and adolescents, which varied considerably between studies, ranging from 4.6 % to 43 % for (PTSD), 2.9 % to 61.6 % for depression, 32.6 % to 38.2 % for anxiety and 4 to14.3 % for behavioral problems. Two studies looking at suicide attempts and deaths, also observed higher rates in URM compared to the host population of the same age. The studies looking at mental health risk factors suggest that levels of social support in the host country, rearing environment, and other factors are associated with psychopathology. Moreover, a meta-analysis of four studies regarding PTSD in URM and accompanied refugee minors (ARM) showed a lower prevalence among ARM: -1.14 (95%CI:-1.56-0.72). CONCLUSIONS: PTSD, depression and anxiety are the most prevalent problems among the URM population in Europe. Early intervention in host countries is needed in order to improve mental health outcomes for this vulnerable population and avoid possible neglect.

Mental health of unaccompanied refugee minors in Greece living "in limbo".

The closure of the Balkan migration route in 2016, had implications for unaccompanied refugee minors (URMs), given that the vast majority, who perceived Greece as "stopover" for their desired final destination, were forced to remain in the country for an indeterminate period of time. This created for URMs a challenging situation of living "in limbo" uncertain about their future awaiting for a long time the outcome of their asylum application. This cross-sectional study aimed to explore the mental health of URMs, who arrived in Greece in 2016. The sample comprised 90 URMs (76 boys), aged 13-17 years, consisting of 46 Syrians and 44 originating from other countries. Participants completed socio-demographic information and a range of clinical measures, including Children's Revised Impact of Events Scale (CRIES), Depression Self-Rating Scale (DSRS), Children's Post-Traumatic Cognitions Inventory (cPTCI), a measure of trauma exposure and perceived social support. Syrian URMs were significantly more likely than URMs originating from other countries to score within the probable clinical depression range (71.7% versus 47.7% respectively, p=0.020), to display probable posttraumatic stress disorder (PTSD), i.e., score within clinically significant range of posttraumatic stress symptoms and negative post-trauma cognitions (87% versus 65.9%, p=0.018), and meet the comorbidity PTSD/depression criterion (65.2% versus 40.9%, p=0.021). Multiple linear stepwise regression analyses showed that legal status (seeking asylum in Europe through family reunification procedure) significantly predicted higher levels of depressive symptoms (ß=0.29, p=0.004), posttraumatic stress symptoms (ß=0.21, p=0.034) and negative cognitions (ß=0.33, p=0.001). The total number of stressful/traumatic experiences and male gender were found to be significantly related only with posttraumatic symptoms severity score (ß=0.29, p=0.003), whereas lower levels of perceived social support were associated with increased levels of depressive symptoms (ß=0.24, p=0.018) and negative cognitions and appraisals of the world and the self (ß=0.26, p=0.008). These findings highlight the burden of living "in limbo" situation and add weight to the argument for amending restrictive EU asylum policies and accelerating the family reunification procedure under Dublin-III Regulation, as well as the pressing need for improved URMs access to mental health services and psychosocial support.

Are State-Level HIV Testing Policies for Minors Associated With HIV Testing Behavior and Awareness of Home-Based HIV Testing in Young Men Who Have Sex With Men?

PURPOSE: The objective of this study was to determine whether state-level policies that restrict minors' access to confidential HIV testing without parental consent may suppress HIV testing in young men who have sex with men (YMSM) in the United States. METHODS: Secondary data from a national HIV prevention trial among YMSM aged 13-17 years (N= 612) were analyzed to evaluate the association between living in a state with restrictive HIV testing policies for minors and HIV testing behavior, awareness of home-based HIV testing, and confidential interactions with a physician. Multilevel logistic regression models were adjusted for age, parents' education level, race, ethnicity, sexual orientation, being sexually experienced, and health literacy of medical forms and controlled for clustering by state. Age-stratified models by state-level age of consent for HIV testing and a subanalysis (including only sexually experienced participants) were also conducted. RESULTS: Residing in a state with restrictive HIV testing policies was associated with the lack of awareness of home-based HIV testing (adjusted odds ratio [aOR]: 3.06; 95% confidence intervals [CI]: 1.49, 6.28). No significant associations were found for HIV testing behavior (aOR: 1.81; 95% CI: 0.85, 3.84), speaking privately with a physician (aOR: 1.00; 95% CI: 0.56, 1.79), or discussing confidentiality with a physician (aOR: 0.95; 95% CI: 0.52, 1.71) and HIV testing policies for minors. These results were consistent in both the age-stratified models and subanalysis. DISCUSSION: HIV testing proportions among YMSM did not differ by state-level minor consent laws. However, YMSM living in states with restrictive policies on HIV testing for minors were less likely to be aware of home-based HIV testing.

[The Mental Health Problems of Unaccompanied and Accompanied Refugees in Childhood and Adolescence in Germany]. / Psychische Belastung bei unbegleiteten und begleiteten Flüchtlingen im Kindes- und Jugendalter in Deutschland.

