Identifying the unmet behavioral health needs that resettled refugee youth present within primary health care settings

Abstract

The following is a six-chapter dissertation explores the behavioral health needs of resettled refugee youth in primary health care settings. All six chapters were based in Urie Bronfenbrenner's Ecological Systems Theory. A literature review was completed examining current research on the behavioral health needs of resettled refugee youth globally to inform treatment of refugee youth in primary care settings. Literature was organized using Ecological Systems Theory. Systematic implications were provided which included need for assessment tools for primary care, focus on family functioning and benefits to primary care behavioral health interventions as a means of addressing barriers to behavioral health care utilization. A systematic review was also conducted analyzing the unmet behavioral health needs in primary health care settings among racial and ethnic minority children in the United States. This systematic review was conducted to examine what themes are currently in the literature regarding racial and ethnic minority children, which is the larger group that refugee youth belong to. As part of the inclusion criteria for this systematic review, studies only including samples of racial and ethnic minority samples that were 50% or more were included. A methodology outlined the details to the explanatory, sequential, mixed-methods design created to assess the behavioral health needs of resettled refugee youth in primary health care settings. As the quantitative portion to the mixed-methods study, the North Carolina Child Health Assessment and Monitoring Program (CHAMP) 2005 was analyzed to determine certain factors that may increase the likelihood of diagnosis of a behavioral health need in a general pediatric population. The results of the quantitative phase were used to construct an interview guide for the semi-structured interviews with primary health care providers were treat refugee youth and families. Results of the two-phase analysis were compared. There were similarities and differences among the two results along with new themes arising from the qualitative analysis. At the close of the study, implications were made including ways that key concepts of Medical Family Therapy could be applied to the treatment of this population in primary health care setting along with the need for trauma-informed, family-focused, culturally attuned care.