Unaccompanied foreign minors and mental health: Implementation and evaluation of the RHS-15 screening procedure for unaccompanied foreign minors

Marco Fontana; Francesco Fattori; Sofia Trezzi; Massimo Conte; Laura Bernardini; Laura Marando; Giovanni Michelini; Andrea Trapani; Maria Antonella Costantino

doi:10.1016/j.jmh.2023.100177

Unaccompanied foreign minors and mental health: Implementation and evaluation of the RHS-15 screening procedure for unaccompanied foreign minors

J Migr Health. 2023 Mar 17:7:100177. doi: 10.1016/j.jmh.2023.100177. eCollection 2023.

Authors

Marco Fontana¹, Francesco Fattori², Sofia Trezzi¹, Massimo Conte², Laura Bernardini¹, Laura Marando¹, Giovanni Michelini³, Andrea Trapani², Maria Antonella Costantino¹

Affiliations

¹ IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Child and Adolescent Neuropsychiatry Unit, Via Pace, 9, Milan 20122, Italy.
² Codici Ricerca e Intervento, Viale Sondrio, 3, Milan 20124, Italy.
³ Sigmund Freud University Milan, Ripa di Porta Ticinese, 77, Milan 20143, Italy.

Abstract

Background and objective: The recent notable increase in refugees' flows, with refugee children and adolescents relocating worldwide, posed severe challenges to the different national healthcare systems. Social groups such as refugees fleeing from their countries because of persecution, wars and violence are considered at high risk of developing mental health-related problems. Despite international and national policies legally regulating the reception process and protecting health-related rights, including the mental well-being of refugee migrants, there is a theoretical and applied need for evidence-based instruments and procedures to support mental health within this population. Recent evidence refers to the Refugee Health Screener-15 (RHS-15) as a reliable and valid instrument for the early detection of trauma-related mental health problems. In this scenario, this study aimed to test the RHS screening process within a multidisciplinary first intervention reception context for unaccompanied refugee minors.

Design: The RHS-15 was administered with the support of cultural-linguistic mediators to 81 unaccompanied minor residents in a first intervention facility in Milan, Italy. This study aimed to assess psychometric characteristics, such as reliability, sensitivity and specificity feasibility and its implementation within a first intervention reception process.

Results: The analysis resulted in the validation of the RHS in its 13-item format. The results highlighted and confirmed an efficient delivery, excellent reliability and a positive predictive and convergent validity of the 13-item version. Further analysis showed an excellent ability to avoid false negatives, although there was a clear tendency to identify false positives.

Conclusions: The early identification of vulnerabilities among refugee minors is recommended to promote their long-term overall well-being. Integrating the screening results with additional observational elements and more specific diagnostic tools is recommended to gain a comprehensive perspective of the minors' well-being.

Keywords: Mental health; Migrations; RHS-15; Screening process; Trauma; Unaccompanied foreign minors.