The Mental Health Problems of Unaccompanied and Accompanied Refugees in Childhood and Adolescence in Germany Abstract. Abstracts: Objective: This articles investigates the psychological distress and stressful life events in unaccompanied minor refugees (UMR) in adolescence and accompanied minor refugees (AMR) in childhood and adolescence living in Germany. Additionally, it analyzes the predictors of psychological distress in the adolescents. Method: We assessed 170 children and adolescents (adolescents: n = 56 UMR, n = 72 AMR; children: n = 42 AMR) using questionnaires on emotional and behavioral problems and stressful life events. In addition, we questioned the adolescents on PTSS (adolescents: self-report; children: caregiver report). Results: 45.8 % UMR (adolescents), 42.4 % AMR (adolescents), and 56.1 % AMR (children) showed emotional and behavioral problems. On average, we identified 7 stressful life events in UMR (adolescents) and 4 in AMR (adolescents, children). UMR (adolescents) reported more emotional problems, more PTSS, and more stressful life events than did AMR (adolescents). 43.8 % UMR (adolescents) and 27.9 % AMR (adolescents) reported PTSS. The number of stressful life events was found to be the most robust predictor for emotional and behavioral problems as well as PTSS in adolescents. Conclusions: The results indicate the need for psychological interventions of refugee minors in Germany.

Review: Unaccompanied refugee minors' perception of mental health services and professionals: a systematic review of qualitative studies.

BACKGROUND: Unaccompanied refugee minors (URMs) are a population at risk of mental health problems and a population with whom the therapeutic alliance can be difficult to set up. The therapeutic alliance's quality can impact the result and effectiveness of psychotherapeutic interventions. The aim of the present study was to gather URMs' points of view about mental health services and mental health professionals (MHP) in the host country. A summary of interviews conducted with URMs will allow a better understanding of their perception and expectations. METHODS: Seven databases were searched with English and French keywords. In the end, nine studies were selected. RESULTS: The review of the interviews shows that URMs do not have a clear perception of MHP - it seems difficult for them to trust MHP, but also to understand the value of sharing past painful experiences to reduce current symptoms. They can have a negative perception of mental health and consider that this is not a priority. URMs prefer to focus on day-to-day problems, do activity-based interventions and do group sessions to value social interactions. CONCLUSIONS: Clinical and methodological implications are discussed. The development of an instrument to evaluate therapeutic care for URMs could be interesting for future research and for clinicians.

Unaccompanied migrant minors in Europe and U.S.: A review of psychological perspective and care challenges.

Unaccompanied migrant minors are youth under the age of 18 who migrate alone, traveling separately from both parents. These youth may be asylum seekers, recognized refugees, or other externally displaced persons. Unaccompanied migrant minors have become an increasingly prevalent global issue. However, this phenomenon might be better understood considering the peculiarities of their contexts, since there are differences related to specific conditions and reception systems. The present study reviewed and compared visually previously reported psychological perspective of unaccompanied migrant minor receiving services from select European countries and the U.S. Unaccompanied migrant minors create a challenge on a nation's care system because these minors are the most vulnerable group in the context of migration. Our explorative assessment suggested underlining similarities and differences between contexts, reflecting the unique needs of the unaccompanied migrants and proposed services and intervention models.

How effective is group intervention in the treatment for unaccompanied and accompanied refugee minors with mental health difficulties: A systematic review.

BACKGROUND: Unaccompanied refugee minors (URM) are at significantly higher risk of trauma exposure and mental illness. Research examining the most effective treatments for this population is limited. AIMS: To study the available research evidence on outcomes from various group interventions in this population. The objective is to investigate if these can be used clinically in future interventions. METHODS: Systematic review was carried out for patient outcomes where group therapy was used as treatment in URM. Studies with ARM (Accompanied refugee minors) were included because of similarities between these groups and because many studies were mixed population. RESULTS: Seventeen papers met eligibility criteria with a total of N = 1,119 participants. About 80% studies with a quantitative component reported improvements, and 69% of the studies that carried out statistical analyses reported statistically significant improvements in mental health symptoms. Every qualitative measure reported positive outcome for the participants. Studies with URM tended to show improved outcomes more often than studies exclusively with ARM. CONCLUSIONS: The evidence demonstrates the efficacy of group therapy in improving mental health outcomes, although the number of studies with robust methodology is small. Group intervention has potential to improve engagement and outcomes of URM with mental illness. Future direction for research is discussed.

The experiences of children and adolescents undergoing forced separation from their parents during migration: A systematic review.

Globally, the migration of unaccompanied minors is increasing, however, the experiences of these children have not been examined. We systematically synthesised the existing qualitative literature to examine the experiences of children undergoing forced separation from their parents during migration. The review was structured based on the PRISMA statement. A systematic search of Ovid MEDLINE, EMBASE, PsychINFO and Scopus databases from inception to November 23, 2020 was conducted to retrieve eligible studies. Only qualitative studies of children aged ≤18 years were reviewed. The data analysis and synthesis were informed by the intersectionality framework. The search yielded 10,956 studies of which eight were included in this review. Thematic analysis identified the following themes: unaccompanied minors experience a deep sense of loss; anxiety over the uncertainty of the migration process; difficulty adjusting to their new life in the host country and adverse health effects. These experiences were heightened by children's exposure to violence during migration. The intersectionality framework suggests that unaccompanied minors experience separation from their parents during migration in ways that marginalise them and widen inequalities. Migration processes need to be streamlined to provide integrated health, emotional, legal and educational supports for unaccompanied children with particular attention given to treating the trauma of past violence. More research is needed to explore how to facilitate the integration of unaccompanied children into host communities in ways that are healing and empowering.