Underutilisation of psychiatric care among refugee adolescents in Stockholm.

ABSTRACT

AIM: Refugee children have been shown to underutilise psychiatric services in Scandinavia. The aim of this study was to investigate determinants of psychiatric care utilisation in adolescents in refugee families. METHODS: The study used regional data on healthcare use linked to sociodemographic data from national registers in a total population of 93 537 adolescents in the Stockholm County born in 1995-2000, including 18 831 with a refugee background. Cox regression analyses were fitted to estimate Hazard ratios (HRs) of psychiatric care utilisation in the age-span 11-18 years. RESULTS: Psychiatric care use was lower in the large majority of adolescents in refugee families that originated in low- and middle-income countries, with adjusted HRs 0.34 (95% CI 0.28-0.42) and 0.51 (95% CI 0.46-0.56), respectively, compared with the Swedish majority population. Among the foreign-born refugee adolescents, psychiatric care use increased with duration of residence in Sweden and was higher in children who obtained residency as asylum seekers compared with those who settled in family reunification. CONCLUSION: Adolescents in newly settled refugee families with a background in low- and middle-income countries should be a priority in mental health assessment of refugee children and referral to psychiatric care facilitated for children in need.