Screening and Assessing Immigrant and Refugee Youth in School-Based Mental Health Programs

Although mental health screening tools in refugee and immigrant children can be very useful, these tools must be used with extreme caution and must be followed up by extensive clinical assessment. A thorough understanding of the child's cultural and family background is a prerequisite for making diagnoses, and treatment plans, for these children.

Data suggest that more than 10 percent of schoolchildren in the United States are immigrants. While Mexicans make up the largest single immigrant group, there are numerous other smaller groups of immigrants, and resources to assist these children may be scarce. Yet, culturally relevant mental health and educational resources, linguistic aids and infrastructure are greatly needed to help these children deal with the stresses of immigration, including traumatic, acculturative and others.

This paper provides an overview of mental health screening, identification and assessment tools that practitioners and researchers working with immigrant and refugee youth can utilize. The paper first describes challenges particular to screening immigrant and refugee children, such as the pros and cons of targeted screening in this population. A variety of screening tools are described, as well as which populations the tools were designed for and in which languages each tool can be administered. The authors break down screening tools into the categories "broad," "selective" and "targeted." Broad measures aim to identify behavioral/emotional problems not necessarily indicative of a mental disorder; selective measures aim to detect an array of symptoms and disorders; and targeted measures screen for specific disorders, such as depression, anxiety or post-traumatic stress disorders (PTSD).

The authors also emphasize the importance of having questionnaires checked out by representatives of the refugee communities in which the children live. Otherwise, judging the effectiveness, efficacy and the cultural relevance of questions is nearly impossible. A team approach can be very helpful, as long as parents and other members of the refugee community thoroughly understand what is expected of them as far as developing a group solution/treatment plan for the child's issues.