Mental Health Screening Approaches for Resettling Refugees and Asylum Seekers: A Scoping Review

Abstract

Refugees and asylum seekers often face delayed mental health diagnoses, treatment, and care. COVID-19 has exacerbated these issues. Delays in diagnosis and care can reduce the impact of resettlement services and may lead to poor long-term outcomes. This scoping review aims to characterize studies that report on mental health screening for resettling refugees and asylum seekers pre-departure and post-arrival to a resettlement state. We systematically searched six bibliographic databases for articles published between 1995 and 2020 and conducted a grey literature search. We included publications that evaluated early mental health screening approaches for refugees of all ages. Our search identified 25,862 citations and 70 met the full eligibility criteria. We included 45 publications that described mental health screening programs, 25 screening tool validation studies, and we characterized 85 mental health screening tools. Two grey literature reports described pre-departure mental health screening. Among the included publications, three reported on two programs for women, 11 reported on programs for children and adolescents, and four reported on approaches for survivors of torture. Programs most frequently screened for overall mental health, PTSD, and depression. Important considerations that emerged from the literature include cultural and psychological safety to prevent re-traumatization and digital tools to offer more private and accessible self-assessments.

Keywords: asylum seeker; health assessment; mental health; migration; refugee; resettlement; screening.

Figure 1

Logic model of mental health screening along the resettlement pathway.

Figure 2

PRISMA Flow Diagram.

Figure 3

Timing of mental health assessments.

Figure 4

Global distribution of mental health assessments for refugees and asylum seekers according to setting of screening. To note: we identified one publication on pre-departure screening conducted in Lebanon prior to departure to the UK.

Figure 5

Setting of mental health assessments.

Figure 6

Overview of mental health conditions assessed among refugees and asylum seekers. * NB: Any mental health assessments that did not include depression, anxiety, trauma, or PTSD were categorized as ‘Other’ (e.g., general mental health, panic disorders, adverse childhood events, etc.)