Exposure to War Events and Mental Health of Refugee Children: Findings from the BIOPATH Study

• In Event: War and Children

Abstract

Background: Among the 100 million displaced people in the world (UNHCR, 2022), many had to flee their home country due to war. About half of these 30 million refugees are younger than 18 years and particularly vulnerable for the development of mental health problems. Many of them were exposed to traumatic war events such as bombing of their houses and loss of loved ones before seeking safety in another country. In addition, they often tend to experience continued hardship in the host country such as challenging living conditions and limited access to education. The conflict in Syria has been one of the key drivers of rising refugee numbers in the last decade. More than 6.6 million Syrians have fled Syria since the beginning of the conflict in 2011 with another 6.7 million displaced within the country. Of the 5.6 million Syrian refugees that fled to neighbouring countries, half are children. It is well established that refugee children are at increased risk for the development of mental health problems and often don’t have access to professional treatment. Here we report new data on the exposure to war events as well as the prevalence of mental health problems among a large sample of Syrian refugee children and their primary caregivers living in Lebanon.

Methods: We collected data from 1,600 Syrian refugee children and their caregivers in Lebanon as part of the longitudinal Biological Pathways of Risk and Resilience in Syrian Refugee Children (BIOPATH) study. Data collection included the War Events Questionnaire (WEQ), a 25-item checklist of war events reported by both children and caregivers as well as established questionnaires for post-traumatic stress disorder (PTSD), depression, anxiety and externalising behaviour problems. All data were collected face-to-face through interviews with trained local fieldworkers at the home of the refugee families. In addition, we conducted structured clinical interviews (MINI Kid) in a representative subsample of 134 children at different levels of risk.

Results: According to analyses, the majority of children (96.9%) had a history of war exposure. They experienced on average 9.59 (SD = 5.53) types of war events, from not being able to go outside due to bullets and bombardment (88.0%) to being injured themselves (4.4%). According to mental health symptom scales, point prevalence was 36.1% for PTSD, 19.0% for depression, 54.3% for anxiety, and 27.6% for externalising problems. These prevalence rates were largely confirmed through clinical interviews. Comorbidity was the norm rather than the exception with 57.5% of children suffering from any common mental disorder. Finally, war exposure was significantly associated with all four mental health disorders.

Conclusion: According to results, most children of our sample experienced a significant number of war events. The number of war events predicted all measured mental health problems with one in two children suffering from significant mental health problems, confirmed through clinical assessment. Our findings provide further evidence of high prevalence rates for mental health problems among refugee children and the pressing need to support affected families with suitable and easily accessible mental health services.

Authors

• Michael Pluess, Queen Mary University of London
  Presenting Author

• Fiona S McEwen, Queen Mary University of London

• Claudinei Biazoli, Queen Mary University of London

• Elie Karam, Institute for Development, Research, Advocacy and Applied Care