# Cross-sectional survey among professionals on communication and mental health care for asylum seeking and refugee minors in Germany

## TL;DR

A survey of German health and social care professionals reveals that many asylum-seeking and refugee minors face mental health issues, but screening and care are limited due to communication barriers and lack of resources.

## Contribution

The study provides new insights into the mental health challenges and care gaps for asylum-seeking and refugee minors in Germany based on professional reports.

## Key findings

- About 21% of asylum-seeking and refugee minors are reported to have mental health problems.
- Only 37% of those with mental health problems receive follow-up care.
- Communication problems are reported by 84% of professionals, often relying on online tools or family translations.

## Abstract

Forced displacement and migration are on the rise worldwide. Asylum seeking and refugee minors (ASRM) are particularly exposed to risk factors for mental health problems. Yet, there is a lack of comprehensive data on the prevalence of specific mental health problems as well as applied screening and follow-up care in Germany.

Using the online platform REDCap, we conducted the cross-sectional SAVE-KID survey among health and social care professionals (HSCP) working with ASRM in Germany (n = 201; 44% medical doctors, 38% social workers) to assess the estimated mental health burden among ASRM, the conducted screening measures, and provided mental health care as well as the extent to which communication problems affect care for ASRM.

Here we show, that on average, 21% of ASRM are reported with one or more listed mental health problem. Only 37% receive follow-up. Less than 24% of participants conduct mental health screening by informal questions, interviews, trained staff or questionnaires. 84% of participants report frequent communication problems. Most used aids are online tools or relatives’ translations.

SAVE-KID describes an imbalance between the occurrence of and screening for mental health problems among ASRM. Comprehensive, systematic detection of mental health problems remains challenging due to communication problems, lack of specialized staff and diagnostic tools as well as follow-up care structures.

Esser et al. conducted a nationwide survey of 201 health and social care professionals in Germany on the mental health care of asylum-seeking and refugee minors. Results show that mental health problems are frequent but rarely followed up with major barriers due to limited screening, communication difficulties, and insufficient care structures.

Children and adolescents who apply for asylum or refugee status in Germany are exposed to numerous mental health risks. We conducted an online survey called SAVE-KID, in which 201 health and social care professionals participated. Respondents reported that about one in five minors had a mental health problem, but only one-third of them received follow-up care. Less than a quarter of professionals used structured mental health screening methods. Most professionals reported serious communication difficulties and often had to rely on online tools or family members for translations. These findings show that mental health problems are widespread among underage asylum seekers and refugees, but effective screening and care are hampered by communication barriers, a lack of trained staff, and inadequate diagnosis and support structures.